Abstract

We asked, Esther Green, Chief Nursing Officer and Director of Health Human Resource Planning, Cancer Care Ontario, Toronto, to share with us the biggest challenge that nursing leadership faces.

Esther Green is the designated leader of Patient Safety for Cancer Care Ontario's Clinical Council. She has authored a chapter titled "Building Cancer Patient Safety in the GTA" for the report to the Minister of Health on the cancer system in the GTA. Ms. Green holds academic faculty appointments at the University of Toronto and McMaster University. She received the Ontario Hospital Association 2004 Award of Excellence in Nursing Leadership at the OHA Annual Convention in November 2004.


There is an old phrase; we live in interesting times. Irrespective of how long any of us have been in healthcare, the commonality is that each year or decade has been 'interesting.' While it is important to be flexible, to understand the need for system change and suggest ways to be effective as a change agent, it is equally critical to demonstrate the impact that nurses have for patients and their families. In fact, it cannot be said enough that nurses have profound accountabilities for patient outcomes.

In these interesting times we are constantly challenged to be mindful of the many demands on the allocation of 'scarce' resources within healthcare. The ever increasing need for new diagnostic and intervention equipment, new drugs and the latest information technology regularly compete with the human resource management (nursing and others) necessary to ensure that patients and families are heard and engaged in their healthcare process. Nurses are at the forefront of this engagement and count on us, as nursing leaders to carry this perspective to the executive, board and ministry where key decisions are hammered out. There are always those who think that nurses are expendable in the system, are not 'doing' enough, or can be replaced easily by other levels of workers. But the interesting times we faced through the crisis with SARS highlighted the impact that nurses made across the system, from public health to hospital and community. Indeed, nurses were the 'heroines/heroes' at that point in time and were recognized and acknowledged for their courage and contributions. The biggest challenge in these interesting times is the ability to stay the course in the face of the constant repartee to the contrary.

Having the evidence to support decision-making is essential. There is a growing body of evidence that links nurse staffing and nursing intervention to definitive patient outcomes. Researchers have provided key information to guide our decision-making related to appropriate staffing. It is critical that we not only use the evidence, but also find ways to generate new evidence to continually validate the outcomes related to nursing.