1 Running head: NURSINGS ROLE

Nursings Leadership Role in Population Based Issues Michelle M. Johnston NURS 340

2 NURSINGS ROLE Abstract This paper will lead its reader through the introduction and explanation of two different nursing roles needed to accomplish the goals of a change proposal. The change proposal is to increase the percent of influenza vaccination rates of adults aged 65 and older in Kent County by 10% in the 2013-2014 influenza season. Two roles are discussed with their agencies identified and leadership qualities addressed in relation to their role, the standards and scope of nursing practice, and position of carrying out the change proposal. The leadership qualities of both nursing roles addressed are then compared and contrasted to one another and the implications of the leadership qualities are explored. My leadership skills and qualities are then compared to those of the two roles identified. Strengths and weaknesses are presented to reflect upon the two roles and the qualities it would take to reach the goal of the change. Interventions to improve competency in the skills that I find weaknesses are then presented.

3 NURSINGS ROLE Nursings Leadership Role in Population Based Issues There are different roles that nurses play within community and public health. At present time, there are four different positions of nurses defined. Community-based nursing, community health nursing, public health nursing, and community-oriented nursing are all different types of nursing positions within community and public health, each with a different focus (Harkness & DeMarco, 2012, p. 9). The purpose of this paper is to reflect on different nursing roles within population based nursing care and to specifically identify and discuss two roles nurses may play in my change proposal. In 2008, Kent County had a report of 32.9% of its residents aged 65 and older who did not receive the flu vaccine (Kent County Health Department, 2008, p. 11). The change proposal is: to increase the percent of influenza vaccination rates of adults aged 65 and older in Kent County by 10% in the 2013-2014 influenza season. Two different roles that nurses may play in my proposal are public health nurse which may be the nurse dealing directly with clients and the Community Clinical Services Division Director who manages/leads and is more population focused. About the Roles Direct Contact Nurse The direct contact nurse holds the title of a public health nurse. The public health nurse most likely would work for the Michigan Department of Health (MDH) working on site and in the community to provide services to the target population. The public health nurse would work one-on-one with the target population of individuals age 65 or older, providing them with information and education about the flu vaccine and immunizing them. This nurse would be responsible for providing the proper education and information about the flu vaccine, including

4 NURSINGS ROLE identifying those in need of resources to receive the vaccination such as help with transportation to clinics, and administering the immunization to the population. Public health nursing has eight principles that it adheres to (Harkness & DeMarco, 2012, p. 9). The eight principles are: analytic assessment skills, policy development and program planning skills, communication skills, cultural competency skills, community dimensions of practice skills, basic public health science skills, financial planning and management skills, and leadership and systems thinking skills (2012, p. 9). All of the principles of public health nursing are skills that are important for the public health nurse to possess. A common thread among those skills is leadership. Leadership qualities such as creativity, communication skills, independent and critical thinking skills, collaboration skills, accountability, and a good professional attitude are all essential to carrying out the role of the public health nurse. The nurse should be looking for creative ways to enhance the care he/she gives, which will contribute to the quality of practice (ANA, 2010, p. 52). Communication skills would be essential so effective care can be given. The nurse should be able to communicate effectively with patients and with his/her supervisor to be sure that he/she is collaborating effectively with other members of the healthcare team. Good communication skills can make a difference in providing high quality care. Being able to think independently and critically is a must for the public health nurse. Often, the public health nurse will find herself/himself working alone either in a clinical setting or another setting in the community. The nurse must be able to think independently to make referrals, find resources, and/or provide appropriate education for the patients. The skill of collaboration is a skill that can fit into communication. According to the ANA (2010), the registered nurse: communicates with the healthcare consumer, the family, and healthcare providers regarding healthcare consumer care and the nurses role in the provision of

5 NURSINGS ROLE that care (p. 57). It is important for the public health nurse to collaborate to provide quality care and help to initiate change. A leader is accountable for his/her actions and the actions of others (2010, p. 55). The public health nurse as a leader in the change project, should have all of these leadership skills and above all have a good professional attitude toward his/her patients and work. The nurse with a professional attitude is one that can be much more effective in the process of change. Leader/Manager Nurse The leader or manager nurse who is more population focused while working toward the change is the Community Clinical Services Division Director. The Community Clinical Services Division Director would work for the Michigan Department of Health (MDH) to ensure the quality of the clinical services provided, report outbreak information to the Centers for Disease Control and Prevention (CDC) and work to organize and write grants to receive funding for programs. The leadership qualities needed to carry out the role of the Community Clinical Services Division Director are: communication skills, delegation skills, integrity, collaboration skills, accountability, independent and critical thinking skills, and a professional attitude. The communication skills needed by the director are necessary in order to speak with other members of the healthcare team, the CDC, and the state government affiliates and agencies. The director will work on improving quality and increasing funding for the vaccination programs, which will require effective communication skills to write a grant and make requests to the government officials. Delegation of tasks can be made by the director to the public health nurse. The director must be able to delegate care appropriately and consult the correct professionals when issues arise and their consultation is necessary (2010, p. 60). Collaboration skills work along with delegation and communication. All areas of the health care team should work together

6 NURSINGS ROLE toward the common goal of improving vaccination for those who are ages 65 and older. Integrity is a quality much needed for the director, which shows work quality and consistency. The integrity of the work the completed by the director will help to keep the change goal in focus and get the tasks accomplished. The director will be accountable for his/her actions as well as the public health nurses actions. A professional attitude and critical thinking skills are also important for the director to have to ensure well thought out decisions for the program are made and others will follow the command. Analysis In analyzing the two roles of the nurses working toward the change, there are some similarities and differences to be noted in the roles. The similarities are that both nurses are collaborative, resourceful, communicative, analytical, and they both act as leaders. The nurses from both roles have to collaborate and communicate with each other and those with whom they work directly. The Community Clinical Services Division Director will work directly with members of other organizations or state departments and government officials. While the public health nurse will work directly with the patients and families they are serving. The communication will be different, but both require effective communication. Both nurses need to know what resources they can go to for more information or to provide the population with the correct information. Analyzing the information provided is a part of both roles. The director is constantly analyzing information provided about the population and funds to assess the needs of the population, and the public health nurse is analyzing the information provided by patients to find ways to more effectively improve the program at the patient level. The differences between the two nursing roles are simply the tasks that the roles are assigned. The Community Clinical Services Division Director is population focused and works

7 NURSINGS ROLE to organize and get funding for the program, the public health nurse is patient focused and works to get information and immunizations to individuals. The public health nurse will not have any contact with government officials, whereas the Community Clinical Services Division Director will. There are politics involved in community and public health. Being that both the public health nurse and the Community Clinical Services Division Director would work for the MDH, there would be government funding involved in the program planning and the change proposal. With leadership skills, the nurses are more likely to accomplish the goals of the change proposal. The nurses should be able to present research to the government officials regarding the change proposal in a formal manner with the purpose communicated effectively. If the information is not communicated effectively or the appropriate resources are not being utilized, there is greater chance that the government will not fund the proposal or help to provide more resources for the proposal or target population. The implications of having good collaborative skills, communication skills, professional attitude, accountability, and independent and critical thinking skills are that the change proposal goal will be met. The nurses each have to do well in their positions to carry out the job demands and help to move barriers to achieve the goal of the change proposal. Reflection In reflection to the different leadership skills needed by each nurse to carry out his/her role; I feel that I have strengths in many of the same leadership areas needed. I am, for the most part, an effective communicator, collaborator, independent and critical thinker, and I hold myself accountable. I also do my best to keep a professional attitude. Though I may find strengths in all areas, I also have weaknesses. I believe that I would struggle with my written

8 NURSINGS ROLE communication. I often find difficulty in writing. I feel that I am not always effective in presenting ideas and keeping the same tone throughout a piece of writing. In this regard, I do not believe that I would work very effectively in the position of the Community Clinical Services Division Director. I also may struggle with dealing with government officials instead of working one-on-one with the patient population. I enjoy working hands-on with patients and I do not do as well with research and paperwork. I would work most effectively as the public health nurse working one-on-one with patients and collaborating with other members of the healthcare team and making referrals for resources for patients. I am able to keep a very positive and professional attitude while on the job and I believe I would do well with the focus population. I would have challenges working in either of the two nursing roles. To become more competent in the role of public health nurse, I would do more research on the population I am to work with in order to find what barriers to healthcare and to receiving the flu vaccination the population are facing. Knowing the common barriers will help to plan interventions to decrease the barriers and meet the goal of the proposal. Working on improving my written communication and doing more research on writing grants and finance would help to improve my competency in the role of the Community Clinical Services Division Director. Though there are many barriers and challenges to improving the health of the population, it can be done with the appropriate skills.

9 NURSINGS ROLE References American Nurses Association [ANA] (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author. Harkness, G. A., & DeMarco, R. F. (2012). Community and public health nursing: Evidence for practice. Philadelphia, PA: Lippincott Williams & Wilkins. Kent County Health Department. (2008). 2008 Behavioral Risk Factor Survey. Retrieved from http://www.accesskent.com/Health/HealthDepartment/