Welcome to the Nursing Outlook Blog – “3 Questions” – Timely Interviews with Thought Leaders in Nursing and Health Care Policy

2016 American Academy of Nursing Living Legend – Linda Burnes Bolton

Dr. Linda Burnes Bolton was the President of the American Academy of Nursing (AAN). In 2016, she was recognized with the AAN’s “Living Legend Award” for her many contributions in nursing and her extraordinary leadership roles including as the President of the National Black Nurses Association and is a Member of the California Strategic Planning for Nursing Committee on Diversity, the Institute for Nursing and Health Care and the National Advisory Council on Nursing Education and Practice. Among her many appointments including chairing the Veterans Nursing Commission at the request of the U.S. Congress, and among other board appointments including the Robert Wood Johnson Foundation (RWJF), Dr. Bolton served as vice chair of the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine (IOM). This report has been one of the most influential documents of our time.

For over 20 years, Dr. Bolton has played a vital leadership role in raising issues of diversification in nursing education and practice. Her expertise includes nursing and patient care outcomes, cultural diversity and inclusion within the health professions, and population health.

We asked Dr. Bolton to inform us on what problems she believes are most likely to impact nursing and healthcare. Her numerous leadership recognitions make her an outstanding role model for aspiring nurse leaders on the major issues facing nursing leadership today. She points to several major issues and followed up with solutions to engage nurses in team science to achieve a “Culture of Health,” part of the RWJF vision and framework for improving health, equity and well-being in America.

Veronica D. Feeg, PhD, RN, FAAN

We invite commentary that is thoughtful and provocative! Join the online dialogue

Linda Burnes Bolton,  DrPH, RN, FAAN
Chief Nursing Office and
Vice President of Cedars Sinai Health System and Research Institute
Los Angeles, CA

Question 1. What are the major issues facing nursing leadership now and over the next five years?

The top three issues facing nursing leadership are in some ways similar to the issues that we have faced in the last 20 years, and that is: how do we meet demands? What is different in terms of meeting demand, is that we are more focused on: how do we meet health needs as just acute care needs? And to meet health needs, we are going to need to have a workforce that is perhaps more prepared to deliver clinical care and to be part of the team of individuals that are helping to engage consumers as equal partners in healthcare. That’s different from the demand that was focused on how many critical care nurses you have or how many pediatric nurses you have. It’s really, we will need more nurses engaged in this work of population health management.

The second issue has to do with: how do we place the leadership talent? If you look at the aging of the nursing workforce, we are coming to a period of time when a solid 20% of the workforce might be leaving and those are the individuals who have the most knowledge and the most experience. So, the aging of the workforce is a concern and how do we deal with that concern is to make sure that we have a pipeline of people who are ready to take our places to succeed us. And in that succession, it may not be exactly how the way we have done it and it and how we have performed as nurse leaders, but they will be prepared to rethink – what does it mean to be a leader in a broader perspective in terms of being part of teams?

Question 2. How can nurse leaders advance the engagement of other health professionals to promote team science?

Team science is very important in terms of achieving health goals. It’s going to take more than nurses to achieve those health goals. We may have the most volume of health professionals, you know we are the largest group, but like trying to describe a camel and having three blind men, each having their hands on different parts of the body, that’s exactly how it is in relationship to this work of engagement of other health professionals. Each comes with their own body of knowledge. Let’s take physical therapists as an example. The work that we’re doing to try to get more movement, physical movement, of consumers as a way of not only treating health issues that have arisen, but preventing health issues. Wow, getting nursing and physical therapists together as team members and adding a podiatrist, a physician member, adding someone who is an expert in looking at different ways of conditioning one’s self. What a great team to be able to address the staggering information that we’re continuing to receive about how little people are engaged in walking, running and other types of physical actives. So that’s just one example.

Another example has to do with the whole issue of science itself. So, on the road to discovery, it’s not something that should be just left to one particular clinician – so not just nurses. But how do nurses discover with physicians? How do the nurses discover with consumers? How do they discover with health educators? So, promoting team science is critical to the engagement of health professionals and to what aim? Because we will have better patient care outcomes, that’s the work that nurse leaders should be pushing forward.

Question 3. How do we promote more consumer engagement in achieving a “Culture of Health”?

The work of health and health professionals is aimed at trying to improve outcomes for consumers. One of the things we haven’t done as good a job as we possibly could, is adopting what Dr. Don Berwick said as he created and lead the Institute for Healthcare Improvement. When you’re talking about you want to do something to improve how people are assisted, how we prevent illness, how do we help individuals? – “Nothing about me without me!” So that’s his famous statement. If we can’t hope to achieve a culture of health where everyone has the possibility to achieve and sustain health; regardless of their age, sex, their ethnicity, their sexual preferences; regardless of the income distribution. We can’t hope to achieve that for everyone without engaging the individuals who would benefit. So, consumer engagement is essential to achieving a culture of health. We can’t decide that health – just as health professionals identify it – is the right thing to do. It has to be done with consumers and with consumers focused on not just diversity, but inclusion. They’re a part of the discovery of the answers to the question: how to we achieve a culture of health?