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Nurses are very instrumental in influencing change in the healthcare sector as such if they are given the opportunity, they can be the reason for driving innovation at their place of work. There are various ways that nurses can spearhead change and some of them include becoming proactive leaders that entails creating solutions which can move the nursing profession to the future. Further it is important that nurses become advocates that can support the patient’s interest while at the same time representing the family’s role in the caring for the patient. Nsiah et al (2019), indicates that advocacy comprises pleading the course of the patient in the court of justice while at the same time supporting their justice and individual rights. 

As a nurse leader the leadership style adopted can hinder the achievement of the goals planed. Clearly the nurse leader should act in liaison with their team and exhibit mutual trust which can encourage collaborative work. As leader one ought to encourage communication and charisma as charismatic leadership moves people as such making leader excel (Keating et al., 2020). Therefore, an example when a nurse leader became instrumental in spearheading change is Clara Barton that created the American Red Cross. The American Red Cross helped nurses manage emergencies and treat patients in need.

Clara Barton encountered many challenges while implementing their theory as it was during the war. As such she based her effort on helping individuals at war to assisting those in natural disasters. Some of the obstacles included the prevailing war that prevented the capacity to implement her views.



One major nursing movement that impacted healthcare policy was the passage of A.B. 394, the historic bill that made minimum, specific staffing ratios the standard in California . The registered nurses of the California Nurses Association successfully sponsored and lobbied the California Legislature to pass. (Ratios: Learning From the California Experience, 2021). The law came in response to growing concern about patient safety as the complexity of care in hospitals increased and California experienced a severe nurse shortage in the 90’s (Ratios: Learning From the California Experience, 2021). It was not easy to get this bill to pass. It took a decade of hard work and multiple efforts by RN’s. The Influence from unions, including the California Nurses Association and the Service Employees International Union, which helped propel staffing issues into the political agenda, despite opposition from organizations such as the California Healthcare Association, which represents hospitals (McHugh et al, 2011). 

               RN’s had to participate in extensive campaigns. There was support by patients and the general public that included thousands of letters, calls, and a massive rally on the steps of the Capitol in Sacramento (Ratios: Learning From the California Experience, 2021). Nurses were persistent and didn’t give up. Obstacles continued even after passage of the bill. Hospital executives and the hospital industry, including the California Hospital Association, lobbied extensively to defeat the law (McHugh et al, 2011). The industry has filed lawsuits to block enforcement of the ratios at all times by permitting averaging, encouraging hospital managers to evade the letter and spirit of the law, and recruiting compliant allies to propose measures to overturn A.B. 394 (Ratios: Learning From the California Experience, 2021). After implementation of the bill nursing became a much more rewarding career. The California ratios attracted nurses from across the country who appreciated being able to practice nursing under a safe working environment and actually get to spend time with their patients. Most importantly, staffing ratios have improved safety and saved lives.