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Being a nurse leader in today's emergency department (ED) requires skills beyond outstanding clinical abilities. Strategic planning, project management, financial acumen, and crucial communications are just a few of the many skills that new nurse leaders must possess to ensure success. A nurse leader will impact healthcare providers, patient and families, nursing and ancillary departments of the facility, and the community, which it serves.

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An overview of the following skills will be covered in this chapter:

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  • Effective nurse leadership abilities
  • Effective communication with all stakeholders
  • Developing a culture that enhances the experience of the patient, staff, and physician

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Effective nurse leaders make a concerted effort to improve their leadership skills and constantly take inventory of their strengths and areas for growth. Continual self-assessment allows nurse leaders to become resilient to their environment and have the ability to adapt as the environment changes. The American Organization of Nurse Executives (Leaders) (AONE) as part of the Healthcare Leadership Alliance outlines 5 domains and the competencies within the domains that are required by today's nurse leader.1

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Models of Leadership

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Competencies are no longer based on the clinical aspect of the job but on leadership, business, professionalism, communication, and the knowledge of the current healthcare environment. The knowledge domain has 10 aspects that are evidenced based across the spectrum of management skills. The National Center for Healthcare Leadership (NCHL) developed a 3-domain, 26-competency model that was created for all levels of healthcare management that will position the nurse leader for the future of the healthcare industry.2 Figure 15-1 shows the 3 dimensions and competencies.

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Figure 15-1.
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NCHL health leadership competency model™.2

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Each of these models can be used to develop the characteristics required for today's ED nurse leader and the ability to develop “big picture thinking.” The shift from clinical thought processes to seeing the “big picture” is one of the prevalent challenges a nurse leader must overcome and this shift is part of the transition all new nurse leaders must face.

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Complicating this transition is the lack of understanding of the complexity of the role and responsibilities (Figure 15-2). Rarely is the organization cognizant of and forthcoming with the multiple and competing priorities of the job. Generally, the new director or manager is not adequately prepared for the specifics of the job. Rather candidates are interviewed and selected based on the key competencies associated with the role.

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There are 3 phases that nurse leaders face at each new level of management, the charge nurse, nurse manager, nurse director, and nurse executive. The 3 phases consist of the honeymoon phase, the conflict phase, and ...

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