Executive Nurse Educational Preparation

Excellence in nursing practice and patient care requires excellence in executive nurse educational preparation and subsequent exemplary leadership in all health care settings. Throughout the past several decades, educational preparation of nurse executives has taken many diverse pathways, so that we could wonder if we might have lost our way as leaders of professional practice environments and vanguards of patient care. However, the increasing number of Magnet awards in practice settings should be substantial evidence of today's growing number of well-prepared chief nurse executives.

In November 1978, Boston University School of Nursing sponsored an invitational conference: "Nursing Administration: Directions for the Future" led by Muriel A. Poulin, EdD, FAAN, RN. Proceedings were published in Nursing Administration Quarterly (Vol 3:4) "Preparation of Nurse Administrators": Summer 1979. In review of those proceedings, a time when nursing administration was viewed as a stepchild in the profession, when only legitimate advanced education was deemed to be in the clinical and education domain, many divergent viewpoints paved the way for the next generation of nurse executives.

Nursing Administration Quarterly, under the esteemed editorial guest leadership of Franklin A. Shaffer, EdD, FAAN, RN, Executive Vice President/CNO Cross Country Healthcare Inc, Boca Raton, Florida, once again presents innovative and challenging directions for "the Executive Nurse Educational Preparation." He is the founder of the Cross Country University and continues to serve as the chief learning officer integrating learning and achievement of the enterprise's mission. The corporate university was the first of its kind in the health care staffing space. Dr Shaffer developed a national competency assessment program as well as a national shared governance council, the first professional collaborative in the health care staffing industry.

Dr Shaffer serves as the corporation's liaison to the professional community and the business world. He frequently translates nursing's contribution to the bottom line of the enterprise and within the marketplace. He is a member of the Joint Commission's Nursing Advisory Council and was instrumental in its certification program for the health care staffing industry. The HSCCS certification program has grown to more than 300 certified staffing firms. Dr Shaffer is President of the Friends of The National Institute of Nursing Research and is currently on AONE's nominating committee. He was cochair of the public relations and communications committee of the American Academy of Nursing and is the recipient of the most distinguished R. Louise Mc Manus medal for his contributions to the profession from Columbia University. Certainly, he is most influential in the education preparation of nurse executives and leads us in this much-needed issue for the future generations of nurse executives.

When we reflect on our history as nurse executives (now a substantially recognized specialty in nursing), and our educational preparation, it is acknowledged that current educational preparation has evolved in various graduate level programs, with many disciplines enhancing our knowledge base.

How do these programs compare with the visions presented more than 30 years ago? Margaret L. McClure, EdD, FAAN, RN, led the conference at Boston University with "The Administrative Component of the Nurse Administrator's Role" and the following unique properties:1^(pp1-12)

* The nature of the work. 24-hour responsibilities, lack of ability to predict and/or control work flow, and physical aspects of the work.

* The nature of the workers. The mix of professional and nonprofessional workers, and female profession.

* The nature of the internal environment. The power of the physicians, interdependence of medicine and nursing, and small group behavior.

* The nature of the external environment. External controls and regulation. (For detailed discussion, review in NAQ archives online at http://journals.lww.com/naqjournal/pages/default.aspx)

"Clinical Nursing: A Basis for Administrative Excellence," followed the administrative component proposed by Dr McClure. Barbara J. Brown, EdD, FAAN, RN, promoted the necessity of advanced clinical nursing knowledge with the art and science of administration to provide leadership in management of patient care, resources, and finances.1^(pp29-35)

Nursing like medicine, is a clinical service, and it demands strong leadership by a qualified professional nurse who is prepared to integrate and apply knowledge of clinical nursing and management-Health care services will develop sound administrative planning only if the nurse administrator is able to bring effective leadership to the clinical practice of nursing and the patient care services rendered.

The third presenter at this landmark conference was Mary E. Conway, PhD, FAAN, RN, the then Dean at the University of Wisconsin, Milwaukee, School of Nursing. The topic was "Knowledge Generation and Transmission: A Role for the Nurse Administrator."1^(pp29-41) "To what extent can knowledge generation be considered a legitimate part of the role expectations for nurse administrators? And, given that role, what is its nature?"

As I reflect on the many years of practice, education, consultation, and research as a nurse administrator, I am in awe of today's nursing leaders and the strides being made in creating truly professional practice environments. Ideas of self-governance, self-staffing, collaborative practice committees, advanced practice nurses billing for services rendered and the nurse executive, not only becoming a regular member of the Board of Trustees in health care systems, but becoming the CEO, were spawned in the seventies, and have become a reality throughout the country and in the world of nursing administration. With expert clinical knowledge as the base of power and the advanced preparation in the science and art of administration, nursing has the potential to organize massive change, and we are doing it.

-Barbara J. Brown, EdD, RN, CNAA, FNAP, FAAN

Editor-in-Chief

Nursing Administration Quarterly

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