Registed Nurses' Association of Ontario

Point-of-care nursing: A learning journey

Connie Wood, RN BScN MN

I love listening to and sharing stories about leadership. Do you ever wonder if you are an effective leader? With that question in mind, I decided to make developing my leadership skills a learning goal.

I am a registered nurse, and have been for more than 40 years. These years of experience have given me a chance to observe and reflect on different leadership styles. I have worked with some stellar leaders and some not so strong.

While I was teaching in the Trent/Fleming School of Nursing program, it dawned on me; I was in a solid position to influence a new generation of nursing leaders. It was then I developed a plan to enhance my leadership skills.

Do you ever wonder if you are an effective leader?

To help achieve my goal, I worked my way through the RNAO best practice guideline (BPG), Developing and Sustaining Nursing Leadership. I chose this particular guideline because it highlights evidence-based leadership behaviour for nurses who are in both formal and informal leadership roles.

My learning journey using the BPG made me more aware of different styles of leadership. As I read about a style called “transformational leadership,” it sounded familiar. A CEO I previously worked for and respected used this style. He had a way of connecting during his conversations with staff. He had a vision for the organization and he always inspired staff to be their best. The guideline outlined the skills it took to be a transformational leader, and I remembered my old boss. In that moment, I realized I wanted to keep learning, because a registered nurse is expected to lead, regardless of a title or position.

A registered nurse is expected to lead, regardless of a title or position.

When I initially came across the term “point-of-care leadership” in the guideline, I admit I didn't know what it was. In fact, this was the first time I'd even heard of it. As I read on, the guideline taught me what makes point-of-care leadership unique from other types of leadership. I learned that every time a nurse was making clinical decisions about the treatment of pain or pressure injuries, providing oral care, and using evidence-based interventions, that nurse was leading. This taught me to be mindful of modeling my leadership behaviours, and to be active in advocating for high quality and safe care practices.

Through my learning journey, I learned about five evidence-based practices to help point-of-care nurses become transformational leaders:

  1. Build relationships and trust.
  2. Empower others by providing encouragement, tools and authority. This enables colleagues, families and patients to use their power, talents and abilities effectively.
  3. Support knowledge development and integration by encouraging knowledge sharing. It means being challenged to ask good questions, to design effective care strategies and carefully craft health messaging. This will inspire a continuous-inquiry approach.
  4. Manage change by shifting your way of thinking to apply evidence to change initiatives.
  5. Balance it all by managing conflicting priorities. Work safely by basing your care on evidence and be proactive by having healthy conversations.

These lessons really resonated with me. It is important stuff. I started thinking back to my learning plan. Yes, leadership behaviours are expected of all nurses regardless of their title or position, and a good first step toward being a leader in all roles is to learn about point-of-care leadership.

Strong leadership at the point of care has a positive impact on clinical practice and work environments, and the Developing and Sustaining Nursing Leadership BPG is a great resource for all nurses. I encourage you to develop your skills and celebrate how powerful you are.