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Leadership Evolution: The Academy's Sustained and Growing Contribution

      Leadership is a fascinating concept. Some will say that you are born with it, while others will say it has to be developed. And there are still others who will say it is both. From my experience, and what the American Academy of Nursing (Academy) believes, all great leaders need development. In preparing for this column, I reflected on the Academy's leadership focus. As I mentioned in my last Nursing Outlook message, it is important that our Academy Fellows and colleagues who read this journal understand our signature initiatives. The Edge Runners, the Institute for Nursing Leadership (INL), and the Council for the Advancement of NursingScience (CANS) are uniquely designed to be open to all nurses who are interested in innovation, leadership, and science. This is purposeful. The organization as a whole supports the dissemination and impact of nursing's novel contributions to health and health care. To that end, CANS has an open membership structure, the Edge Runner designation can be awarded to any nurse with an edgy model, and the INL's annual Leadership Workshop and Luncheon can be attended by anyone, Fellow or otherwise.

      Academy's Leadership Evolution

      So how did the focus on leadership arise? I firmly believe that it has always been at the Academy's core. The Academy is a Fellowship where leaders are among leaders—this is central to our mission and vision. In fact, the Academy's original operating objectives in 1973 united a community of nursing experts to:
      • Advance new concepts in nursing and health;
      • Identify and explore issues in health, in the professions, and in society as they affect and are affected by nurses and nursing;
      • Examine the dynamics within nursing, the interrelationships among the segments within nursing, and examine the interaction among nurses as all these affect the development of the nursing profession; and
      • Identify and propose resolutions to issues and problems confronting nursing and health, including alternative plans for implementation ()
      These objectives continue to guide the Academy's work, even to this day. They are action-orientated and require the best minds in nursing to create direction. The Academy is proud to represent leaders around the globe who continue to be trailblazers for health. Each Fellow's unique journey, straight-forward or winding, led them to a place or time in which they were called upon to act, advance an effort, and make an impact.
      I became a Fellow in 1997. For 23 years, I have seen the Academy grow in its leadership bench strength. Much of this was centered around our annual conferences. I had a chance to look through past conference themes since the Academy began in 1973 and I could see a clear commitment to diving into the critical issues of the day. The themes were futuristic, timely, and dedicated to improving the public's health. While policy was among the topics covered throughout our 47-year history (taking center stage in 2010 to present), the Academy took on topics such as Primary Care in a Pluralistic Society: Impediments in Health Care Delivery (1977), The Economics of Health Care and Nursing (1983), Violence: Nursing Debates the Issues (1993), and Designing Nursing's Legacy for the Future (2000). It is incredible to think that these weighty topics remain at the top of our agenda today.
      Many of us may remember the 25th Anniversary of the Academy. In 1998, Raising the Standard: The Role of the AAN in Transforming the Nursing Profession was published. Going through this history, I could not help but be inspired by the thought leadership at the time. For example, it was the Academy that commissioned the Magnet Hospital study in the early 1980s, which considered the key characteristics that made certain hospitals attractive places for nurses to work such as, administrative support of professional nursing practice, a teaching-learning environment, and an openness to change and significant input into that change (
      American Academy of Nursing
      Raising the Standard: The Role of the AAN in Transforming the Nursing Profession.
      ). Today, the Magnet Recognition Program®, is thriving through the great leadership of the American Nurse Credentialing Center, a part of the American Nurses Association Enterprise. What is so powerful about this example is the vision. Nursing leaders set a clear direction to usher in positive change that eventually launched one of nursing's most critical programs for quality care— nationally and internationally. That is leadership. For nearly five decades, the Academy has been setting a target and supporting our Fellows in order to transform health and health care through their unique vision.

      The Academy's Sustained Contribution

      At the same time, the Academy recognizes our purpose beyond the honorific nature of our organization and we have intentionally developed our signature initiatives to be much broader than the Fellowship alone. As I think about what leadership means in our profession, I am struck by the fact that each and every nurse can lead from the seat they hold. This is incredibly powerful when we consider the population of nurses. Currently, 50% of the healthcare workforce around the world are nurses and midwives, which translates to 20.7 million potential leaders (

      World Health Organization. (n.d.). Strengthening the nursing and midwifery agenda globally. https://www.who.int/activities/strengthening-the-nursing-and-midwifery-agenda-globally

      ). Soon the World Health Organization will announce the updated number of nurses and midwives in their 2020 State of the World's Nursing Report. Considering the global impact, I cannot help but be inspired by the leadership of nurses at this perilous point in time. I recently saw photos of nurses in China whose faces held the deep imprints left by the masks they were wearing while treating patients with the coronavirus, COVID-19, for 12 hours straight. Their faces, captured in an instant click of a camera, documented the heroic commitment nurses have for the care of their patients. And this commitment has stood the test of time.
      Many of us remember when the Ebola virus came to the United States back in 2014. Through a compassionate and poignant article published in the Washington Post, Dr. Susan Mitchell Grant, an Academy Fellow who was the Chief Nursing Officer at Emory Healthcare when the Ebola patients arrived at their health system, wrote, “We can fear, or we can care” (
      • Grant S.M.
      I'm the head nurse at Emory. This is why we wanted to bring the Ebola patients to the U.S.
      , para 6). I found Dr. Grant's statement to be the personification of nursing. In the height of crisis and chaos, we care and by caring, we lead. This is why the Academy focuses on leadership. It is the hope that we bring nursing knowledge to the center of the biggest debates and policy priorities of the day. And over the last 50 years, this has been a cornerstone for the organization.
      In 2014, the Academy purposefully launched the Institute for Nursing Leadership. After the release of the 2010 Future of Nursing: Leading Change, Advancing Health report, which called for greater leadership by the profession (
      Institute of Medicine
      The Future of Nursing: Leading Change, Advancing Health.
      ), a national initiative was created to increase the representation of nurses on healthcare, community, and other state/federal boards, known as the Nurses on Boards Coalition (). It was during that time that the Academy leadership wanted to support the national effort and continue our leadership legacy, thus INL was created. The goal of this work was to prepare nurses for appointments to key international, national, and state governing boards of health-related entities/systems, councils, commissions, and task forces (). An outgrowth of this work was the Appointments that Matter Essay Series. Open to the public, these essays written by establishedand prominent Fellows, who have held Board positions, addressed such issues as finding board mentors, sharpening your financial savvy, and non-profit vs. for-profit boards. 2020 will mark INL's seventh Leadership Workshop and Luncheon that brings thought-leaders together for skills building, mentoring, and coaching.

      The Academy's Growing Contribution

      In June of 2019, the International Council of Nurses Congress launched the global initiative called the Nightingale Challenge (International Council of Nurses (

      International Council of Nurses. (2019, June 28). Nightingale Challenge inspires the next generation of nurse and midwife leaders during 2020 Year of the Nurse and Midwife. https://www.icn.ch/news/nightingale-challenge-inspires-next-generation-nurse-and-midwife-leaders-during-2020-year

      ). The request was for employers to provide “leadership and development training” to young nurses and midwives in recognition of 2020 as the Year of the Nurse and the Midwife. This charge inspires the Academy to continue our leadership trajectory. This year, INL will continue to evolve and offer more opportunities for nurses across the country to lead from any seat. As Academy President, I look forward to targeted outreach to not only grow the INL Workshop and Luncheon but the program as a whole. The INL National Advisory Council will meet later in the spring to provide direction and create new approaches to leadership development. The Academy Board believes our focus on leadership is linked directly to our roots as an organization. We are leaders and it is our duty to support our own development and encourage the leadership development of others. The Academy's commitment to leadership is an extension of our deeper obligation to improving the health, well-being, and equity of every individual.

      References

      1. American Academy of Nursing. (n.d. (a)). About the Academy. https://www.aannet.org/about/about-the-academy

      2. American Academy of Nursing(n.d. (b)). The Institute for Nursing Leadership. https://www.aannet.org/initiatives/institute-for-nursing-leadership

        • American Academy of Nursing
        Raising the Standard: The Role of the AAN in Transforming the Nursing Profession.
        Springer Publishing Company, 1998 (https://books.google.com/books/about/Raising_the_Standard.html?id=jDYHAAAACAAJ&source=kp_cover)
        • Grant S.M.
        I'm the head nurse at Emory. This is why we wanted to bring the Ebola patients to the U.S.
        The Washington Post. 2014, August 6;
        • Institute of Medicine
        The Future of Nursing: Leading Change, Advancing Health.
        The National Academies Press, Washington, DC2011
      3. International Council of Nurses. (2019, June 28). Nightingale Challenge inspires the next generation of nurse and midwife leaders during 2020 Year of the Nurse and Midwife. https://www.icn.ch/news/nightingale-challenge-inspires-next-generation-nurse-and-midwife-leaders-during-2020-year

      4. Nurses on Boards Coalition(n.d.). Our Story. https://www.nursesonboardscoalition.org/about/

      5. World Health Organization. (n.d.). Strengthening the nursing and midwifery agenda globally. https://www.who.int/activities/strengthening-the-nursing-and-midwifery-agenda-globally