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Leadership Model Applied to Nurse Practitioner Role


The healthcare industry constantly evolves and requires healthcare professionals to adapt quickly. Clinical Nurse Specialists (CNS) play a crucial role in healthcare by providing advanced nursing care, managing complex patient cases, and serving as clinical experts for healthcare teams. However, CNSs must be equipped with tools and strategies to navigate change effectively as healthcare evolves. Kotter’s 8-Step Change Model is a widely recognized framework for managing and implementing organizational change. The model outlines eight essential steps to help organizations navigate and manage change successfully. In the context of clinical nurse specialists (CNS), the Kotter model can be used to implement change within the organization to improve patient outcomes, enhance nursing practice, and drive operational efficiency.

Why I chose Kotter’s 8-Step Change Model

As a clinical nurse specialist (CNS), you are responsible for leading change initiatives within your organization that aim to improve patient outcomes, enhance the quality of care, and increase efficiency (Heinen et al., 2019). To drive change successfully, you need a structured approach that can guide you through the complex process of organizational transformation. I chose Kotter’s 8-Step Change Model because it provides a comprehensive and structured approach to managing change applicable across various industries and contexts. As a clinical nurse specialist, understanding and applying this model can be beneficial in managing change within healthcare organizations.

Application of Kotter’s 8-Step Change Model to clinical nurse specialists (CNS) practice role

Kotter’s strategy begins with instilling a feeling of urgency. The first step in implementing change is for clinical nurse specialists to recognize the need for improvement. Methods include polling patients and healthcare providers for opinions and analyzing past patterns. The CNS may then convey the situation’s critical nature to other healthcare team members, such as doctors, nurses, and executives. In addition, clinical nurse specialists may collaborate with other healthcare community members to form a change-driving team. Members of this alliance should hail from various divisions and fields of expertise, all of which have something to offer the cause of transformation. In addition, the CNS must articulate a compelling vision for the profession’s future. The team needs to hear this vision to be inspired and motivated to make the necessary changes.

Furthermore, the clinical nurse specialist must share the vision with patients, employees, and managers. The plan should be simple to grasp. Clinical nurse specialists are responsible for equipping their colleagues in the healthcare system to realize the goal. Training, schooling, and exposure to modern tools are all examples. Goals that can be swiftly and efficiently achieved with this framework. The team’s momentum and morale may be boosted by accumulating these little victories to the greater prize. Once short-term wins have been achieved, the CNS can consolidate the gains and build on them to produce more significant change. This can involve expanding the scope of the change, implementing new processes, or introducing new technologies. Again, the Clinical nurse specialists should ensure that the implemented changes are integrated into the organization’s culture. This can involve developing new policies, procedures, and training programs that support the change.

Model characteristics

Kotter’s 8-Step Change Model

Application clinical nurse specialist Role (CNS)
1Create a Sense of Urgency (Saunders, 2021) Clinical nurse specialists can create a sense of urgency for change by identifying the need for change and its benefits to the organization and patients (Saunders, 2021). This can involve gathering data and statistics to demonstrate the situation’s urgency.
2 Build a Coalition (Parchman et al., 2022) Building a coalition of people who support the reform endeavor is crucial. Included should be essential stakeholders, clinical leaders, and other healthcare experts. The clinical nurse specialist may advocate for the project and try to increase its support (Parchman et al., 2022).
3 Form a Strategic Vision and Initiatives (Fischer et al., 2019) The clinical nurse specialist and the coalition may create a strategic vision and objectives for the transformation endeavor. (Fischer et al. 2019). This might include deciding on particular goals and objectives and creating a strategy for achieving them.
4Enlist a Volunteer Army (Chan et al., 2021). The clinical nurse specialist can enlist a group of volunteers who are committed and willing to the change effort and can help spread the message throughout the organization (Chan et al., 2021). This can include nurses, physicians, and other healthcare professionals passionate about the change.
5Enable Action by Removing Barriers (Blok et al., 2022) The clinical nurse specialist can work to identify and remove barriers to change, such as resistance from staff or lack of resources. This may involve providing education and training to staff, as well as working to secure necessary resources to support the change effort.
6 Create Short-Term Wins (Campbell et al., 2022) The clinical nurse specialist can create short-term wins by identifying and celebrating small successes (Campbell et al., 2022). This helps build momentum and keep the change effort moving forward.
7Sustain Acceleration (Varkey et al., 2010) The clinical nurse specialist can work to sustain the acceleration of the change effort by continuously monitoring progress and making adjustments as needed. This may involve collecting feedback from staff and stakeholders and making changes based on that feedback.
8 Anchor the Changes in Corporate Culture (Todic et al., 2022). The clinical nurse specialist can work to institute change by embedding new initiatives and practices into the organization’s culture and operations (Todic et al., 2022). This can involve developing policies and procedures to support the change and providing ongoing training and education to staff to ensure its success.

In conclusion, Kotter’s 8-Step Change Model is a helpful framework for healthcare companies to manage change. According to the model’s instructions, I may create a systematic strategy for introducing novel procedures, enhancing patient outcomes, and boosting healthcare quality. To drive change and enhance patient outcomes, CNS must establish a sense of urgency, build a strong coalition, develop a vision, effectively communicate that vision, delegate authority, achieve rapid success, build on that success, consolidate gains, and embed new methods into the organization’s culture.


Blok, A. C., Alexander, C. C., Tschannen, D., & Milner, K. A. (2022). Quality improvement engagement: Barriers and facilitators. Nursing Management53(3), 16-24.

Campbell, J., Ziefle, K., Colsch, R., Koschmann, K. S., & Graeve, C. (2022). Completing accreditation during the COVID-19 pandemic: A step-by-step process for success. Journal of Professional Nursing40, 79-83.

Chan, G. K., Bitton, J. R., Allgeyer, R. L., Elliott, D., Hudson, L. R., & Burwell, P. M. (2021). The impact of COVID-19 on the nursing workforce: a national overview. Online Journal of Issues in Nursing26(2), 1–17.

Fischer-Cartlidge, E., Houlihan, N., & Browne, K. (2019). Building a renowned clinical nurse specialist team: recruitment, role development, and value identification. Clinical Nurse Specialist33(6), 266-272.

Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of advanced nursing75(11), 2378-2392.

Parchman, M. L., Palazzo, L. G., Mogk, J. M., Webbon, J. C., Demosthenes, L., Vossenkemper, E., … & Diaz del Carpio, R. (2022). What strategies are used by clinician champions to reduce low-value care?. SAGE Open Medicine10, 20503121211069855.

Saunders, M. M. (2021). Informing and supporting the new clinical nurse specialist prescriber. AACN Advanced Critical Care32(4), 404-412.

Todic, J., Cook, S. C., Spitzer-Shohat, S., Williams Jr, J. S., Battle, B. A., Jackson, J., & Chin, M. H. (2022). Critical theory, culture change, and achieving health equity in health care settings. Academic Medicine97(7), 977.

Varkey, P., & Antonio, K. (2010). Change management for effective quality improvement: a primer. American Journal of Medical Quality25(4), 268-273.


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