The field of nursing has become more complex than anyone could have imagined just a generation ago. Today’s nurses are expected to be not only great caregivers but great innovators, too. The increased demands of health care require a new generation of thinkers who want to be agents of care innovation. As a result, nursing has become a profession for those who are passionate lifelong learners.

These changes have given rise to a new type of nurse, which Coleman Associates has named The Tactical Nurse™. Tactical nurses serve as the hub for all patient care team members. They see patients independently, within their nursing scope, and they assist the MA or provider with complicated cases. They can help determine the care plan and health maintenance needs for all team patients, while also increasing access in a clinic.

Tactical nurses learn to make decisions confidently and swiftly. They are flexible, adapt quickly to change, and are first and foremost team players who know that territorialism can negatively impact patient care. Tactical nurses are the grease that keeps the wheels of the patient care team moving, allowing team members to see patients efficiently while ensuring that those patients receive the highest quality care possible. They know that they need to keep a keen eye on prioritization, as they focus on the use of time and space and evaluate how the team is moving along in the day. They understand the importance of seeing that all patients have their needs met in a timely manner, and are skilled in matching clinical skills with patient needs.

A Typical Workday

So what does the workday entail for a Tactical Nurse™? A typical day begins in the patient care team huddle, where team members identify new or complex patients that are appropriate for the nurse to see. The nurse then initiates the interaction with new patients by establishing a relationship between the patient and the team.  By taking a full and appropriate patient medical history, and setting the agenda for the initial visit, the nurse can make it much easier for the provider to have a streamlined first visit with each new patient.

The tactical nurse also sees complex patients. These patients might need education about their conditions prior to or after the provider visit. They might have several issues that the nurse can address, such as reviewing medications, setting the appointment agenda, and deciding which issues the nurse can follow up with independently. These issues might include education regarding insulin administration for diabetics, home care of wounds, smoking cessation, or other behavioral modification.

In addition to new and complex patients, the tactical nurse also needs to incorporate other patients into the schedule, including walk-ins, previous patients needing follow-up, and phone calls seeking advice or triage.  This patient-centered system works because the nurse who huddled, planned, and is active with the patient care team has the knowledge of where the team is with respect to volume and type of patients for the day.  As a result, the tactical nurse is in a perfect position to make informed decisions regarding which patients to see and in what order.

Professional tactical nurses can assess a patient’s condition, provide health and wellness education, and make educated decisions to interpret complicated situations. Nurses are an integral part of the healthcare team when their critical thinking skills are cultivated and they are encouraged to be tactical in their approach to patient-centered care. Expanding the role of nurses is essential in order to provide patients more coordinated, team-based care. If nurses have more responsibility over care management and more say in designing workflow, not only will public health improve, but the health system also will also become more cost efficient and effective.

So what are the key defining qualities of a tactical nurse?  A tactical nurse is someone who can anticipate what’s coming next and is appropriately reactive. The person filling this key position must be organized, flexible and adaptable, empathetic, fair, patient, positive, preemptive, open-minded, humble, evaluative, and invested—in short, someone who is clearly a team player. Does this sound like you or someone you know? To learn more, contact Coleman Associates or read about this key role through the story of one clinic that experienced great success with  The Tactical Nurse™ in Action.

by Laura Spindola RN, Melissa Stratman, and Diane DeBella, Coleman Associates. Updated by Melissa Stratman.