A change agent is someone who acts as a catalyst for change. According to George Couros, world-renowned leadership consultant, people who fit this description typically have a clear vision of what they want to change; are patient yet persistent, understanding that change does not happen overnight; ask tough questions; are knowledgeable and lead by example; and develop strong relationships built on trust. This is where transformational leadership in nursing comes into play.

Transformational Leadership in NursingDepending on the profession and culture in which they reside, change agents have a particular set of skills that helps them identify what is truly worth changing (and what can actually be changed) in their profession in order to improve outcomes, services, and/or culture.

For example, modern healthcare delivery systems have become more and more complex in recent years, thus hastening the need for increased leadership in both clinical and administrative positions. Clinical nurse leaders are educated and trained to act as change agents when it comes to patient outcomes and quality of care.

A Unique and Far-Reaching Role: Transformational Leadership in Nursing

CNLs assume accountability for patient-care outcomes through the assimilation and application of evidence-based information to design, implement and evaluate patient-care processes and models of care delivery. They also act as providers and managers of care at the point of care to patients anywhere healthcare is delivered. As change agents, they use these unique competencies in a variety of healthcare settings to improve outcomes.

In a Hartford Business.com article, Lynn Babington, Dean and Professor, School of Nursing, Fairfield University, stressed that keeping pace with the demands of today’s changing healthcare environment requires clinical experts who have the knowledge and skills to be effective and practical change agents. “In order for nurses to provide high-quality, cost-effective, evidence-based care to patients and their families,” she added, “they need the knowledge and skills to be able to use research to guide their practice, communication skills to be effective patient advocates, and critical thinking skills to navigate the healthcare system.”

Master’s-prepared, advanced-generalist registered nurses, CNLs have all of the advanced practice skills and knowledge that Babington refers to in the article. Clinicians who provide care with an emphasis on health promotion and risk-reduction services, they also act as client advocates who ensure that clients, families and communities are well informed. As educators, CNLs make use of all available technology to teach clients and healthcare professionals using evidence-based principles and strategies. As lifelong learners and valuable members of a profession, they recognize the value of the pursuit of knowledge and skills in order to change healthcare practices and outcomes.

CNLs Leading Change

Based on their education and experience, CNLs can assume a variety of roles that all include the important responsibility of acting as change agent perform transformational leadership in nursing. These roles include as advanced nursing coordinators, central authorization unit managers, clinical education coordinators, directors of performance improvement, directors of development, evidence-based practice specialists, nurse innovators, nurse navigators, patient care resource managers, quality review coordinators, and unit coordinators.

In 2009, a few years after the CNL role was created and implemented, Susan Hassmiller, Ph.D., R.N, F.A.A.N., commented that the clinical nurse leader role shows “enormous promise” in redesigning the way healthcare is delivered. She called the role a “marvelous experiment that places decision-making in the hands of people who work at the bedside and know how patient care is delivered.”

Eight years later, the effectiveness of CNLs in a variety of healthcare delivery settings has proven that the “experiment” has worked. CNLs have functioned as catalysts and planners for change when it comes to patient safety and outcomes. Their clinical expertise, theoretical knowledge, and commitment to the outcome of the change project have empowered them to successfully assess, plan, implement, and evaluate the change process.