Why Nurses Should Lead

I see a lot of recommendations to enhance workplace empowerment and build nurse leaders to improve healthcare. And that’s good. But not for the reasons you might think.

Let me explain.

The quality cycle of improvement requires an evaluation. The reason this evaluation step is critical is to see if the problem is still there. When the problem is still there even after an intervention, it often means that we were chasing the wrong problem and the root cause is yet undiscovered.

Well, the problem is still there.

Healthcare still needs improvement and we’ve been trying the same stuff for decades now. It might be time to say we’ve been chasing some of the wrong problems and go back to finding that pesky root cause.

One of the pieces that I see missing from our interventions is the patient-driven component. We have so many goals, yet few are the actual stated goals of real patients.

This is critical because the healthcare workforce thrives when patient outcomes are positive. When patients do well, clinicians do well. We love this work when it is fruitful. But it doesn’t matter how empowered our workplace might be, if our patients are experiencing poor outcomes, clinical staff cannot thrive.

I believe we had the wrong problems because they were not patient-driven problems.

And this is where the nurse-led initiatives come into play. Why are nurses so special, so uniquely gifted at improving healthcare? For the same reason that our partners in respiratory therapy and physical therapy and all the other ancillary teams are able to contribute as well:

We spend the most time at the bedside.

We spend the most time with patients.

Without this patient connection, it is useless to conceive of healthcare improvement as a theoretical exercise to implement on some utopian plane that does not exist, to serve humans that never make mistakes.

Nurse leaders are special because they keep us grounded, laser-focused on patients, listening and making decisions based on the hope and fear in their patient’s eyes, and they keep working until the patient is comfortable.

And what do patients want most of all? What quality measure most ardently defines their healthcare goals and experiences?

To get better and go home.

Nurses excel in healthcare leadership because they have spent years at the bedside hearing patients ask them:

“When can I go home?”