In 2017, when I completed my doctoral studies in healthcare administration at Capella University, my dissertation’s focus was on determining if there were any specific competencies that affected leadership proficiency and management involvement in healthcare settings. Even before COVID-19 disrupted healthcare, a lack of consensus existed on core competencies for nurse administrators. Although the Healthcare Leadership Alliance identified key skills—such as critical thinking, strategic planning, and change management—the pandemic further highlighted the need for strong, adaptable leadership in the diverse and dynamic healthcare sector. Existing research already pointed to variations in leadership approaches and their connection to core competencies, emphasizing the need for clarity and development in this area.

In the repertoire of leadership, competencies are critical for organizational effectiveness. Leaders are professionals who manage organizations and are distinguished by ambition, hard work, intelligence, and political clout. Managers, also leaders, participate in daily operational decision-making. Effective leadership is crucial in the complex and ever-changing healthcare industry. Nurses, the largest healthcare group, need strong leadership skills beyond traditional management to navigate this multifaceted system. While managers maintain the status quo, leaders drive innovation and strategic development, a critical need in the unpredictable U.S. healthcare landscape.

Lack of consensus

The lack of consensus on the competencies needed for nurses to lead in healthcare administration can be attributed to several factors. Varied educational backgrounds and on-the-job experiences within nursing create differing perspectives on essential leadership competencies. The constantly evolving healthcare landscape, with its new technologies and policies, further complicates defining a fixed set of skills. Finally, contextual differences across healthcare systems, influenced by geography, organizational type, and local regulations, also contribute to the lack of agreement on required leadership competencies for nurse administrators.

A key factor in the lack of consensus on nursing leadership competencies is the absence of a standardized framework, unlike other professions. Guidelines exist, but no universally accepted standard has emerged. Interdisciplinary collaboration in healthcare further complicates matters, as required competencies frequently overlap with other disciplines. Ongoing dialogue, research, and collaboration among nursing stakeholders and other healthcare professionals will prove crucial to developing a shared understanding and establishing a more unified competency framework for nurse leaders.

Nurse scientists

Nurse scientists are registered nurses who also have advanced education (typically a doctoral degree, such as a PhD, DNSc, or DNP) in a field related to nursing science or health research. They conduct research to improve patient care, advance nursing practice, and shape health policy. Their work bridges the gap between research and clinical practice, translating scientific findings into real-world applications. They work in a variety of settings, including:

• Academia. Teaching nursing students, conducting research, and mentoring future nurse scientists.
• Healthcare organizations. Leading research programs, implementing evidence-based practice changes, and evaluating the effectiveness of interventions.
• Government agencies. Contributing to health policy development, conducting research on public health issues, and evaluating healthcare programs.
• Pharmaceutical and biotech companies. Conducting clinical trials and developing new treatments.

Nurse scientists are the driving force behind evidence-based nursing practice; they ensure that the best available scientific evidence informs patient care.

Since 2018, I’ve been a nurse scientist; the consensus on core competencies in this specialty invites a discussion. In the wake of artificial intelligence and its impact in healthcare trajectory, what challenges might a nurse scientist encounter in their efforts for effectiveness and efficiency in the research community and healthcare system? Nurse scientists are doctoral nurses with varying specialization; they’re steeped in creating new knowledge in research.

Allen and colleagues reported that the ambiguous role of nurse scientists in clinical settings leads to inconsistencies in how their positions are implemented, including variations in responsibilities, management, financial support, and institutional connections. The success of nurse scientists in clinical settings hinges on standardized guidelines for role implementation and strong support from organizational leadership, including resource allocation for infrastructure development. Although the level of support may vary depending on institutional resources, leadership buy-in is essential for the role to thrive. Could it be that, like administrative nursing leadership, nurse scientists need a consensus-based framework to be successful in infrastructure development?

Consensus-based framework

A consensus-based framework—developed collaboratively by stakeholders like nurses, educators, researchers, regulatory bodies, and administrators—defines the essential knowledge, skills, and attributes of nurse leaders. This standardized framework guides professional development, education, evaluations, and career advancement, ensuring shared expectations and promoting consistent leadership standards across the healthcare system. It typically encompasses various core competencies relevant to healthcare leadership.

Essential competencies for nursing leadership encompass leadership and management skills, healthcare systems and policy knowledge, financial and human resource management, ethical and legal principles, quality and safety practices, and strong communication/interpersonal abilities. A consensus-based framework for nursing leadership is developed through literature review, best practices, and stakeholder input. Regular updates ensure relevance to evolving healthcare trends and leadership expectations, ultimately improving patient outcomes and care quality.

Nurse scientist competencies

Essential competencies needed for nurse scientists are literally in discussion and require consensus. Smaldone and Larson discussed what PhD competencies should guide the preparation of nurse scientists. Currently, summits and symposiums are being held to gain consensus on this relevant topic of interest.

A study by Wyman and Henly found a concerning lack of modern science and technology courses in PhD nursing programs. Roughly half of the 120 programs reviewed included courses on nursing research methods, while informatics and genomics were present in less than a quarter and 10% of programs, respectively. This gap suggests that doctoral nursing education may not adequately prepare future nurse researchers for the evolving demands of healthcare and scientific advancement.

Smaldone and Larson concluded that innovation, methodologic, and problem-solving skills were core competencies relevant to this specialty. This may be the beginning of intense discussions on competencies in nurse scientists with PhD and DNP degrees.

Carolene Stephenson, PhD PhD., MBA, MSN, FNP-C is a Nurse Scientist & APN at Hackensack Meridian Health in Neptune, NJ.

References

Allen DH, Arthur EK, Blazey M, et al. A scoping review on the nurse scientist role within healthcare systems. Worldviews on Evid Based Nurs. 2023;20(1):47-55. doi:10.1111/wvn.12624

Greenhill RG, Pearson JS, Schmidt RN, Stuart D, Rossettie S. Exploring healthcare leadership competencies for the fourth industrial revolution: A scoping review of the literature. J Health Adm Educ. 2021;38(3):695-708.

Smaldone A, Larson EL. What PhD competencies should guide the preparation of nurse scientists? J Prof Nurs. 2020;37(1):201-3. doi:10.1016/j.profnurs.2020.06.010

Stephenson CG. Assessment of Leadership Effectiveness, Management Experience, and Core Competencies of Nurse Administrators in Healthcare Settings [dissertation]. Capella University; 2017.