Thompson Pamela A
American Organization of Nurse Executives, Washington, DC 20004, USA.
J Nurs Manag. 2008 Nov;16(8):912-4. doi: 10.1111/j.1365-2834.2008.00951.x.
What are the key challenges facing nurse leaders in the United States? To find out, I asked 20 prominent nurse leaders to respond to that question and tell me their top three issues. Their voices tell a compelling story on challenges faced by the nurse leaders in American healthcare. The focus is no longer just on the process of how care is delivered, but on the outcomes of that care. More attention is being given to documenting that the care is provided according to specific standards associated with better outcomes. Many of the standards are directly related to the care given by nurses, including some indicators that are specifically sensitive to nurse intervention. There is also a new focus on federal reporting of patient satisfaction with the services provide. Producing quality outcomes, high patient satisfaction and effective measurements of both are now a central theme for the entire hospital administrative team. For the nurse leader, however, it represents explicit accountability for managing and leading the staff responsible for providing the patient care. Safety and quality issues are directly linked to financial pressure. Reimbursement for hospital is being whittled away as financial accountability for services receives greater scrutiny from the federal government and private insurers. Close on the heels of the financial challenge is the ever present workforce shortage. The most troublesome challenge identified by these nurse leaders is the absence of an adequate pipeline for nursing leaders. It is an exciting time for nursing in the United States. Challenges to be sure, but these nurse leaders have identified the priorities that will create a successful future.
美国护士领导者面临的关键挑战有哪些？为了找到答案，我询问了20位杰出的护士领导者回答这个问题，并告诉我他们认为的三大问题。他们的声音讲述了美国医疗保健领域护士领导者所面临挑战的引人入胜的故事。重点不再仅仅是护理提供过程，而是护理的结果。人们越来越关注记录护理是按照与更好结果相关的特定标准提供的。许多标准与护士提供的护理直接相关，包括一些对护士干预特别敏感的指标。此外，还新关注了联邦政府对患者对所提供服务满意度的报告。产生高质量结果、高患者满意度以及对两者进行有效衡量，现在是整个医院行政团队的核心主题。然而，对于护士领导者来说，这意味着对管理和领导负责提供患者护理的员工有着明确的问责制。安全和质量问题与财务压力直接相关。随着联邦政府和私人保险公司对服务财务问责制的审查日益严格，医院的报销费用正在被削减。紧随财务挑战而来的是一直存在的劳动力短缺问题。这些护士领导者确定的最棘手挑战是缺乏足够的护理领导者人才储备。对美国的护理行业来说，这是一个令人兴奋的时代。当然存在挑战，但这些护士领导者已经确定了将创造成功未来的优先事项。
