This is part 15 of the Nursing Research Challenge.

The Article: Sherman, R. O. (2010). Lessons in innovation: Role transition experiences of clinical nurse leaders. The Journal of Nursing Administration, 40(12): 547-554.

Big Idea: This qualitative study researched 71 nurses as they pioneered the Clinical Nurse Leader (CNL) role, which premiered in 2004 as the first new role within the nursing profession in nearly 40 years. The CNL is a master’s-prepared, certified nurse, and the “role was designed to address many concerns related to patient care in the current healthcare system…includ[ing] a need for more effective clinical problem solving, better coordination at the point of care, stronger interdisciplinary relationships, and more rapid implementation of evidence-based practice findings at the patient-provider interface” (p. 547). I had to quote from the article regarding the CNL role purpose because it is still very new to me and, honestly, still a bit unclear in my mind, which is why I was drawn to this article. One thing is for certain, the CNL is meant to be a dynamo bedside nurse, reporting to either a nurse manager, a director, or straight to the Chief Nursing Officer.

Survey Says!: Five themes emerged from the telephone interviews with the nurse pioneers – staying at the bedside, explaining who we are, keeping things from falling through the cracks, proving our value, and cautious about the future. Being a qualitative study, there are some great quotes from CNLs as they introduced the new role into their respective organizations – what worked, what didn’t, barriers, successes, ongoing challenges, etc.

Quotable: “As with every new innovation, the introduction of the CNL role has not been without controversy. Critics from both academic and practice settings questioned the need and wisdom of introducing a new role to the profession at this time” (p. 548).

“Most CNLs in this study wished that a better job had been done at the organizational level to introduce the role more effectively and redesign care to facilitate the innovation. In organizations that were highly successful with the innovation from the CNL perspective, the involvement of the CNO and unit manager as champions of change was a key factor” (p. 553).

So What?: The CNL role is still in its infancy within our profession. It is just now starting to be studied in regards to outcomes, and it is showing promising results, improving patient care and employee satisfaction. Still, more long-term studies are needed. The article discusses key points about the CNL role including the concern for overlap with the CNS role, and I highly recommend it to all considering incorporating the CNS role within their organizations or anyone wanting to learn more about the innovative role.