Nursing administration is considered a specialty in nursing.

It takes certain
characteristics to be able to successfully lead an organization. They must be able to
communicate with people in various disciplines to keep the organization working
as a whole. This paper will discuss the scope of practice of a nursing administrator
and the history of how it evolved, and also different characteristics and leadership
skills that a nursing administrator must have.  It will also discuss the domains of
competencies and my own strengths and weaknesses.

Nursing administrators are dedicated to the “design, facilitation, supervision, and

evaluation of systems that educate and/or employ nurses.” He or she is a registered
nurse who chooses nurse administration as a specialty. “Nursing administration
combines leadership practices and values to influence the future, oversee
healthcare service delivery, inspire clinical practitioners, and promote the health
and safety of individuals, families and significant others, groups, communities, and
populations,” (American Nurses Association, 2009). This specialty, as an art,
encourages positive outcomes by creating and nurturing a healthy work
environment by: keeping plenty of resources, leading and encouraging change, and
working with key partners and stakeholders. Nursing administration is also
considered a science due to the fact that uses science with evidence-based practice
to ensure patients are receiving the best care. It uses concepts from leadership,
business, and public policy to achieve the best outcomes for the healthcare system
(American Nurses Association, 2009).

Like nursing, nursing administration can be traced back to Florence Nightingale in

the 1850s when she implemented changes in nursing by observing patients, and
then collecting and analyzing outcome data. After the Crimean War, she returned
to England and continued her studies of the health of the British army and
collecting and analyzing data. Using Nightingale’s work, groups such as the Sisters
of Charity or Sisters of Mercy visited sick patients in their homes and establishing
hospitals, this helped control disease outbreaks in America (American Nurses
Association, 2009).

Nurse administrators can work in a variety of places. Nursing schools need nurse
administrators (program directors and deans) to lead nursing programs so that we
can get new nurses into practice. There are nursing administrators in public health
nursing, this started in 1893 when Lillian Wald and Mary Brewster started a
program based on immigrant populations and then sent nurses into public schools
in 1902. This started public health departments forming in different states. There
are also administrators in hospitals; in the 1930s nursing administration was first
recognized as a specialty and the “rise of hospitals and the development of a
hierarchical structure in health care advanced the development of nursing
administration practice,” (American Nurses Association, 2009).

We need nurse administrators because their influences stretch far beyond that of
just nursing. They collaborate with all stakeholders, system wide to create the
mission of the organization while upholding the unique perspective of nursing. The
administrator has a big responsibility in that they are held accountable as to
whether or not their organization is providing standard, safe, and cost-effective
nursing practice across the healthcare system (American Nurses Association,
2009).

Nursing administration is a difficult job to have. Someone in this role must have
certain characteristics that make them able to be respected by staff members. There
are four main characteristics that make a respectable nurse administrator. The first
is that of a “super integrator.” This trait means that this person can successfully
align nursing practice, technology, and information and have a successfully
running together over an entire system. They are self-motivated, ambitious, and
determined (Crawford & Spicer, 2017). The second important trait of a Chief
Nurse Executive (CNE) is that they are strategic and goal-driven. They must focus
on making a difference to patients, nurses, and health care. The third characteristic
is that they must be realistic. They must be able to “manage time, opportunities,
and deficiencies with skill and grace.” The last characteristic of a strong CNE is
competence. They must be highly educated and experienced in several different
locations. “Executive leaders inspire and engage people. They manage behavior
change by influence, rather than authority, and challenge the status quo while
encouraging system loyalty,” (Crawford & Spicer, 2017).

 A survey of nurse leaders was done to evaluate what they thought were important
characteristics of a nurse executive. The first, and most important one, that they
thought of was self-awareness. This is described as a constant process of
examining strengths, weaknesses, and personal values. The second one that they
thought was important was balanced processing. This refers to looking at opposing
views and being open minded. The third most reported quality was transparency.
They described this as having honesty and integrity, and being able to minimize
inappropriate emotions, while still being able to share their thoughts and beliefs.
The last important quality that the leaders named was moral leadership, which they
felt was having “an ethical foundation for decision making learned early in their
careers: doing what is in the best interest of patients, supporting the voice of the
nurses, and finding joy in the work,” (Alexander & Lopez, 2018).
 I believe that I am strategic, and goal driven. When I have a project in mind, I
work on it as much as I can to try and get it done, the best that I am able. I am
realistic and efficient with my time. I have a very strong moral compass and try to
have strong self-awareness. When I was a team leader, when I would get an email
about changes coming soon, I would instantly start running ideas by my manager
about how we as a unit can change to incorporate those changes.

 There are five domains for establishing competency in a nursing administrator.

Those domains are as follows: communication and relationship building,
knowledge of the healthcare environment, environment, leadership,
professionalism, and business skills and principles. The domain that I believe I am
strongest in is knowledge of the healthcare system. I have worked in the healthcare
field since I was 19 and worked in various rolls, from a nursing assistant, to
management, and now as an educator I feel that I have a good bit of knowledge in
several different areas. My weakest area would be business skills and principals. I
have not worked very much in the business aspect of it (American Nurses
Association, 2009). I am learning a lot in my clinical about the business side of it.
When I finish my masters program, I will purchase a nurse executive study course
to help me prepare sit to take my certification. I will graduate in August and could
possibly take the certification test by December.

 In conclusion, there are many characteristics that make a respectable nursing
administrator. I had never thought about nursing administration as being a
specialty in nursing, but it truly is. It takes someone with higher education to think
about the big picture and be able to make decisions about what is best for the
organization. I found it interesting that what was determined in one article to be
important characteristics of a nursing administrator were more management type
characteristics, but when you ask the leaders what were the most important
qualities, they named things such as self-awareness, being open minded, and
transparency, things that make them respectable to staff members.