The role of nurses within the healthcare industry has always been a pivotal one. Increasingly, nurses have started assuming greater significance in providing necessary technical assistance as well as adding a humane touch to the patients and their families. An area of particular interest is leadership in nursing mental health, as greater number of people is seeking assistance for psychiatric and psychological problems such as anxiety, depression, schizophrenia, senility, etc. In this context, an analysis of the wide array of skills required to provide clinical leadership in nursing mental health is of importance. The rest of the essay will broadly foray into these required skills.
One of the most requisite skills for nursing officers is conviction and courage in handling financial decisions for their hospital or clinic. With healthcare insurance becoming unaffordable for an increasing number of Americans, people end up in hospital wards with insufficient finances. While running a hospital or a clinic has a business element to it, its first priority is to serve needy patients, especially the ones suffering from mental ailments. An ethically conscious leader will always keep this in mind and put the interests of the patient before that of the organization. While this may sound a touch idealistic and its implementation may seem unfeasible in a competitive healthcare industry, it is nevertheless an ideal worth persevering for. According to Shawn Ulreich, the chief Nursing Officer at Spectrum Health, “It is time to bridge the gap between nursing–and all of operations–and finance…Nursing leadership entails measures to tackle the massively flawed payment system. Other times, it is demonstrating that you sincerely care about patient care” (Fifer, 2007).
Continuing in a similar vein, leaders in Nursing should reverse recent trends of high employment dissatisfaction among nurses and other support staff. Nurses across the country are not happy with the remuneration package handed to them and consequently shifting to jobs that pay more. Another reason cited for this state of affairs is the lack of mutual understanding between the business and nursing wings of the healthcare organizations. For example, according to a recent survey,
“Approximately 38 percent of the respondents reported having left a CNO position–13 percent within two years before the survey and 25 percent within five years before the survey. When asked about the context of their departure, a high percentage reported leaving their position to pursue another CNO position (50 percent) or for career advancement (30 percent); approximately 26 percent reported leaving because of conflicts with the chief executive officer. Of great concern is the finding that approximately 62 percent of respondents anticipate making a job change in less than five years, slightly more than one-quarter for retirement” (Jones, 2008).
From the above statistics it is clear that the onus is on the community of nurses, including that of the Chief Nursing Officers to put their collective cause before personal gains. At a time when catering to mental illnesses has become a specialized field in itself, such apathy toward mentally disordered patients is unbecoming of a nurse or a nursing officer. This point need be adopted and reinforced by the leaders themselves, so that those lower in the nursing hierarchy can emulate worthy role models.
Another area where nurses in mental healthcare should advance their skills is “management development” activities. With mental healthcare becoming a more specialized and complex industry, the expected nursing skills are also equally more elaborate. Nursing leaders should adopt an “activity competency model” to assess the prevailing state of nursing skills within their organization (Lin Li-Min, et. al., 2007). Later, depending on the findings, they can implement training programs that would inculcate nurses catering to mental health patients on the intricacies and nuances involved therein. Nursing Officers play am important role in hospitals and other healthcare centers. They should communicate effectively with other departments within the organization as well as interact with other allied organizations, so that they can “manage nursing resources, influence hospital strategy, and plan nursing activities to cope with the hospital’s competitive environment” (Lin Li-Min, et. al., 2007).
Lately, Nursing Officers have come to be treated as the crucial resource for the hospital. Commensurate with this new capacity, their range of skills has also widened. For example, they are being asked to maximize and optimize available resources at hand. But the level of training and their competence in fulfilling this expanded role is still lagging behind. Among all the skills and qualities that is required of mental health Nursing Officers, only a few are actually evident in practice. In general, Nursing Officers were found up to mark in such competencies as “analysis and judgment, planning and organizing, and monitoring and controlling”; but they were found wanting in such skills as “learning and adapting, multilingual, and information processing” (Lin Li-Min, et. al., 2007). This discrepancy is of grave concern to the industry as a whole. This is an area where strong and motivational leadership can make a difference. In my professional practice as well, I see the aforementioned deficiencies manifest themselves while providing mental patients quality care.
For the modern mental healthcare systems in place, nurses need to gain multiple skills, some of which might have been thought quite removed from nursing per se. The following list of skills has been identified as essential ones to provide quality healthcare for patients diagnosed with psychiatric or psychological disorders:
1. Analysis and judgment skill
2. Creativity (innovation) skill
3. Planning and organizing skill
4. Leadership skill
5. Monitoring and controlling skill
6. Communication and coordination skill
7. Learning and adapting skill
8. Social skill
9. Multilingual skill and
10. Information processing skill (Jones, 2008)
There are some studies that indicate that mental healthcare for the elderly has failed to catch up with advancements in other aspects of healthcare. Given the fact that elderly patients are more susceptible to dementia, senility, and other conditions that worsen with age such as Parkinson’s disease, Alzheimer’s disease, etc., special training and education need be incorporated into the nursing college curricula to alleviate this deficiency. The reason why clinical leadership in mental healthcare for the elderly is imperative is based on the fact that administrative understanding is as important as core professional competencies such as diagnosis and treatment. The quality of the management team that leads the hospital organization can have a significant impact on the clinical efficiency and innovation. Hence, managerial ability is another key skill that is expected of nursing leadership and the team.
A case in point is the Hospital Elder Life Program (HELP) that had seen widespread implementation across the country. A core component of the program pertains to mental health of the elderly. Here, more that anywhere else, successful leadership becomes a key factor in patient outcomes. With life expectancy on the rise across the world due to various medical advancements and a stagnant birth rate, the elderly have come to comprise a larger section of the demography. In this scenario treating common geriatric mental conditions, including dementia, delirium, functional decline and senility have assumed greater significance; and special skills are to be acquired to cater to mental conditions that are unique to the group (Bradley et. al, 2006).