Preparation of Nurse Leaders in the 21 st Century Workplace

The restructuring mania of health care settings of the 1980s and 1990s was driven by the need to save money, with organizations emphasizing efficiency over patient safety. A common action that took place in the restructuring was the elimination of nurse manager positions and the perceived reduction in power of chief nurse executives.2 The nursing managers who remained employed in most health care systems were challenged with the overwhelming responsibility and accountability of the staff and patients on many units. Nurse leadership was consumed with managing large operations to their maximum fiscal efficiency, and the priority to create a culture of patient safety within the setting was nonexistent. Creating work environments in which health care is dePreparation of Nurse Leaders in the 21st Century Workplace