Editor’s Note:
This blog was authored by Dr. Karlene Kerfoot, PhD, RN, FAAN, who served as symplr’s Chief Nursing Officer and was a nationally respected leader, author, and mentor in the nursing profession. Karlene’s insights into nursing leadership and workforce transformation continue to shape healthcare organizations worldwide. This piece has been updated to reflect current data and workforce trends, while preserving her original voice and message. We honor her lasting contributions and the legacy of leadership she leaves within the nursing community.
As a nurse leader, I’ve spent my career helping organizations navigate the complex balance between caring for patients and supporting those who provide that care. Even today, staffing shortages and the emotional well-being of nurses remain some of the greatest challenges we face in healthcare. What gives me hope is the growing recognition that the health of our workforce is directly tied to the health of our patients.
The American Organization for Nursing Leadership’s (AONL) 2025 Nursing Leadership Insight Study echoes what I’ve long believed: the well-being of nurse leaders is critical to sustaining an engaged, resilient workforce. When we care for our leaders, they can better care for their teams–and ultimately, for their patients.
The power of nurse leadership in healthcare
As nurse leaders, we coordinate the largest segment of the healthcare workforce—nurses—who spend the most one-on-one time with patients. Our influence extends beyond our units; we help shape organizational culture, safety, and financial outcomes.
Effective nurse leaders do more than manage schedules. We build trust, drive innovation, and help teams achieve quality and financial goals. We also use data-driven workforce tools to make staffing decisions that improve both patient outcomes and staff satisfaction. Modern nurse leadership is both human-centered and technology-informed.
Who are nurse leaders?
When people hear “nurse leader,” they often think of chief nursing officers or directors of nursing. But leadership exists at every level. The American Nurses Association (ANA) reminds us that every nurse is a leader. Whether mentoring a new graduate, coordinating patient care, or guiding a quality initiative, leadership begins at the bedside.
Early mentorship is key. We must invest in developing leadership skills from the start of a nurse’s career–teaching communication, adaptability, and resilience. The AONE’s Nurse Executive Competencies outline five domains that remain essential to success: communication, knowledge of the healthcare environment, leadership, professionalism, and business acumen. These principles, paired with agility and empathy, allow nurse leaders to thrive amid constant change.
Key organizations supporting nurse leaders
Several organizations have shaped my own leadership journey and continue to elevate nursing leadership nationwide:
American Organization for Nursing Leadership (AONL): AONL serves as the voice of nursing leadership, advocating for professional development, workforce well-being, and innovation. Its 2025 study shows progress in engagement and emotional health, but also reminds us that retention and work-life balance remain challenges.
The DAISY Foundation: DAISY has transformed how we recognize nurses. Their awards honor extraordinary compassion and skill across roles–from bedside nurses to executives. I’m deeply proud that the DAISY Foundation, AONL, and symplr created the Karlene Kerfoot Nursing Leadership in Technology Education Grant, which celebrates innovation in leadership education.
American Nurses Association (ANA): ANA continues to emphasize inclusive, evidence-based leadership and psychological safety. Leaders must foster environments where nurses feel seen, supported, and empowered to advocate for their patients and themselves.
American Association of Critical-Care Nurses (AACN): AACN’s Healthy Work Environment Standards have long guided nurse leaders in creating safe, supportive workplaces. Their 2024 update emphasizes data transparency and equitable staffing–both crucial to team well-being.
The expanding role of the clinical nurse leader
The Clinical Nurse Leader (CNL) role reflects how leadership has evolved. These master’s-prepared nurses blend clinical expertise with data analytics and systems thinking to improve outcomes. In 2025, CNLs are driving quality improvements across hybrid care models and interdisciplinary teams. They anticipate patient needs, reduce risk, and lead quality-improvement initiatives that directly support the Quadruple Aim: better health, lower costs, and improved patient and provider experiences.
The vital role of nurse managers
If CNLs are the bridge between care and systems, nurse managers are the foundation of daily operations. As a former health system executive, I know how complex this role is. Nurse managers hire, train, and support staff while balancing budgets, schedules, and patient care quality. They are change agents–leaders who motivate teams through both data and compassion.
Nowadays, nurse managers face the challenge of maintaining workforce resilience amid ongoing staffing constraints. Technology can’t replace the human connection they bring, but it can enhance it. By aligning data-informed staffing decisions with organizational goals, nurse managers help sustain safe, efficient, and supportive care environments.
How nurse leadership improves quality and patient safety
Strong leadership saves lives. Studies consistently link relational leadership—mentorship, empathy, and open communication—to higher patient satisfaction, fewer errors, and stronger safety cultures. The Institute of Medicine’s Future of Nursing reports, along with AONL and National Academy of Medicine updates, emphasize that nurse leaders must be full partners in redesigning healthcare.
As leaders, we create safety cultures by encouraging transparency, celebrating those who report concerns, and communicating changes that result from incident reviews. Workforce and safety analytics tools now help us see trends earlier, so we can intervene before small issues become major risks.
Leading change and meeting strategic goals
Strategic planning and nursing have more in common than people think. Both rely on assessment, planning, implementation, and evaluation. When I led systemwide initiatives, I used the nursing process to set goals, whether improving HCAHPS scores or strengthening retention.
To lead effective change, nurse leaders must understand people. We must anticipate resistance, communicate with clarity, and show genuine optimism. The most successful leaders I’ve known can connect seemingly unrelated ideas, energize their teams, and stay adaptable without losing sight of the vision.
Some of the key traits that drive successful change include flexibility, persistence, trustworthiness, and the ability to articulate a clear, inspiring vision. Above all, effective leaders know that not all change equals improvement, but all improvement requires change.
Building a culture of recognition and shared leadership
Creating a healthy work environment requires recognition, visibility, and shared governance. Too often, nurse leaders go unrecognized for the systems they build or the culture they sustain. That’s why meaningful recognition programs like The DAISY Awards and leadership grants that promote innovation matter deeply. They remind us that leadership is not about hierarchy; it’s about service.
Dr. Kerfoot’s lifelong advocacy for recognition and shared governance continues through the Karlene Kerfoot Nursing Leadership in Technology Education Grant, created in partnership with AONL and The DAISY Foundation.
