Could I get help with this question pls?

In Huston's (2010) brief, but impressive article (required reading this week), the author outlines several leadership competencies that EVERY nurse leader will need for 2020. That year is not too far in the future, is it?

Select one of the eight leadership competencies Huston described and relate it to your own leadership of nurses and nursing. This should promote a robust discussion as we come from different clinical and nonclinical perspectives.
Discuss how the BSN-prepared nurse can assist a nurse leader in the budgeting process by contributing data readily available to the staff nurse.

WHAT SKILLS WILL THE NURSE LEADERS OF 2020 NEED?

Carol Huston - a brave new nursing world Keynote speaker at the conference, American nursing professor and former president of the international honour society of nursing, Sigma Theta Tau, Carol Huston, painted a picture of a brave new nursing world in 2020, in her opening presentation, Preparing nurse leaders for 2020. She outlined eight leadership competencies every nurse leader would need in the 2020. The first was a global perspective. "Every health care issue has to be looked at from a global perspective. We used to think pandemics were confined to developing countries. We now know they are just one short flight away." There was a more urgent need for international standards for basic nursing education. The nursing shortage was one of the most serious threats to global health, she said, and it would get significantly worse before it got better. Nurse migration was a global problem. (See news p7.) The second leadership competency was better use of technology to connect people. Technology had driven so many changes already in health care but knowledge and information acquisition and distribution was going to multiply exponentially. "Forty percent of what we know today will be obsolete in three years," Huston said. She listed a range of technological developments that would have a major impact on health care in the next 20 years. By 2030 diagnostic body scans, which could identify underlying pathology, would become part of showering. Improvements in body scanning technology would mean there would be no need for invasive surgery or tests. "Nano bots" circulating in the blood stream would identify disease processes and begin to repair them. Gene therapy would mean what was now untreatable would be treatable and could see cancer abolished completely

within two decades. Stem cell therapy would eliminate the need for organ transplants "as we will grow new organs. It is predicted we will be able to grow heart, kidneys and livers by 2020. There are already clinical trials underway growing new teeth - instead of dentures you would grow you own new teeth." Merging of the human and the machine would advance significantly and by 2020 there would be pancreatic pacemakers for diabetics and the technology to enable blind people to see and deaf people to hear. Robotics would continue to develop, with physical service robots which could wash patients and help feed and carry patients. There was the potential for the use of robots in therapeutic roles. Paro, a robotic seal developed in Japan, responded to patting by closing its eyes and moving its flippers and was already being used as a therapeutic device for those with autism and Alzheimers. Kansei (emotion) robots are being developed and are programmed so key words trigger facial expressions. Robotic simulation for nursing education provided a safer environment for students and mannequins could now cry, sweat, and become cyanotic. "The challenge for nurse leaders in 2020 will be how much simulation is too much? How important is human contact to learning the art of professional nursing?" Huston said. Other areas of development would be digital records of health care history, the continued development of biometrics, with confidentiality protected by biometric signatures, the increasing use of "smart" objects, including a bed that could call a nurse if the patient was attempting to get out of bed, or a coverlet which could take a patient's vital signs as they lay in the bed. "Nursing leaders will have to balance technology and the human element. I'm not worried about the science of nursing but I am a little worried about the art of nursing. Technology can supplement but not replace nursing care," Huston said. The third leadership competency was expert decision-making skills rooted in both empirical science and intuition. She referred to "wicked" problems, ie those with no right answers. Clinical decision support software packages will, with provider input of data, come up with a list of differential diagnoses and best practice. There would be increasing numbers of tools to help decision makers, including the opportunity to buy information and advice from expert networks of thinkers. Nurse leaders with both

right brain and left brain skills were needed and Huston suggested that nurse leaders should surround themselves with people with a different brain dominance from their own. The fourth leadership competency was the development of organisational cultures which emphasised quality patient care and worker and patient safety. "There has been an inordinate amount of money spent on medical errors but we haven't seen that greater reduction in error rates. Part of the reason is how health care systems are created." If as much energy was focused on fixing the underlying processes which caused errors as was focused on blame, much more would be learnt. "I'm not absolving individual health providers. We must find a balance between creating safer health care systems and individuals' responsibility for the care they provide." Being politically smart was the fifth leadership competency. "Nurses are the largest group of health care professionals but they are not always an integral part of health care decision making. This has something to do with how women are socialised to view power and with how they have been controlled by outside forces, notably medical and administrative. Politics can be defined as the art of using power effectively. In 2020 nursing input will be needed more than ever. Nurses must use their political skills to solve problems such as workforce shortages, turnover rates, reforming broken health care systems and bringing nursing education entry levels up to that of other professions," Huston said.

Team building skills Nurse leaders of 2020 must also have highly developed collaboration and team building skills. The key to leadership success in 2020 would be the ability to integrate the priorities of industrial age leadership, with its emphasis on productivity, and relationship age leadership. "Health in 2020 will be characterised by highly educated, multidisciplinary experts and this will complicate, not ease teamwork. The key will be to create teams of experts, not expert teams. The nurse leader will have to be a team builder." The nurse leader of 2020 must be visionary and proactive in response to an environment which will be increasingly characterised by chaos and change. "Health care organisations in the 21st century will be in a state of constant, dramatic change and will be more fluid, more flexible and more mobile. Nurse leaders in 2020 will be experts in addressing resistance

The three-day conference programme featured a plethora of speakers, including five plenary speakers. As well as Carol Huston, Michal Boyd and Debbie Gell, the other two plenary speakers were MidCentral District Health board clinical nurse specialist community, Denise White, and respiratory programme manager at Harbour Health Primary Health Organisation in Auckland, Wendy McNaughton. McNaughton spoke about the web-based asthma assessment and decision support tool, GASP (giving support to asthma patients) she was instrumental in developing and which

enables health professionals to follow the New Zealand Guidelines on asthma. She introduced her presentation with a rundown of international and national asthma statistics, including that there are 300 million sufferers worldwide, New Zealand is second only to the United Kingdom for asthma prevalence, asthma is the most common chronic condition among children, that in 2007 asthma was one of the top three avoidable hospital admissions in the Waitemata DHB region and that there are huge disparities between Mâori and non-Mâori asthma rates.

She said more than 300 GASP nurses had completed a two-day, New Zealand Qualifications Authority-accredited course based on the Asthma Foundation's course but with sections on critical thinking and how to establish nurse-led clinics added. Two GASP audits of 205 patients ranging in age from five to 64, had revealed a 76 percent decrease in hospital admissions, a 58 percent decrease in exacerbations and a 46 percent decrease in use the of oral steroids. McNaughton "implored" the government to fund nurse-led respiratory clinics. continued on p16

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