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Nurses Urged to Examine Their Changing Role

 |  By  
   November 01, 2011

The three topics on everyone's lips at last week's Nursing Management Congress were:  transforming care delivery, the changing role of nursing, and which show to go to that night.

While the Las Vegas setting provided some much-needed fun for the approximately 1,000 nurse managers and leaders who gathered for education and networking, it was the chance to discuss the pressing issues of healthcare reform and nursing's role that truly electrified the audience.

Keynote speaker Tim Porter-O'Grady told attendees that it's time for nursing to unbundle its work and decide what it will no longer do so that nurses are able to focus on what's most important in the changing face of care delivery.

"We've been too addicted to our protocols and our rituals," said Porter-O'Grady. Nursing can't keep doing what it's been doing in the new world of healthcare reform and value-based purchasing. Instead, it's time to embrace meaningful changes.

Here are the key strategies Porter-O'Grady outlined.

1. Change the new graduate nurse experience

"When millennials first graduate and get into preceptorships, we kill them," said Porter-O'Grady. How? Because we ask the oldest and most experienced nurses to serve as preceptors. Too often these preceptors cannot relate to the younger new grads. "We need to stop precepting and start mentoring," said Porter-O'Grady.

Preceptorships should focus around mentoring relationships that recognize new nurses have as much to teach us as we have to teach them.

2. Lead the next generation of nurses

The current crop of nurse leaders is tasked with leading the next generation into a future we don't understand and that we will never fully occupy, said Porter-O'Grady. By holding onto the past, it becomes an impediment to occupying the future.

Nurse leaders should embrace technology and its ability to revolutionize healthcare, rather than viewing it as something foisted on nursing by others.

3. Measure value not volume

"We are moving out of an age of volume into an age of value," said Porter-O'Grady. Nursing needs to stop measuring itself in terms of volume and start looking at the value it provides. Nurses are not valuable to their organizations simply because of all the many tasks they do. They are valuable because of the outcomes they produce and this is what needs to be emphasized.

Nurse leaders' role is to identify the parts of the job nurses do that have value and make a difference and the parts that don't belong in the role of RN. Do this by asking what impact the work has or whether it changed something, he said.

We will no longer be paid for volume of work. "Work is not valuable because you do it. It has to have meaning," he said. We all know healthcare is getting more complicated—the only way to maximize the value of what nurses do is to do less of the work that doesn't add value so there is more time to devote to the increasingly complex work that does.

The frontline nursing leaders attending last week's conference are the ones who can help organizations make this crucial distinction.

Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at

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