CLINICAL NURSE LEADER PORTFOLIO

What is a CNL? The designation of Clinical Nurse Leader (CNL) is a new nursing role recently identified by American Association of Colleges of Nursing (AACN) in order to differentiate types of educational preparedness among practitioners, and increase the number of point-of-care practitioners who are skilled in high-level competencies. A Clinical Nurse Leader is a Registered Nurse who is an advanced generalist, trained at the masters or post-masters level and equipped to implement outcomes-based practices and quality improvement measures to any type of practice environment (AACN, White Paper). This type of practitioner has an eye toward improving safety, risk reduction and cost containment for their practice environment as a whole. A Clinical Nurse Leader is also a patient advocate a proactive member of the interdisciplinary health care team who is capable of implementing the most innovative evidence-based practice to ensure better patient outcomes, use decision-making authority in overseeing the coordination of care for specific patient populations and interfacing between both microsystems and macrosystems with the goal of continual quality improvement and systems integration. Research shows institutions that have employed CNLs have enjoyed decreases in nursing turnover, increases in customer loyalty, and increased compliance with core measures (Stanley, 2008). Personal Philosophy on Nursing Nursing is an inherently collaborative profession and, often, an individual vocation in which high-skilled practioners utilize scientific evidence, critical thinking and creative approaches to deliver practical and holistic care to the community. Working in interdisciplinary teams within a variety of environments, nurses strive to promote overall wellness to all populations, advocate for social justice, and foster improvement within the systems through which they operate. A nurse must be ready to address the physical, psychological, emotional and spiritual needs of patients and families and draw upon relevant resources to promote these objectives. Ideally, a nurse should have a great degree of self-

CLINICAL NURSE LEADER PORTFOLIO awareness and be able to pool all of his or her own personal and professional experience into an established personal approach to advocacy for both individuals and the nursing profession. A competent nurse knows that he or she must continually strive to better ones self both educationally and spiritually in

order to be equipped to give the best possible care to the community in which he or she serves. Self-Assessment of Competencies from the 2007 AACN White Paper on the Education and Role of the Clinical Nurse Leader

Competencies I. Health care systems and policy

Sub-competencies - Use systems theory in the design, delivery, and evaluation of health care - Understand how health care delivery systems are organized and financed, and the effect on client care - Identify the economic, legal, and political factors that influence health care delivery - Articulate the significance of the CNL and other nursing roles to policy makers, health care providers, and consumers - Incorporate knowledge of cost factors in delivering care - Understand the effect of legal and regulatory processes on nursing practice and health care delivery

Experience Relevant UCLA-MECN Courses: 250. Ethical Issues, Social Justice, and History of Nursing; 254A & B. Theoretical Foundations of M.S.N./MECN Role and Fundamentals of Professional Nursing Lecture/Clinical Skills Practicum; 252. Health Promotion/Risk Reduction Systems: Population Level; 266. Healthcare Systems/Organizations; 267. Healthcare Policy; 268. Systems (Hospital Unit): Individual Level; 269. Quality Improvement and PopulationBased Quality of Practice Analysis of current systems and their mechanisms through readings, research papers, actual clinical experience and relevant reflection through class discussion and projects such as Identification of Clinical Unit Risk Poster (465A) and role-playing as an elderly Medicaid patient on a strict budget (465B). Relevant Experience Outside of MECN Program: Liaison between families serviced by Continuum Hospice NYC and certain providers; Assisted Beth Israel Hospitals Palliative Unit in compliance for JHACO evaluation; Laboratory and

CLINICAL NURSE LEADER PORTFOLIO

3 Grants Manager for two Biochemical Research Laboratories at the Rockefeller University

II. Communication

- Demonstrate communication skills during assessment, intervention, evaluation, and teaching - Express oneself effectively using a variety of media in a variety of contexts - Establish and maintain effective working relationships within an interdisciplinary team - Communicate confidently and effectively with other health care workers both in collegial and subordinate positions - Produce clear, accurate, and relevant writing - Appropriately, accurately, and effectively communicate with diverse groups and disciplines using a variety of strategies - Access and use data and information from a wide range of resources - Manage group processes to meet (team) objectives and complete team responsibilities

Relevant UCLA-MECN Courses: All coursework. Including, but not limited to: 174. Physical Assessment; 225A & B. Advanced Pharmacology I & II; 250. Ethical Issues, Social Justice, and History of Nursing; 252. Health Promotion/Risk Reduction Systems: Population Level; 465A & B. Foundational Concepts for Tertiary Prevention and Care of MedicalSurgical Patients and Families; 461. Mental Health Nursing; 464. Pediatric Nursing Learned to implement appropriate communication methods to a myriad of varied patient populations through cultural exploration, selfvalues assessment, numerous opportunities for group work, patient interaction in clinical rotation, numerous APA formatted writing assignments, qualitative and quantitative research assignments, Power Point presentations such as Identification of Vulnerable Populations (250) and Pharmacological video projects (225A). Relevant Experience Outside of MECN Program: Including, but not limited to: MFA in Acting from the American Conservatory Theatre; Speech Instructor and Public Speaking Coach in both corporate settings and at institutions such as Hunter College and Barnard College; Volunteer Liaison for Continuum Hospice of NYC; Facilitator for the StoryCorps Memory Initiative for patients with dementia and their families

CLINICAL NURSE LEADER PORTFOLIO III. Critical thinking - Engage in self reflection and collegial dialogue about professional practice - Engage in creative problem solving

4 Relevant UCLA-MECN Courses: All coursework. Including, but not limited to: 171. Public Health Nursing; 250. Ethical Issues, Social Justice, and History of Nursing; 269. Quality Improvement and Population-Based Quality of Practice; 465D. Human Responses to Critical Illness; 467. Clinical Internship: Integration Explored attitudes and approaches to the nursing profession and patient care relevant to microsystems, macrosystems, barriers and opportunities. Devised hypothetical and actual solutions to barriers to health through patient care plans in clinical rotation, poster presentation of potential opportunities for quality improvement on a Medical Surgical Unit at UCLA Ronald Regan (465 A&B) and several role-playing activities to simulate potential, real world conflicts.

Relevant Experience Outside of MECN Program: Including, but not limited to: 4 years experience as codirector of a non-profit arts collective, Laboratory and Grants Manager for two Biochemical Research Laboratories at the Rockefeller University

IV. Provider and manager of care

- Integrate theory and research-based knowledge from the arts, humanities, and sciences to develop a foundation for practice - Demonstrate knowledge of the importance and meaning of health and

Relevant UCLA-MECN Courses: Including, but not limited to: Clinical Internships 461 Mental Health; 462 Maternity; 464 Pediatrics; 465A & B Medical Surgical Patients - Gero; 465 D Human Responses to Critical Illness; 467 Clinical Integration Implementing foundational tools in communication, scientific core

CLINICAL NURSE LEADER PORTFOLIO illness for the patient in providing nursing care

5 course work and evidence-based research, we learned to deliver care to a varied population of patients in a variety of environments while collaborating with an interdisciplinary team. Devised care plans to improve levels of care, offered patient education to empower patients and reduce recidivism and created hypothetical models of unit structure (465 A&B). Relevant Experience Outside of MECN Program: Liaison between families serviced by Continuum Hospice NYC and certain providers; Hospice patient volunteer; Primary care provider for family member with late-stage colon cancer during chemotherapy and follow-up

V. Nurse technology and resource management

- Provide effective health teaching using appropriate materials, technologies, resources, and formats - Evaluate effectiveness of health teaching by self and others

Relevant UCLA-MECN Courses: All coursework. Including, but not limited to: 252. Health Promotion/Risk Reduction Systems: Population Level; 260 Secondary Prevention; 465A & B. Foundational Concepts for Tertiary Prevention and Care of MedicalSurgical Patients and Families United States Preventive Services Task Force iTouch application training for use in clinical settings (260); CareConnect technology training at UCLA Ronald Regan Medical Center (465B) Relevant Experience Outside of MECN Program: National Institutes of Health and American Heart Association grant submissions and grants maintenance; Assisted Beth Israel Hospitals Palliative Unit in compliance for JHACO evaluation;

VI. Member of a

- Understand the history,

Relevant UCLA-MECN Courses: All

CLINICAL NURSE LEADER PORTFOLIO profession philosophy and responsibilities of the nursing profession - Assume responsibility for the professional presentation of oneself - Advocate for professional standards of practice using organizational and political processes - Negotiate and advocate for the role of the professional nurse as an essential member of the interdisciplinary health care team - Support and mentor individuals entering into the nursing profession

6 coursework. Including, but not limited to: 171 Public Health Nursing; 254A Theoretical Foundations of Masters Entry Clinical Nurse Role Expected Registered Nursing License: 2014. Expected Clinical Nurse Leader Certification: 2014. Institute for Healthcare Improvement Certification in Introduction to Patient Safety and Fundamentals of Patient Safety: 2013. Independent Action: Collaborated with 2 other members of the MECN cohort as well as a trusted faculty mentor to create a forum with UCLASON Administration to address course sequence and learning concerns. This intervention culminated in a fireside chat with Administration and subsequent alterations to 2013- Q2 schedule. Future continuing education classes and certifications. Independent actions and readings to keep up to speed with current research and health care innovations.

VII. Lifelong learner

- Recognize the need for lifelong learning and actively pursue new knowledge and skills as ones role and the needs of the health care system evolve

CLINICAL NURSE LEADER PORTFOLIO References AACN (2007). White Paper on the Education and Role of the Clinical Nurse Leader. Stanley, J.M. et al (2008). The clinical nurse leader: a catalyst for improving quality and patient safety. J. Nurs. Manag. 16(5), 614-22.