We must be actors in changing healthcare, not just observers.
A nurse leader from Turkey shares her vision for improving patient safety and encourages readers not to underestimate their leadership and influence.
Worldwide, patient safety is a serious public health issue. According to the World Health Organization, in developed countries, as many as 1 in 10 patients are harmed while receiving hospital care. At any given time, seven of every 100 patients in developed countries and 10 of every 100 patients in developing countries will acquire healthcare-associated infections that affect hundreds of millions every year. Thus, patient safety has become a primary concern of healthcare organizations and a precondition for high-quality, productive, and cost-effective services.
In recent decades, major changes in healthcare systems have occurred in Turkey, and the government has published plans to implement a health transformation program that makes patient safety a priority. The Ministry of Health developed Hospital Health Services standards and established an accreditation process. The Joint Commission has accredited many private hospitals as well as a large university hospital. Although it is a great pleasure to see collective action result in higher quality and safer patient care, there are still problems to overcome. Studies show that when nurse perception of the importance of patient care is low, there are more frequent medication errors and increased incidence of decubitus ulcers and urinary tract infections.
Nursing leadership pivotal to safe patient care
Provision of safe and high-quality patient care is achieved by establishing a culture of patient safety. To do so requires robust leadership, and nursing leadership is pivotal to delivery of safe patient care. Nurses, therefore, need to have a supportive and coordinating role in ensuring patient safety.
Unfortunately, many nurses underestimate their power and ability to influence changes that need to be made. They don’t see themselves as leaders or captains on the world healthcare ship. Many don’t believe they can make a difference. In my studies, I observed that many nurses believe that only physicians are leaders when it comes to healthcare services. But I believe nurses do have power to impact healthcare and make a difference! What do nurses need to prepare for this crucial role? Education, training, and support.
My leadership journey
After graduating from nursing school, I started working as a community health nurse. It was a great opportunity for me to impact lives and, together with other healthcare professionals—primary physicians and midwives—make a difference. There were many healthcare problems, and leadership was needed to improve services. Thanks to effective leadership, we secured public support and involvement in providing primary healthcare services by establishing a local council to determine priorities and identify necessary steps. By being involved in their healthcare, people in the community found their voice and became active partners with professionals.
I found many other opportunities to be a leader in achieving better healthcare—and, sometimes, a follower. For example, I worked for the Ministry of Health in coordinating nurses’ in-service education. The objective was to ensure effective in-service training and continuing education throughout Turkey with the aim of providing high-quality and safe patient care. We also worked to develop strategic objectives to accommodate current and future needs in nursing education. In this capacity, I also developed and implemented transformational leadership programs for unit charge nurses and mentored nurse managers in the development of unit-based change projects.
Since 2001, I have been a member of the Hacettepe University Faculty of Nursing. This has been another leadership journey for me. It is a great opportunity to educate future nurse leaders who will impact lives and make significant differences in healthcare. My primary goal is to educate them in the use of evidence-based teaching. I also try to be a good role model for them.
A lifelong journey
As nurse educators, we need to encourage our students to adopt different perspectives on leadership—to believe they can make a difference—and we are providing many opportunities to promote that, such as study abroad and interprofessional education. Kouzes and Posner (2003) point out that the best way to learn about leadership is through good education, role models, and experience. During my professional career, I have had good educational opportunities, role models, and many leadership experiences. But this is a journey, and it will never end because I am committed to lifelong learning to become a more effective nurse leader and educator.
Around the world, healthcare needs nurse leaders to provide high-quality and safe patient care. As nurse educators, we have a responsibility to prepare nurses to lead in the future and make a difference in global healthcare. The key to creating that future is to know where we are going. As nurses, we must always know our destination. That is vision!
Then we must decide how we will reach our destination and how to act when we get there. It is not easy, but it is also not difficult! As nurses and nurse educators, we must be actors in changing healthcare, not just observers. That’s how to create the impact we need and want to make.
Here are a few questions for you to think about. In the past, my mentors asked me these questions, and now I am posing these questions to my students and other nurses. Your carefully considered answers will help you reach your destination and promote safe, high-quality nursing care.
- What if all possibilities were open to you for being an effective leader and a champion for patient safety on your healthcare team?
- What if you could walk into the future as a fully empowered nurse leader?
- How do you want to describe yourself in the future?
- What new possibilities do you see for providing safe, high-quality patient care? RNL
Editor’s note: Sergül Duygulu will present “Nurses’ Perceptions of Patient Safety Culture and the Transformational Leadership Practices of Unit Charge Nurses” on Sunday, 29 October, at the 44th Biennial Convention in Indianapolis, Indiana, USA. See the Virginia Henderson Global Nursing e-Repository for additional information.
Sergül Duygulu, PhD, RN, is associate professor, Hacettepe University Faculty of Nursing, Ankara, Turkey.
Kouzes, J.M., & Posner, B.Z. (2003). The leadership challenge (3rd ed.). San Francisco, CA: Jossey-Bass.