For most CNLs no two days are the same. Check out what a daily routine may look like for a Clinical Nurse Leader. Since the Clinical Nurse Leaders role is one of a generalist, CNLs can have a variety of routines and perform a variety of different tasks in one day. This article will help you better understand Nurse Leaders of today.
Many CNLs work in inpatient care, but CNLs have also been known to work in out-patient care as well. Most facilities will have them work either 3/12s a week or 5/8s. This is a position of leadership, so usually the schedule will dictate that. But no matter what the shift or where a CNL works, one thing remains constant; CNLs are there to help improve quality care and patient safety. (Stanley, Gannon, Gabaut, & Burch, 2008)
Beginning of the Shift
When arriving at shift change it is always very important to educate yourself about what is going on in your department. A thorough analysis of patient’s electronic charts is needed first. Next a Clinical Nurse Leader reviews all labs, vitals, test, and any changes from overnight. A CNL never wants to be caught off guard. They want to know what is happening with all their patients in the microsystem in which they work. You are the leader in your department and people will be coming to you for resources and information.
Best practices for a CNL include hosting an initial huddle with the staff. This huddle is a great way to exchange announcements, updates, and to also convey important information about best practices. This is a wonderful way to brainstorm as a group and to plan out the day. Once the nursing staff has been updated it is great to pull each of the nurses aside after the meeting to understand each of their patient’s cases. A CNL has to designate time to patients, especially the creative or unique problem cases. So understanding which patients may need your time is a must from CNLs. The earlier that a CNL knows that they are needed the better chance a patient will have to recover swiftly. But because the needs of a CNL extend further than the floor, it is imperative to ensure that all communication methods are in place for a CNL to keep her finger on the pulse of her department.
Once measures of communication have occurred it is best to do your rounds with doctors if possible in your microsystem. This furthers the importance of understanding the department in which you work. By shadowing and working side by side with the doctors in your department a CNL can develop new training ideas and have a complete understanding of what their department needs. This also gives the CNL a chance to show off their advanced assessment techniques and evidence-based practice techniques. This sometimes is the one step in the morning that has to be pushed back. This is a nice chance to network and to see patients, but just like every nursing role, your time is not easily scripted.
The middle of a CNLs shift consists of proper planning and strategy for the patients. Discharge plans are put in motion usually around this time. A lot has to go into discharge plans. A solid education plan has to go into effect for the patients and their caregivers. They must have a solid understanding of proper pain management so that they don’t abuse any prescriptions. They need to understand about any physical, speech, occupational and clinical therapy routines or follow-ups needed with doctors. Working with case managers and discharge planners can assist with these steps. Once discharge plans are in place, then CNLs can turn to the preparation portion of their day.
One last thing about the middle of the shift for a CNL- they don’t expect a scheduled lunch break. As clinicians would expect, your break (if any) is decided by when things are calm for you at work.
End of the Shift
A CNL is a resource to its entire staff to find research, protocols, and teaching material. Usually in the end of a shift, barring any emergency situations with patients, a CNL will review notes about the day and look for trends in the department. They will then start to prepare any teaching material to help relay to the staff to help improve the microsystem. CNLs are educators, as well as clinicians, so they are usually in charge of creating or implementing the training for departments.
There are also a variety of administrative meetings that a CNL may be asked to join in on. CNLs are not the administrators hosting the meetings but are the voice to the floor or microsystem they work in. Administrators often come to CNLs to ask for input when creating new protocol or policies. A Clinical Nurse Leaders is the conduit between the floor and administrative offices.
Lastly, CNLs will prepare for the next rotation of nurses that are starting their shifts. They will review all discharges, needs of the facility, and any incoming patients. The more prepared they are, and the nurses are around them, the better the results. “The CNL is also the guardian of the nursing profession, always supporting fellow nurses and seeking new knowledge by looking for the best evidenced-based practice. The role reviews the quality of care and seeks to understand how to continue improving it for patient safety and the best outcomes.” (Hosseini, 2013)
We hope this article provided you with perspective on a typical day is for some nurse leaders of today.
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Hosseini, C. (2013, July 22). Day in the Life of a Clinical Nurse Leader. Retrieved December 27, 2016, from http://www.queens.edu/News-and-Information/Day-in-the-Life-of-a-Clinical-Nurse-Leader.html
Stanley, J. M., Gannon, J., Gabuat, J., & Burch, D. (2008, August). The clinical nurse leader: A catalyst for improving quality and patient safety. Retrieved December 27, 2016, from https://www.researchgate.net/publication/5297656_The_clinical_nurse_leader_A_catalyst_for_improving_quality_and_patient_safety