Regarding “Contemporary Perspectives on Preparing Nurse Leaders for Cardiovascular Disease Prevention”

The need for leadership in cardiovascular nursing is at an all-time high. As noted in our paper published in the Journal of Cardiovascular Nursing, the demand for nursing leadership continues to grow to reduce the global burden of cardiovascular disease (CVD), and to reduce CVD risk through focused efforts toward prevention.1 The recently published Global Burden of Disease study underscores the alarming, continued global growth of CVD burden since 1990 due to changing exposure to harmful risk factors, population growth and aging, and geographic inequality.2 The opportunities for prevention are enormous. Cardiovascular nurses at all levels of care and career phases can demonstrate leadership to shape decisions that ultimately improve ineffective and inequitable systems to enhance cardiovascular outcomes. From serving in informal or formal roles such as a direct care provider, clinical leader, administrator, case manager, educator, mentor for emerging cardiovascular nurses or nurse leaders, champion for quality of care, or policy advocate, cardiovascular nurse leaders can have a profound impact on improving outcomes for individuals, families, and communities. While there are many frameworks and theories for leadership, we focused on preparation for leadership through development of specific competencies refined from prior work in cardiovascular nursing and that of the International Council of Nursing: setting a vision and being strategic, setting a vision for personal development, mentorship, making a difference through diversity and inclusiveness, partnership building, and boldly embracing change and technology.1 Development of these and other leadership competencies can happen through observation, experience from on-the-job training, formal programs, organizational activities (such as participating in professional organizations), mentorship in leadership development, leadership competence assessment, and self-study, to mention a few. We offered examples including known workshops, and the Preventive Cardiovascular Nurses Association (PCNA) certification program and PCNA chapter activities.1 In this editorial, we offer a series of case scenarios for the application of several of the emphasized competencies. Case Scenario 1 for Setting a Vision and Being Strategic Through Transformational Leadership An experienced cardiovascular nurse in an acute care hospital transformed outpatient care for heart failure patients by addressing gaps in follow-up and education that led to frequent readmissions. The nurse cast a vision that heart failure readmissions could be reduced by 30% within the first 30 days after discharge through a new approach. The nurse introduced a new care model combining face-to-face consultations with digital platforms to improve patient self-management, follow-up care, and treatment adherence. By adopting a transformational leadership approach, the nurse advanced a vision for better patient outcomes. Being strategic, the nurse secured support from the lead interdisciplinary providers, approached administration with data reflecting potential return on investment and financial outcomes with support for the resources needed to implement the ideas, and selected a champion to lead the project. The leader fostered a collaborative environment, encouraging team members to contribute ideas and take ownership of the model. Regular meetings promoted open communication, and the nurse provided mentorship to junior staff, enhancing their skills and confidence. This exemplar of casting a vision for improved secondary prevention and use of the transformational leadership approach reduced readmissions, improved patient outcomes, and strengthened the nursing team’s capacity to sustain positive changes in cardiovascular care. Case Scenario 2 for Leadership Assessment A leader of a professional nursing cardiovascular and prevention-focused organization arranged for the completion of the DISC assessment for all members of the Board of Directors and key staff. Each board and staff member received their leadership style and gleaned insights into their past experiences with leadership, values that influence decisions, communication styles, and challenges. Each shared their styles with the group. Colleagues could better understand the contributions and communications of those considered high on each trait/profile. Those high in Dominance were more focused on tasks and action to achieve outcomes, while the Influencers were more people and relationship-oriented in their action planning. Those high on Steadiness were people-oriented and tended to be the implementors (managers of projects), and those high on Conscientiousness tended to provide important insights into the logistics and risks associated with decisions and tasks. Not all styles are discreet, and most had dominance of one but some aspect of another, which was helpful to know as the team worked more cohesively in the strategic goals and projects of the organization. Case Scenarios 3 for Leading Through Mentoring Others Academic Scenario: Enhancing Cardiovascular Nursing Education Through Mentorship A university nursing program was facing challenges in retaining students in its prelicensure cardiovascular nursing elective and specialty. The faculty recognized the need to implement a mentorship program to support students’ academic and professional development. A senior cardiovascular nurse educator was assigned to mentor a group of third-year nursing students. The mentorship program included regular one-on-one meetings, group discussions, and practical sessions in the university’s simulation lab. The main objectives of the mentoring program were to provide role modeling and encouragement, exchange of knowledge, and open communication. The faculty mentor demonstrated best practices in cardiovascular care, including patient assessment and management of complex cardiovascular conditions, and provided emotional and academic support, helping students manage stress and workload. Through interactive sessions, the faculty mentor shared the latest research on cardiovascular disease prevention and the role of comorbidities such as diabetes and chronic kidney disease in cardiovascular health. Students were encouraged to ask questions and discuss their career aspirations, fostering a trusting and respectful relationship. Due to the mentoring program, students reported increased confidence in their clinical skills and a deeper understanding of cardiovascular nursing. The mentorship program led to higher retention rates, academic performance, and intent to practice in cardiovascular areas after graduation. Clinical Scenario: Distance Mentorship for Cardiovascular Nurses in Under-Resourced Areas A small hospital in a rural area lacked senior cardiovascular nursing staff to mentor new nurses. An advanced practice nurse and nurse educator from the urban hospital agreed to mentor a new cardiovascular nurse in the rural hospital through bi-weekly video calls and online training sessions. The main objectives of the mentorship were role modeling, nuturing support, knowledge exchange, and open communication. The mentor demonstrated cardiovascular procedures via video, which allowed the new nurse to observe and ask questions in real-time. The mentor provided emotional support and professional advice, which helped the mentee navigate the challenges of working in an under-resourced setting. The mentor also shared the latest guidelines on cardiovascular disease management and prevention, tailored to the rural context. They used communication technologies to maintain regular contact, which ensured the mentee felt supported despite the distance. The mentee gained confidence and competence in their role, leading to improved patient care in the rural hospital, and the eventual mentorship of others in the rural setting. The distance mentorship program also fostered a sense of professional community and collaboration. Case Scenario 4 for Making a Difference Through Diversity and Inclusion While some pushback has occurred for formal diversity, equity, and inclusion programs, nurses remain responsible for identifying and addressing inequities in care and outcomes. A clinical nurse specialist (CNS) in a large safety net hospital serving ethic and minority patients in an urban setting recognized that patient education for heart healthy lifestyles was failing to result in engaged interaction and intention for risk factor reduction. The CNS saw opportunities to address social determinants of health (SDOH) affecting this population’s CVD risk and also wanted to promote inclusive care. To more effectively address SDOH, the CNS learned more about this population’s predisposition to CVD and the lack of resources for many of these patients. The CNS also became aware of a new assessment tool on social needs of housing, food insecurity, transportation, and neighborhood characteristics that was being pilot-tested in the hospital’s electronic health record. The nurse also observed that few of the needs were being discussed or addressed by the provider team who did not reflect the culture or ethnicity of the patient population. Inviting a diverse team of nurses, social workers, and providers, and a patient advocate to partner, the nurse cast a vision that they start with addressing one aspect of SDOH, food insecurity, or the worry patients expressed of not having enough resources to feed their family. The nurse leader sought input from patients and providers, facilitated cultural awareness with emphasis on the cultural aspect of food, researched community resources, invited several community agencies to their team meetings, and identified sources for relevant and acceptable heart healthy food, quick delivery services, and funding for groceries. Culturally relevant patient education materials and approaches were implemented along with team training. Referrals to the social team increased, transition between the hospital and community improved, and patient satisfaction with the support was high. The next steps are to address other unmet social needs through this type of leadership process that clearly included addressing an inequity and building partnerships. Case Scenario 5 for Partnership Building: Collaborative Approach to Hypertension Control in a Community Health Setting A nurse leader/manager was passionate about improving hypertension control among the patient population in their community health clinic. The leader recognized that achieving this goal required the expertise and cooperation of multiple disciplines and stakeholders including patients, community members, interdisciplinary team members, and external partners. The main objectives of the partnership were to build trust, to seek feedback, and to create a collective vision. The leader organized community meetings to introduce the project, share information on the importance and need for blood pressure (BP) control, listen to concerns, and build trust with patients and community members. They ensured that all stakeholders were kept informed through regular updates, newsletters, and an online portal where they could access information and provide feedback. They conducted surveys and focus groups to gather input from patients, community members, and healthcare professionals on their needs and preferences. Then they facilitated workshops with stakeholders to develop a shared vision and goals for the hypertension control project. A comprehensive hypertension management plan was created in collaboration with a team of nurses, doctors, dietitians, pharmacists, and social workers. Each discipline contributed with expertise in the development of patient-centered care protocols. The leader involved local community leaders and organizations and promoted awareness and education about hypertension. Community health workers were trained to support patients in managing their BP and to lead patient support groups as a platform for sharing experiences and promoting peer support. A patient advisory board was established to ensure that patient perspectives were included in decision-making and to obtain perspectives on barriers to BP control behaviors. Patients shared their experiences and suggested practical solutions for improving control. For external partners, the leader invited partners from local universities, professional nursing organizations, other healthcare institutions, and patient organizations to access additional resources, training, and support. For the implementation of the hypertension control project, the leader and team launched educational campaigns on hypertension prevention and management, engaging social media, local media, and community events. Regular BP events were organized in collaboration with local pharmacies, businesses, and community centers. For the monitoring and evaluation of the hypertension control project, the leader implemented a system for collecting and analyzing data on hypertension control rates, patient adherence to treatment, and overall health outcomes. The project team held regular review meetings to assess progress, address challenges, and make necessary adjustments. Through effective stakeholder engagement, the project achieved significant improvements in hypertension control among the patient population. The collaborative approach led to increased patient adherence to treatment plans, better health outcomes, and a stronger sense of community involvement in health promotion. Case Scenario 6 for Embracing Technologies A senior nurse leader within a cardiovascular unit successfully guided their team through a dual transition involving the adoption of a remote monitoring system and the expansion of telehealth services. They implemented a comprehensive strategy focusing on staff training, interdisciplinary collaboration, and evidence-based practice. The approach included interactive workshops to build digital competency among staff, regular stakeholder meetings to ensure open communication, and a pilot study to demonstrate the effectiveness of remote monitoring in improving patient outcomes. The strategy also featured a mentorship program to develop aspiring leaders within the team. This leadership approach enhanced staff confidence with technology and strengthened multidisciplinary teamwork. The next steps are to see what effect the introduction of the remote monitoring system has on patient satisfaction and hospital readmission. The case highlights the crucial role of effective leadership in embracing and navigating technological change in cardiovascular nursing within the healthcare system. Summary These scenarios and leadership development activities were expanded upon in the PCNA Global Conference on Nursing Leadership Forum’s Transforming Heart Health through Global Nursing Leadership held in October 2025. Additionally, an important framework for Global Nursing Leadership Competency was recently developed by Sigma Theta Tau International,3 and the framework includes many of the evidenced-based competencies noted above and in the case scenarios. Sigma’s framework identifies 4 levels of competency including novice, competent, expert, and luminary, and notes that a leader may not be at the same level for all competencies. Their self-assessment tool of leadership abilities may be of assistance to cardiovascular nurses as they develop a plan to enhance their global leadership abilities. All cardiovascular nurses are called to action at this crucial time to exert and develop their leadership competencies. Reducing the global burden of cardiovascular disease depends on you.