Running head: NURSING'S LEADERSHIP ROLE IN POPULATION BASED

Nursing's Leadership Role in Population Based Issues Shannon Sheffer Ferris State University

NURSING'S LEADERSHIP ROLE IN POPULATION BASED Abstract Teen pregnancy among the 15-19 year olds continues to be a concern in Kent County, Michigan where the average teen pregnancy rate is higher than the state average. Nurses play crucial roles in assisting these teens in the prevention of pregnancy and promotion of birth control or abstinence. School health nurses are in direct contact with these at risk teens and their families.

Other nurses impacting these teens are those in influential positions such as directors, executives, or political heads. Nursing director of Michigans Teen Pregnancy Prevention Initiative will be an important piece of helping secure funding, raising awareness, and continual monitoring of progress at the state level in helping reduce and prevent teen pregnancy.

NURSING'S LEADERSHIP ROLE IN POPULATION BASED Nursing's Leadership Role in Population Based Issues

Nurses have profound and varied roles in the field of healthcare. One of the primary goals of a nurse is to safely guide the patient towards a healthy and happy life. The topic my group chose for the community change proposal project focuses on teen pregnancy. Specifically, the theme of our group project discusses teen pregnancy prevention for teens 15-19 years old in Kent County, Michigan. Preventing teen pregnancy has been a concern for decades nationwide. Kent Countys teen pregnancy rates of 61.5/1000 are higher than Michigans average of 53.1/1000, making it an area of needed help and focus. Several agencies must be involved in collaborating interventions to help teens with the prevention of pregnancy. Nurses in direct contact with at risk teens may include a school nurse or public health nurse. These nurses work to create learning material and programs that teens can utilize for success. Another organization involved would be the Michigan Teen Pregnancy Prevention Initiative. The nursing director of this program would play an important role in program success through acquiring and safeguarding funds, forming and supporting education programs, and reporting data findings to state officials. Role of Direct Contact Nurse Nurses serve many roles in the prevention of teen pregnancy. Nurses with direct involvement with these at risk teens include school nurses and public health nurses. These nurses have become the educators, counselors, and mentor to these teens. According to an article written by Porter and Holness, approximately 98% of all junior and senior high schools provide teen pregnancy prevention programs that are taught by school nurses. Other school-based programs incorporate the school district, community hospital, and local health department to develop interventions on advocacy, case management, collaboration, health teaching, referral and

NURSING'S LEADERSHIP ROLE IN POPULATION BASED follow-up for teen mothers (2011). These programs together have helped decrease and prevent teen pregnancy over the last decade. The role of the school nurse has many different facets. The primary goal is to support

students of all ages. The school nurse can accomplish this by promoting health and safety. Some aspects of the school nurse include education, counseling community involvement, health services, and support system to teens (Nurse for a Healthier Tomorrow Career Info, 2012). School nurses have the opportunities to create educational programs to implement in the schools which educate students on abstinence, pregnancy prevention, sexual health, and sexual transmitted diseases. In collaboration with public health nurses and organizations such as Planned Parenthood and Michigan Teen Pregnancy Prevention Initiative to make sure all education and counseling is up-to-date and age appropriate. Community health fairs and support groups would need to be organized and include the community members and teens that are not in school. The involvement of school nurses in Kent County and members of the community would cement the success of these organizations and educational programs. Leadership Role Characteristics School and public health nurses need to possess leadership skills such as motivating, managing, achieving workable unity, and explaining data to others (Kearney-Nunnery, 2008). I believe the school nurse of Kent County has the opportunity to play an active and substantial role in supporting and educating teens on the prevention of pregnancy. The nurse employed by the school has the change to research and be knowledgeable about a variety of sexuality issues and the long term effects they have on both teen and their families. The nurse is responsible for providing education and counseling to the teen women. These can be accomplished through one on one conversation, group activities, newsletters, emails, blog postings, or educational seminars

NURSING'S LEADERSHIP ROLE IN POPULATION BASED and fairs. The Kent County school nurse is also responsible for building bonds with community members such as other healthcare providers, in an effort to provide a complete, comprehensive educational guide for these teens. Nurses need to be caring, non-judgmental, compassionate, and committed to teens and excellent communicators. The direct contact nurse will also need to possess outstanding leadership skills to communicate and head local committees and organizations. Strength in research is also a necessity to help analyze data for local and national trends. This leader motivates and inspires the teen population while still listening to concerns and averting possible obstacles. American Nurses Association Standards of Professional Practice The American Nurses Association (ANA) has established a set of nursing practice

standards which are utilized to aid a nurses daily practice. According to Harkness and DeMarco (2012), there are eight specific principles of practice to help aid in the advancement of the nursing specialty while providing benefits to both nurse and patient. One of these principles is cultural competency. School nurses will need to identify cultural barriers and come up with a plan to successfully adapt the information on preventing teen pregnancy in those teenage years to a multitude of different cultural and ethnical students. Public health nurses, I believe, need to have excellent communication, leadership, and an eye for the global view on the organization and community. Role of Management Nurse I believe the best nurse suited to oversee, lead, direct, and evoke change would be the nursing director of the Michigan Teen Pregnancy Prevention Initiative program. This job entails some of the same fundamental cornerstones as the school or public health nurse in preventing

NURSING'S LEADERSHIP ROLE IN POPULATION BASED

teenage pregnancy. This nursing director would be able to review the research on teen pregnancy rates, see how receptive and beneficial existing programs have been, and creating new educational programs. They also would secure funds for allocation to teen pregnancy prevention programs. The Teen Pregnancy Prevention Initiative (TPPI) of Michigan was created by the Department of Community Health. TPPI programming consists of the implementation of comprehensive, evidence-based interventions that target the sexual and non-sexual factors that lead to delayed initiation of sex and increased condom or other contraception use (State of Michigan, 2009). A nursing director working for the TPPI would be able to secure funds, provide a comprehensive view of the program and agencies, be able to review data and alter programs, and be able to communicate program outcomes and progress to community members and officials. Leadership Characteristics The TPPI nursing director must be a decision maker, committed to the cause and effective. This nurse needs to be focused on county and statewide data, becoming the bridge from direct care nursing to the government. It is imperative that the nursing director be very knowledgeable and versed in preventing teen pregnancy since they will be the ones battling for funding and raising awareness among politicians. Drive, ambition, unparalleled communication skills, and tenacity are all attributes a nursing director of TPPI should encompass. American Nurses Association Standards of Professional Practice The nursing director of TPPI adheres to the same standards and expectations as the school nurse or public health nurse. The nursing director needs to be an advocate with decision-

NURSING'S LEADERSHIP ROLE IN POPULATION BASED makers to influence public health policies, programs, and services to promote healthy populations (ANA, 2007). Analysis

The objective of reducing teen pregnancy rates is a goal of both direct contact nurses and nursing directors. There are several ways in which the direct contact nurse and the nurse leader roles share characteristics. First of all, both roles require stellar communication skills. The direct contact nurse will need to utilize these skills in discussions with teens as well as collaborating health professionals. The nurse leader will also need to hone her skills for communication; generally for speaking with other health professionals as well as program directors and administrative leaders. In addition, both types of nurses will need to be passionate about helping at risk teens and the prevention of pregnancy. They both must have a non-judgmental demeanor and be understanding of the population with which they are working. Just as the two nursing roles share similarities, they also share differences. I believe the primary dissimilarity lies in the education needed to be successful in each role. As a school nurse, I believe that a Bachelors Degree in Nursing would suffice for the duties required for the position. However, I believe that the nursing director is responsible for managerial type of issues. This profession is most likely suited for a nurse who has completed their Masters Degree in Nursing. The school nurse is responsible for working directly with the students, families, and faculty. This nurse will have a primary impact as they are working on a daily basis to encourage, understand, respect, and educate teens on the prevention of pregnancy. In contrast, I believe the TPPI nursing directors role is secondary; they are behind the scenes in a supervisory role. This nurse is responsible for compiling facts and figures related to teen pregnancy as well as the

NURSING'S LEADERSHIP ROLE IN POPULATION BASED prevalence in each county in the state. I believe this nurse also utilizes research to determine the successfulness of certain interventions like education, support groups, or public health fairs in order to recommend these advances to other county public health programs within the state. Reflection I believe my current nursing skills provide me with the knowledge to perform certain

tasks within each nursing role. As a registered nurse, I believe that I am organized and have good collaboration and team building skills needed for the nurse leader. In light of the information above, I believe my current skill set would be most appropriate for the direct contact nurse. I came to this decision as a result of two different facts. First of all, my current education level is an associates degree. As stated before, I believe the nurse leader needs to hold a masters degree. Secondly, I do not like confrontations or possess strong leadership skills. My talent does not lie in making speeches to committees of board members or making important decisions for multiple people. If I were to become a nursing leader, I would need to be mentored in the ways of negotiation and sharpen my communication skills. I believe that each individual nurse is gifted with a certain skill or skills that benefit the nursing profession and the patient population. Some nurses may be excellent communicators while others may excel at physical assessments. From there, the nurse needs to refine and enhance the natural skills and dedicate extra time to work on improving the skills that are less easy. This will improve the nurse as a whole, making them a skill driven nurse for the future.

NURSING'S LEADERSHIP ROLE IN POPULATION BASED Reference: American Nurses Association (2012). Professional standards. Retrieved from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/ NursingStandards. Harkness, G.A., & DeMarco, R.F (2012). Community and Public Health Nursing: Evidence for Practice. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing. (4th ed.) Philadelphia, PA: F.A. Davis Company. Michigan Public Health Institute. (2011). Kent County 2011 community health needs assessment and health profile. Retrieved from www.kentcountychna.org/pdfs/healthprofile.pdf Nurses for a Healthier Tomorrow Career Info (2012). School nurse. Retrieved from http://www.nursesource.org/school/html Porter, L.S., & Holness, N.A. (2011). Breaking the repeat teen pregnancy cycle. Nursing for Womens Health, 15(5), 368-381. Dio:10.1111/j.1751-486X.2011.01661.x State of Michigan. (2009) Division of family and community health adolescent and school health unit teen pregnancy prevention initiative program profile report. Retrieved from http://www.michigan.gove/documents/mdch/TPPI_Programs_Profile_208999_7.pdf