This chapter provides examples of programs and services beyond the foundational elements and global resources that can be used to overcome traditional nursing research barriers. It is assumed that at least one doctorate-prepared nurse researcher is available to facilitate research opportunities and educate nurses about research and evidence-based practice. Many clinical nurses fully understand their clinical roles but are completely unaware of opportunities and resources in nursing research within their hospital. Since contributions of nursing research are vital to the science and art of nursing and provide foundation for evidence-based practices, it is important to overcome the traditional cluster of barriers that include problems with nursing research visibility/priority, time and money, and research education. Nurses need confirmation that nurse leaders support research; when it is visible, it is valued. Moreover, nurses need time, education, and resources to complete rigorous research that leads to discoveries and answers to important clinical problems.

This chapter addresses the need for dissemination of research and focuses on dissemination both inside the hospital organization and outside. Disseminating results of research is often the most exciting phase of the process, as it is the culmination and highlight of countless hours of work. Common areas for dissemination internally include presentations to colleagues on people’s unit, as well as across hospital organization. Internal presentations offer a direct way for people to provide new evidence for practice in their hospital organization. In addition, however, it is important that results of their research reach nurses and other health professionals nationally and internationally. Thus, people want to participate in media dissemination of their research, systematically look for calls for abstracts to present at professional conferences, and disseminate their research through professional publications. Disseminating results, whether internally or externally, by media, poster, oral presentation, or publication, requires effort and attention to detail.

Interprofessional education (IPE) and collaborative practice are increasingly called upon to improve these domains such as patient care, community health, health care delivery systems respective and overlapping spheres of activity with the larger goal of improving the overall health care system. Nurse leaders are moving the interprofessional collaboration agenda forward by serving in key leadership positions nationally and on local campuses. Nurse leaders, through a combination of their training, professional experiences, and personal preferences, have unique knowledge and skills for which they are enthusiastic champions. Effective leaders apply principles of good communication in their work with individuals and groups. Nurse leaders possess valuable professional knowledge and skills, and when coupled with individual talents and strengths, they offer important assets to the success of a collaborative effort. Nurse leaders should recognize how they can best capitalize on their leadership abilities and confidently apply them.

An inadequate nursing workforce will jeopardize the functioning of the healthcare system as increasing evidence shows a relationship between registered nurse (RN) care and patient outcomes. This chapter illustrates how research is shaping health human resources (HHR) strategies for nursing in Ontario and Canada and describes policy responses to alleviate widespread fears about a looming nursing workforce shortage. It discusses the HHR theoretical framework and its application in research and policy. Researchers should understand the nature of the policy cycle in order to promote effective collaboration with policy makers. The chapter explains the policy cycle and conveys how research evidence, using a continuous quality improvement process, is contributing to current strategies aimed at strengthening the nursing workforce in Ontario. It highlights some considerations for the future of nursing that are proposed in current literature.

Barry H. Smith’s opening is significant: that nursing care is at the core of humanity. He recounts his own experiences with nurses, when as a surgical resident he learned the value of team work, and developed a respect for the nurses who were so tuned in to the needs of the patients and families. Smith asserts that nurses must be the central point of any health care system, and yet many factors have converged to keep nurses in a subservient role within health care. Today, there are Nurses Aides, Licensed Practical Nurses, Registered Nurses, Nurse Practitioners, and those with doctorates in nursing, with an increasing premium being placed on advanced nursing clinical practice, as well as research. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

Jerry Cromwell has a rich history of both preparing nurse leaders in research and collaborating with nurse researchers. On the basis of his extensive experience, he offers cogent advice on leadership roles that nurses can fill in research on health care policy formulation and implementation that will change the course of health care payment, delivery, and quality throughout the United States. Cromwell believes that nurse researchers can provide leadership through the development of skills in management, program development, research, and teaching. To illustrate the characteristics of nurse research leaders, Cromwell describes one such leader with whom he has worked for more than two decades. He details her skills in project leadership, her technical research skills, and her management skills. Cromwell also identifies other nurse researchers who are leading policy development at the government levels, including those at some of the top federal agencies.

This chapter describes the various roles and functions of the treatment program or clinical management staff in the residential facility. It characterizes the roles of support staff and agency personnel. Teachers, physicians, nurses, psychologists, social workers, lawyers, and accountants in the TC ply their professions in the usual way. The relationship between staff and peer roles is rooted in the evolution of the Therapeutic Community (TC). In the TC approach, the role of staff is complex and can be contrasted with that of mental health and human service providers in other settings. An array of staff activities underscores the distinctively humanistic focus of the TC. The chapter describes how primary clinical staff in the treatment program supervise the daily activities of the peer community through their interrelated roles of facilitator, counselor, community manager, and rational authority. Other staff provide educational, vocational, legal, medical, and facility support services.

This chapter explains how chaos and confusion impacts staff as they move through the second phase of transition toward a new way of being. When departments or organizations merge, multiple policy and procedure manuals are supposed to merge as well, but this rarely happens fast enough. In the meantime when nurses are challenged by a practice issue and go looking for the correct policy or procedure to follow, they may find several or none. When this happens, staff can feel confused, anxious, frustrated, and fearful for patient safety. They may feel patients are being cheated of quality care and feel guilty about it, but not necessarily motivated enough to change. Mixed emotions, accommodating different practices, and mental and physical exhaustion can cause staff to more readily call in sick and feel less inclined to go the proverbial extra mile. The chapter provides tips for managing chaos and confusion.

Aiming for impact means that one not only thinks that one can transform clinical service, but wants to develop and provide patients and their families with the kind of positive moments that are remembered 20 years later. Leadership presupposes aiming for impact; that is, a determination to address the challenges inherent in the current healthcare system. Impact means always giving some thought to how something good can be parlayed into something better. If one is aiming for impact, developmental learning will inevitably move from focusing on mastery of what today is considered to be best practice to imagining and developing a new and improved version of future practice. Nurses have historically been socialized in the direction of convergent thinking, but leadership requires divergent thinking, experiences that promote creativity and innovation.