Nursing Influence

The latest featured article in the current issue of ANS is titled “Understanding Influence within the Context of Nursing: Development of the Adams Influence Model Using Practice, Research, and Theory” authored by Jeffrey M. Adams, PhD, RN, NEA-BC, FAAN and Sudha Natarajan, PhD, MSN, RN.  While it is featured it is available for download at no cost, so I invite you to read the article and return here to share in discussion of these important ideas!  Here is a message from Dr. Adams about this work:

The Adams Influence Model (AIM) can be used as a framework for anyone seeking to understand more about the factors, attributes, and process of influence.  However, the concept of influence is an especially important one for

Jeffrey Adams

nurses.  The basis of exploration of influence highlighted in this article started well over ten years ago and drew from years of experiences as a consultant working in the clinical information systems (CIS) space.  At that time, I found that CISs were largely selected by CFOs, CIOs, CMOs and I felt that while nurses were “involved” in the selection process, often times product chosen did not benefit nursing care or capture nursing data.  This was despite nurses overwhelmingly being the largest users of the CIS.  I wanted to simply understand why or how this happened?

Around that same time RWJF and Gallup released a report identifying that respondents did not perceive nursing as influential in reshaping health policy (what is now the ACA) when compared to nearly every other group.  And several other smaller studies also identified that executive nurses self reported as having less influence than their non-nurse executive counterparts on a host of issues.  So we thought, how could this be?  At 1% of the entire US population nurses are by far the largest percentage of the healthcare workforce, nurses are overwhelmingly the most trusted profession, and nurses are well documented addressing each component of the quadruple aim.  Of course nurses SHOULD be influential… and because we aren’t, how do we get there?  We decided to start at the beginning and asked the question “what does influence look like?” The AIM, as represented in this article, is the result of our efforts to answer that question.

While the origins and development of the AIM are chronicled in this manuscript, the AIM has been widely used since 2009 to frame health policy and strategy, to describe leadership practices, and serve as a guiding framework for research and instrument development.

Current projects using the AIM include development of:

• understanding nursing leadership’s influence over professional practice environments and the relationship to workforce and patient outcomes (with Maja Djukic, Ashley-Kay Basile and Matt Gregas)
• a guiding framework for baccalaureate health policy curriculum (with Ashley Waddell and Jaqueline Fawcett).
• the influence of nurse leaders on the professional practice environment and nurse engagement (with Maria Ducharme, Jeannie Bernstein, and Cynthia Padula)
• Leadership Influence Self Assessment (LISA©) instrument (with RWJF Executive Nurse Fellows colleagues Debbie Chatman Bryant, Joy Deupree, Suzanne Miyamoto, Casey Shillam and Matt Gregas).

It would be wonderful to see everyone take inventory and articulate how we anticipate each of our projects, papers, presentations, courses and other efforts will INFLUENCE practice, research, education, theory and/or policy.  This “influence” framing provides us opportunity to be purposeful and forward thinking toward an end that doesn’t leave assimilation of our contributions and value to chance.