ICN has been responding for the last decade to the needs identified by member associations to change and improve the way nurses are prepared for management and leadership. It recognises that leadership is an essential component of modern management.
The whole environment of nursing and health services has been undergoing rapid change. Health reform is occurring in many parts of the world. This trend is accelerating. Organisations such as the Organisation for Economic Cooperation and Development (OECD), the World Bank and the World Health Organisation are focusing on health reform as this is often seen as part of a much wider process of social and political restructuring.
The relevance of health system reform to nursing is significant. Countries are trying to improve the health status of their populations and get the best value possible from the money that is spent on health care. Health needs are increasing at the same time as increasing financial constraints.
In most non-industrialized countries, nurses (often also midwives) are the only regular providers of health care in rural areas and low-income inner cities. Most rural and urban primary care is provided and managed by nurses. In other countries, nurses are key health providers in both hospital and community settings. Nurses plan services, allocate and manage resources, and contribute their knowledge of health and health needs to policy development and decisions.
For health reform to change health policies and reform institutions effectively, nurses need to be part of the reform process. Those who are or will be in key leadership and management positions need to be adequately prepared to help shape policy, work effectively in interdisciplinary teams, plan and manage effective and cost-efficient services, involve communities and key stakeholders in health care planning and delivery, and prepare other nurse managers and leaders for the future.
Experience suggests that health reform is developing at a rate that many nurses have been unaware of and/or are unprepared for.
Nurses must have a good understanding of the context and purpose of health reform, a vision of how health and nursing services may develop in their countries, the ability to plan strategically for and manage change, and the strength and confidence to be proactive and "up with the play" in a challenging and often stressful change environment.
This is often a major challenge because of the hierarchical education nurses may have received or because health structures have not supported nurses or women despite their major role in health care. Often nurses feel powerless and without the skills they need for the responsibilities they none-the-less carry.
In addition, nurses are often perceived as traditional and reactive, and not as leaders who could have an important contribution to broader health service policy development and management. Nurses' potential or confidence to operate in other ways is often not clear to themselves. The Leadership For Change™ global programmes aim to help change this situation.
Regional and national programmes are part of the broader ICN initiative on the preparation of nurses for leadership, focusing on the current climate of health reform. A key assumption is that specific management and leadership skills are best developed in relevant educational programmes at a country level. However, regional and national projects aim to assist this country level responsibility by working with leaders or potential leaders from different countries to:
- Develop their understanding of international health reform and its implications for nurse leaders and managers.
- Develop skills and strategies in management, leadership and policy development that will have an impact at a country and organisational level.
A key premise is that nurses must be prepared for management, leadership and policy positions not only in nursing, but in the broader health service. The accelerating scope and pace of health system reform gives this urgency.
LFC™ focuses on enhancing effectiveness in:
- Health planning and policy development.
- Leadership and management in nursing and health services.
- Developing quality cost effective nursing services.
- Preparing future managers and leaders, nurses and non-nurses.
- Sustaining development.
- Contributing within the broader health and management teams.
- Influencing curricula changes.
- Networking nationally, regionally and internationally.