"Clinical leadership is really a full time job and the management part is really a full time job and for someone to try and do both doesn't work effectively," says Ott. "The nurse manager has ideas for outcomes he or she wants to see on that unit and the CNL is the person who makes that happen. The two of them together set goals for the unit."
To understand the effect that CNLs can have on an organization, Ott recommends hiring a CNL for a turbulent unit and seeing what happens. She believes when an organization has one CNL, it will soon want more, and a good place to start is on an inpatient unit—such as a busy med-surg unit—with many admissions and discharges. "A unit where bedside nurses are consumed with tasks all day is ripe for a CNL who can come in and provide leadership," says Ott.
"The key to growth will be when the private sector sees the outcomes that these individuals have," notes Ott. "We're firmly supportive of continuing to implement this role in the VA."
There are roughly 900 certified CNLs in the country right now, and the numbers should rise as healthcare embraces a genuinely new role in nursing. CNLs can raise the bar of clinical experience on a unit and thereby improve the quality of care delivered to patients.