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Patient advocacy is an important obligation of nursing leadership especially for Doctor of Nursing Practice (DNP)-prepared nurses; they have training to promote positive influences on healthcare systems, policies and patient outcomes. Nursing leaders advocate for their patients through the establishment of organizational policies in order to encourage appropriate staffing ratios for patient safety, develop better initiatives for patient safety, establish evidence-based practice guidelines and create equal access to healthcare services. One evident example is when nurse leaders may be active participants in policy committees, quality improvement, and strategic planning meetings, ensuring the emphasis remains on reassuring and providing quality care and patient safety within the organization. (Dempsey, 2022).

Nurse leaders advocate for their patients at the government level by taking part in professional organizations, advocating through legislation, advocating for healthcare reform and creating and developing policies which will create greater accessibility to affordable and quality healthcare. Advanced practice nurses, who are prepared with a DNP, are able to translate their research into practice and impact decisions regarding health policy. In addition, according to (Heuer et al., 2026), DNP competencies enable advanced practice nurses to lead positive improvements in healthcare, lead policy development and positively affect healthcare systems through leadership, collaboration and the application of evidence-based practice. These opportunities allow nursing leaders to advocate for vulnerable populations and improve healthcare delivery systems at both local and national levels.

Through my shadowing experience with a nurse leader in a clinical organization this past week, I was able to observe each of the five AONL Nurse Executive role-specific competencies in practice: communication and relationship building, knowledge of the healthcare environment, leadership, professionalism and business skills.

Communication and relationship-building competencies were demonstrated daily through the nurse leader's interactions with physicians, nurses, case managers, and administrators. The nurse leader established meetings with these groups, discussed concerns or issues raised by staff and provided clarity around organizational goals and patient care priorities. Through effective communication, the nurse leader improved teamwork, increased staff engagement and enhanced patient care coordination.

The second competency of knowledge of the healthcare environment was demonstrated by the nurse leader through her knowledge of federal regulations governing the provision of healthcare, accreditation standards of various accrediting agencies, patient safety initiatives implemented throughout the organization and organizational policies. She reviewed data from quality indicators such as patient satisfaction surveys, infection rates and hospital readmissions, demonstrating she understood the current state of the healthcare system including its performance and what is expected of it by regulatory bodies.

Leadership was demonstrated by the nurse leader through her decision-making processes, problem-solving efforts and staff support. She managed the day-to-day staffing needs, provided emotional support when needed due to high census, resolved conflicts between team members. Leadership also included guiding staff in mentorship activities as well as encouraging professional development of staff. Additionally, the nurse leader supported the implementation of evidence-based practice throughout the organization. Leadership development and strategic planning are two important skill areas for nurse executives if they are going to successfully manage healthcare organizations and ultimately improve patient outcomes. (Johnson et al., 2025).

Professionalism was demonstrated by the nurse leader through her commitment to ethical leadership, accountability, respect for others and establishing a culture of safety. She consistently demonstrated professional behavior and encouraged her staff to hold themselves accountable for their actions/decisions.

Lastly, business skills were demonstrated through budgetary discussions with the finance department, monitoring of productivity measures for staffing personnel, making resource allocation decisions to achieve cost savings and planning for cost-efficient patient care. The nurse leader monitored staffing schedules to meet the needs of patients based on their acuity and the number of patients being treated at any given time; therefore, illustrating her financial and operational responsibilities as a nurse executive.

This topic relates to many of the DNP Essentials specifically related to organizational leadership, interprofessional collaboration and healthcare policy. DNP-prepared nurses are educated to work at the system level and utilize evidence-based practice, quality improvement methodologies and advocacy for healthcare policy in order to improve delivery of care to patients and ultimately improve patient outcomes. DNP-prepared nurses assist in designing and implementing system-wide changes that result in safer care delivery systems, more coordinated care delivery systems and higher performing healthcare organizations. These types of positions illustrate how DNP-prepared nurses enhance not just individual patient care but also overall patient outcomes through influencing the entire healthcare system.

Overall, nursing leaders are pivotal to the process of patient advocacy using policy development, leadership development and enhancing healthcare systems. The AONL Nurse Executive Competency Model provides a framework for successful nursing leadership development for organizational success. DNP-prepared nurses have a unique opportunity to shape health policy, enhance patient outcomes and guide healthcare organizations through today’s complex healthcare landscape.

References

Dempsey, C. (2022). Nursing leadership across the continuum. Nursing Administration Quarterly, 46(2), 128-136. https://doi.org/10.1097/NAQ.0000000000000544

Heuer, B., Spruit, J. L., & Derouin, A. (2026). DNP preparation: Competencies will sustain the pediatric NP profession. Journal of Pediatric Health Care. https://doi.org/10.1016/j.pedhc.2025.11.028

Johnson, S. A., Macchiano, S., & Harding, A. (2025). Enhance strategic planning and execution skills through leadership investment. Lippincott Williams & Wilkins. https://doi.org/10.1097/nmg.0000000000000210