Question: The Clinical Nurse-Leader Application You are the Unit Coordinator of a medical/surgical unit in a small acute care hospital. One of your greatest management challenges has been implementing evidence-based practice at the unit level. Your staff nurses have access to many healthcare resources via their computer workstations. In addition, computerized provider order entry (CPOE) is used in your hospital, which includes links to best practices and standardized clinical guidelines. Yet, you are aware that some of your staff continue to do things as they have always been done, despite repeated workshops on how best to integrate new evidence into their clinical practice. You hope to address this problem by hiring someone with the leadership skills needed to champion the change effort and the management skills necessary to direct staff in their new roles. When you return to your office today, you find an application for employment from a CNL. She recently completed her CNL program as part of a master's entry program so her clinical experience is limited to what she received in nursing school. You are aware though that her educational background will have prepared her to lead a change effort on the unit to foster evidence-based decision making and outcomes-focused practice. You also have an employment application from a master's prepared nurse with many years of clinical experience as a staff and charge nurse although she is just returning from a 5-year leave of absence to care for a sick family member. She completed a master's thesis as part of her graduate nursing education 20 years ago, so you know she has at least some expertise in nursing research and its translation to practice. Given your budget constraints, you can hire only one of these individuals.

ASSIGNMENT: Identify the driving and restraining forces for hiring the CNL or for hiring the experienced nurse with clinical and research expertise. Do you believe that the limited clinical experience of the CNL would impact her ability to serve as a leader and change agent on the floor? Would the CNL role have the management skill set you also want in your new hire? Do you believe that the CNL would be better prepared as a leader in this change effort? Justify which employee you would choose to hire and suggest strategies you might use to help this individual acquire the leadership, management, and change skill sets they may be lacking to achieve your desired outcomes.