Running head: LEADERSHIP

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Leadership
Salena Barnes, RN, BSN
NRSG 7410
Georgia College and State University

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High quality and safe patient care is achieved by nurse practitioners (NP) with strong
leadership skills. These leadership skills include the ability to communicate, collaborate,
formulate, and coordinate care for a variety of patient populations in various settings.
Development of these skills are imperative to Masters of Science in Nursing (MSN) prepared
nurses. The purpose of this paper is to discuss my growth from Bachelors of Science in Nursing
(BSN )to MSN and illustrate how this program assisted in my proficiency in leadership.
Reflection on where you were in leadership when starting the program
Before I decided to pursue an MSN, I worked in a variety of settings as a registered nurse
(RN) to include Medical-Surgical, Surgical Trauma Intensive Care Unit (ICU), Orthopedics, and
at a Pain Management Clinic. The way that I practiced leadership in these settings was to operate
within my facilities policies and procedures. Staying abreast of standing orders and protocols
helped me to deliver care to my patients in a safe manner. Specifically on the orthopedic floor,
awareness of what I could do to assist a patient experiencing pain management issues following
a procedure was paramount. I knew that patient outcomes would not be good if they were unable
to participate in their physical therapy sessions post-operative day one. Thus, it was my
responsibility as the RN caring for these patients to ensure adequate pain control.
Further, being present for all floor meetings and participating in unit council meetings
kept me current on the things going on in the department and the hospital. It allowed me to offer
a firsthand perspective on suggested changes to processes. I also felt that educating the patients
on the floor about what was happening and why it was happening was an important part of my
role. Letting patients know that I was there for them as their advocate to help them in the acute
care setting was an important part of my job as the RN. I believe that developing a rapport and
establishing trust that I am there to help them was imperative. Many times the RNs interpret the

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physicians conversation for the patient. There have been numerous times that when the
physician walks out the room the patient has no idea what the physician was telling them.
Overall, leadership as an RN meant providing patient care in a safe and cost effective
manner. It also meant having a voice within the organization. Being a leader was to carry myself
in a professional manner and to inspire others to do the same. I know I have carried some of
these principles with me as I have pursued my MSN.
What parts of the program helped you to become more proficient in leadership.
All of the courses have helped me to become more proficient in leadership. In the
reviewing the Essentials of Masters Education in Nursing, it provided an explanation for how
Masters prepared nurses should participate in organizational and system leadership. In regards
to leadership, this document helped to define the role of nurse practitioners (NP) and their roles
within an organization. In the review, I learned that leadership skills are essential to put emphasis
on ethical and critical decision-making, effective collaborative relationships, and a systemsperspective (American Association of Colleges of Nursing, 2011).
The part that I see that differentiates RNs from NPs is the systems-perspective piece. NPs
focus on eliminating health disparities, promote excellence in practice, and are responsible for
ethical and critical decision making within an organization. The major difference in leadership
qualities between the RN versus the NP are that RN carry out orders, while NPs coordinate
comprehensive care with an interdisciplinary team for patients in various settings. RNs
collaborate with an interdisciplinary team, yet the NP coordinates that team. Furthermore, the
RN is cost conscious, but the NP has a working knowledge of healthcare policy, organization,

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and financing. The NP knows how to coordinate care, while keeping cost effectiveness for the
organization and the patient at the forefront.
What did you do to help yourself meet this outcome?
In order to meet this program outcome, I have worked closely with my preceptors, in
particular Dr. Kumar, to learn about the operations in a primary care office. I put myself in
uncomfortable situations to learn how to navigate them. For example, in the second semester of
school, I was very uncomfortable with taking the lead in patient assessment and
recommendations for further diagnostic testing. I noted I was particularly uncomfortable with
patients my own age or that I recognized from the community. By accepting the challenge of
assessing these types of patients multiple times, I eventually got over my nerves and am now
able to perform these tasks without difficulty. Now I take the lead with whatever patient presents.
Additionally, in collaboration with the care team at Dr. Kumars office, I suggested some
clerical changes that could improve time management and reduce costs for the office. I suggested
going green with new patient paperwork (when possible), which would involve emailing new
patient packets and receiving the information back via email or fax. I felt this would save time
when getting a new patient in office and would reduce the overhead that would be associated
with mailing paperwork. I noticed this need almost immediately, which I contribute to studying
the aforementioned Masters Essentials. Dr. Kumar and the office manager discussed the changes
and are working to implement the plan. One other suggestion I made was developing a form that
would allow the patient to consent to leaving messages regarding lab results on a designated
voicemail or to receive them by email.

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Moreover, during my time with Dr. Kumar, I attended a meeting with a pharmaceutical
representative presenting information on SGL-2 medications. I took the opportunity to absorb the
information and disseminate it to some of the staff and a few patients. I thought it would be
important to discuss this information because the presentation involve comparison to several
standard oral hypoglycemics. I took this opportunity to act in the role of an NP to help the office
and the patients.
What could you have done better to become more proficient?
I think learning more about the healthcare system, reimbursement, and community
resources available to patients would be helpful in improving my ability to lead effectively. I
could also subscribe to a nursing journal, such as the Journal of the American Association of
Nurse Practitioners (JAANP), which is a scholarly, peer-reviewed journal to stay abreast of
issues that affect NPs. I also believe that taking more time to familiarize myself with E-Clinical
would improve my understanding of reimbursement, billing and coding. I could have
participated in Legislative day to gain a better understanding of how government influences the
nursing profession.
What could the SON have done better to help you or other students with this outcome?
I believe that every course I have taken during this program has integrated some form of
leadership that applies to MSN prepared nurses. Additionally, I believe that integrating a training
or tutorial on E-Clinical at the onset of the program would be helpful to future students. If I had
learned how to navigate this system prior to beginning my clinical experiences, I would have
experienced less stress and would have been able to focus more time and attention to patient
interaction. Lastly, integrating a case narrative that illustrated the role of the NP in implementing

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a quality improvement initiative may prove effective in helping students understand the
responsibilities of an NP in mitigating risks and enhancing the healthcare delivery systems.

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References

American Association of Colleges of Nursing. (2011). The essentials of masters education in