Great Leaders Exist in All Facets of Oncology Nursing

Stephanie L. Jackson, DNP, MSN, RN, AOCNS, BMTCN

Let us say that an oncology nurse named J.P. has been practicing full time on an inpatient oncology unit for 5 years. He graduated from a prestigious nursing program on the East Coast and was always told that “the sky is the limit in the field of nursing.” During his 5 years on the unit, he has completed a 1-year residency program, precepted new hire nurses, trained as a charge nurse, and assisted with performance improvement initiatives. While receiving his yearly evaluation from the manager, he asks, “What distinguishes a great leader from a good leader?”

His manager responds by saying, “That’s a great question. Let’s discuss this further.”

Nursing leadership and management are paramount to our health care system. Specialists working in oncology face numerous changes and challenges, which include emerging therapies, geriatric care, aging clinicians, and fiscal burden because of innovative treatments.¹ Key to sustaining the prestige of this specialty are the frontline professionals and the quality of care they provide to patients and families. Nurse leaders are recognized for their expertise in their respective specialties, and their ability to articulate their contributions regarding the care of patients is vital to their ongoing visibility. This visibility at the departmental, organizational, and systems level will be necessary in reducing the number of traditional hierarchical leadership models previously utilized in health care.

The first component of great nurse leadership is critical thinking: Nurse leaders must be action oriented and committed to advocacy. They must be able to understand the present climate and visualize future potential.¹ Leaders must share their vision with others as well as serve as a change agent for those whom they lead. Although most leadership positions are viewed as an official title, in actuality, every nurse involved in the care of oncology patients is a leader. Creating a culture of inquiry at every level of nursing is vital to a thriving environment as well as to patient-centered care. Knowledge is the second component of great leadership that is essential to daily work.¹ It is key to improving the quality and safety of care, and leaders must use their knowledge to communicate changes to vital team members. Additionally, leaders must maintain their competency in clinical practice, as well as that of their team members.¹ The knowledge needed to obtain a nursing degree will not suffice for the ongoing complexity of oncology care; continuing education, certification, and professional development will also be required to meet the necessary demands.

Certification validates specialty knowledge beyond licensure and can lead to greater outcomes.² It indicates the individual’s commitment to lifelong learning and development. For nurses like J.P., with several demonstrated years of commitment, certification can also lead to career advancements beyond bedside care.

Finally, the third component in great leadership is clinical leadership. It is essential to quality care and a healthy work environment. In the current era of fragmented health care, frontline nurses and leaders must be able to adapt to the complex needs of patients and their families. This requires integrating evidence-based practice and various partnerships across the continuum of care. The expertise and prior experience of nurses in positions of leadership are paramount to guiding clinical practice. With advanced training in evidence-based practice, nurses will be able to make pertinent inquiries and to question clinical practices through systematic approaches. Professional development councils that exist within Magnet hospitals create environments that give bedside nurses, managers, and directors an equal platform for decision-making regarding nursing practice using evidence-based principles. Extensive, formalized training such as doctor of philosophy and doctor of nursing practice programs are additional opportunities that create avenues for advancement as well as for contributions to nursing literature.

Further to J.P.’s question about great vs good leaders, his manager might add that we are all leaders regardless of position. As members of the most trusted profession for nearly 2 decades, nurses have proved themselves to be the voice for patients. They are partners when a patient receives a new diagnosis of cancer, during chemotherapy administration, when treatments do not achieve optimal outcomes, and even during the end of life. Current and future delivery of care will require ongoing self-development and engagement, as well as advocacy from bedside to boardroom.

Ultimately, great leaders are not only the clinicians who possess a title but those who have unwavering commitment to the partner, advocate, and clinical expert for the vulnerable.

References

1. Sulosaari V, Kosklin R, De Munter J. Nursing leaders as visionaries and enablers of action.Semin Oncol Nurs. 2023;39(1):151365. doi:10.1016/soncn.2022.151365
2. Halm MA. Specialty certification: a path to improving outcomes. Am J Crit Care. 2021;30(2):156-160. doi:10.4037/ajcc2021569