On an orthopedic unit, which practice demonstrated true leadership by the nurse?

• A. Incomplete intake and output records on the night shift were a problem; records have been consistently complete since the new staff nurse arrived.
• B. The new staff nurse has scheduled staff journal club discussions once a month to increase current knowledge about client care issues.
• C. The new staff always works overtime when asked by the nurse manager,
• D. Incomplete shift counts for medications were first noticed by the new staff nurse.

Answer: (B)

Leading in nursing means guiding colleagues toward better care by taking initiative to improve practice and empower the team. Scheduling staff journal club discussions once a month to explore current client care issues shows this kind of leadership in action: it identifies a need for ongoing education, creates a regular opportunity for the team to learn, and motivates participation, all with the goal of applying up-to-date, evidence-based care on the unit.

This kind of initiative has a ripple effect—it builds collective competence, promotes critical thinking, and supports safer, higher-quality patient outcomes. In contrast, simply addressing problems after they arise, like reporting improved record-keeping or agreeing to overtime, reflects responsibility or compliance but not the proactive leadership of organizing and guiding ongoing professional development. Likewise, noticing incomplete med shift counts is important for safety, but it doesn’t demonstrate leading a structured educational effort for the team.