Nurse leaders are essential to bringing the nursing industry forward, especially during the tumultuous times like the present. With a global pandemic disrupting life as we know it, nurse leaders are needed to advocate for the safety and health of nurses and those they care for.

Assanatu (Sana) Savage, PhD, DNP, FNP-BC, RN-BC, and director of the American Academy of Ambulatory Care Nursing (AAACN) recently shared her thoughts on how leadership roles are important for nurses in any position and to the nursing industry as a whole.

  1. How can nurses increase leadership experiences on the job and in the community?

Nursing leadership is multidimensional across healthcare organizations. Nurse leaders range from the bedside (clinical level) to the boardroom (administrators, chief executive officers, etc.). Many settings have mid-level managers. There are also leaders in research, academia, and technology. Regardless of this complexity, a key factor that fosters nurses’ leadership experiences on the job or in the community is being involved in their professional organization. This kind of engagement helps attune nurses to their professional landscape and broadens their skills and knowledge, which in turn can be used on the job and in their communities. Personally, my involvement in the American Academy of Ambulatory Care Nursing (AAACN) was a game changer in my leadership development. Not only have I been able to meet and forge relationships with my AAACN colleagues, but the education and resources AAACN offers really helps build and connect nursing leaders. Our Special Interest Groups (SIGs) are designed specifically for that purpose.

In addition, the knowledge I’ve gotten from my role as an AAACN leader has helped me move to the frontlines in building and sustaining ambulatory care practices in my career. I’ve brought new ideas, evidence-based best practices, and other benefits to my workplace and my community, helping  me increase my leadership experiences and strengthen my leadership skills in additional areas. This is why I encourage other nurses to get involved in professional nursing organizations. It helps them develop interprofessional collaboration in their workplaces to improve patient outcomes and participate in the improvement and design of health systems and practice environments to achieve a common/collective goal/purpose. In our communities, leadership experience for nurses involves engaging at the local, state, and national levels to improve the culture of health. This can take the form of serving as a nurse educator, working with community groups on promoting health and preventing disease, getting involved in campaigns, and informing the community about the level and quality of services of their facility.

  1. Why should nurses continue to seek these experiences throughout their careers?
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Nursing leadership is characterized by a wide range of responsibilities across the profession. It’s important to continue to seek leadership experiences to ensure proper responsibilities and accountability for different operations such as human resources and patient outcomes. I believe it’s also crucial for nurse leaders to understand the economic influences that affect health care delivery. You’re seeing that financial focus right now as the world struggles to meet the economic challenges of a global pandemic.

Leadership roles are changing rapidly in a fast-paced healthcare environment, and nurses need to evolve in that direction. The knowledge and skills for leading healthcare services and personnel are ever-changing, and nurses must continue to seek growth in leadership to enhance their problem solving, critical thinking, and decision making abilities. The nurse leader who is passionate about learning and evolving is able to empower other nurses, and subsequently improve many aspects of the healthcare system.

  1. How does leadership make a nurse better?

Leadership keeps a nurse up-to-date on today’s healthcare environment. For instance, in the clinical arena, the nurse leader who is well-informed in evidence-based studies and public health issues is able to make the right choices for optimal patient care. In other instances, leadership sharpens a nurse leader in the areas of policies and healthcare strategies that affect patient care.

​The ability to lead and be the voice for other nurses, the bridge between policy and practice, leading change or becoming a change agent, are also factors that contribute to the betterment of a nurse. Leadership can afford the nurse with practical skills and knowledge to understand the business of healthcare as a whole. Understanding the impact of nurses in healthcare/patient outcomes through Nurse-Sensitive Indicators (NSIs) is one such example. AAACN partnered with the Collaborative Alliance for Nursing Outcomes (CALNOC) and through this leadership, a number of indicators are now available to nurses in ambulatory care and telehealth settings for benchmarking.

  1. Why is it important to the nursing industry to have more nurses in leadership roles?
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According to the Bureau of Labor Statistics (BLS; 2018) nursing is the country’s largest healthcare profession, with approximately 3.9 licensed RNs. Yet there continues to be a lack of nursing representation on hospital and health system boards and governance of community health efforts. In our 21st century healthcare industry, increasing the number of nurses in leadership roles will allow nursing to have a greater impact on policies, strategies, and tactical healthcare decision making for communities and health systems across the nation.

Nurse leaders who, for instance, understand value-based purchasing/care can help eliminate waste and inefficiencies and transform their organizations to high-reliability health systems. This also speaks to the Future of Nursing 2020-2030 Campaign. Unlike when I was in nursing school, today’s nursing curricula have a leadership component, and professional organizations are also offering leadership training and/or toolkits. AAACN has a Leadership Special Interest Group (SIG), a diverse group of both experienced and novice nurse leaders. They work together within the SIG to foster continued leadership support, growth, and development for themselves and other nurses.

  1. What are some challenges facing nursing leaders today?

​I believe one of the challenges that continue to face nursing leaders is staff retention and recruitment. COVID-19 has made this challenge even greater as nurse leaders not only are working on staffing patterns to meet the demand for COVID-19 care, but also working on retaining staff and mitigating burnout and compassion fatigue.

It must be noted that the BLS projected a yearly need of 203,700 registered nurses through 2026 to replace retiring RNs and fill newly created positions. This shows the nursing shortage is real and serious. And, of course, the shortage has been brought to the forefront by the current pandemic. Healthcare organizations such as the VA and many others are calling urgently for the return of retired nurses or fast-tracking students to their workforce to augment COVID-19 staffing.

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I must say in times like this, staying connected with other nurse leaders is crucial to gain insight on staff leveraging and related issues. Our AAACN Connected Community (online networking platform) has been extremely active during the pandemic, with nurses of every level connecting and sharing their experiences and best practices in ambulatory care and telehealth. And, like so many other healthcare organizations, AAACN is offering education for free. We just did a free webinar on “Telephone Triage and COVID-19,” and we will continue serving nurse leaders and the community this way.

Although the pandemic is top-of-mind right now, I have to say that violence against nurses is another serious concern facing nursing leaders. There has been an increased trend of violence against health professionals, with nursing taking the brunt.

The more nurses there are in leadership roles on hospitals and health system boards, the stronger advocacy efforts will be for policymakers to assess this phenomenon thoroughly and enact measures to protect nurses and all healthcare providers.

With 2020 being the “International Year of the Nurse and Midwife,” is it indeed the right time to highlight this challenge and advocate for eradication.





Julia Quinn-Szcesuil
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