1. Alexander, Mary BS, CRNI(R), CAE, INS Chief Executive Officer, Editor

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"Nurse Leader"-the words conjure images of CEOs, nurse entrepreneurs, managers, and professors of nursing. But what if these titles don't describe your current position? Could you still be a leader too? If you're not in a position of authority, you may not feel empowered to step into a leadership role. Nurses have historically been considered support staff, and while this perception of nurses is outdated, many of us (with nursing certification and degrees under our belts) continue to see ourselves this way.

Figure. Mary Alexand... - Click to enlarge in new windowFigure. Mary Alexander BS, CRNI(R), CAE, INS Chief Executive Officer

In order to meet the growing demands placed on nurses and stem the problems caused by the nursing shortage, nurses must learn to develop a range of leadership skills. This isn't as daunting as it sounds. Developing leadership skills doesn't mean we all have to become executives or managers, or earn an advanced degree. It means learning to think critically about our work, about ourselves, and about the healthcare organizations in which we work. It means not just pointing out problems in patient care or infusion procedures, but offering solutions. All of this can be accomplished without a change in our job title, but it will require a change of mindset.


What defines a nurse leader is the ability to facilitate changes and initiate ideas. Consider the role of the infusion nurse, who often serves as a coordinator within the care continuum. The Joint Commission on Accreditation of Healthcare Organizations1 has identified coordination of care as an opportunity for leadership because it includes educating patients, family, and caregivers. Helping to coordinate the efforts of the healthcare team is a place where infusion nurses in particular can shine while still maintaining the structure of teamwork. Infusion nurses are also uniquely qualified and vitally necessary for organizational committees. Committee work is a prime opportunity to grow leadership skills by helping to set agendas, building consensus among departments, and enlisting the support of other staff members to become more involved in setting organizational policy.


Communication among members of the healthcare team represents another opportunity for leadership among infusion nurses, especially because therapies are often delivered across multiple settings over the course of treatment. Communication is of critical importance when transitioning an infusion patient from hospital to home, for example, to ensure that the patient's care is not interrupted. As infusion nurses, we have the ability to initiate efficient communication plans and procedures that involve all members of the healthcare team. Creating consistency of care and mechanisms for follow-up will help to avert miscommunication and the potential for complications.


Finally, think about your problem-solving skills. Nurse leaders have the ability not only to identify problems, but also to become part of the solution. Infusion nurses are excellent leaders in establishing performance improvement initiatives for determining the cause of problems such as phlebitis, occlusions, and infiltrations, and then identifying measures to correct it using the latest published data. With all of the new technology coming onto the healthcare market, infusion nurses often express difficulties in implementing new infusion products and equipment. This too presents the nurse with the chance to cultivate problem-solving and leadership skills by tracking and monitoring problems with new technology and recommending solutions. Is there a need for additional in-services on the product? Are the manufacturer's directions unclear? Ask yourself and your colleagues what measures would help. Consider the problem an opportunity to show that you are proactive, that you can anticipate problems, analyze processes, and look for ways to improve.


If you are new to the specialty, remember that INS also offers plenty of volunteer opportunities to learn leadership skills. Just give us a call or visit our Web site to learn more. Whatever leadership role suits you, remember that you are always, on some level, in a position to improve the quality of healthcare and the quality of your working environment. No job title change required.


Mary Alexander




1. Joint Commission Resources, Inc. Issues and Strategies for Nurse Leaders: Meeting Hospital Challenges Today. Oakbrook Terrace, Ill: Joint Commission Resources, Inc.; 2005:9-23. [Context Link]