Time for a Change

In the evolving landscape of healthcare, nurse managers are expected to lead across systems, influence patient outcomes, and drive strategic priorities, far beyond the traditional scope of direct supervision. Yet, the term "span of control" remains a default metric for evaluating their workload and effectiveness. Rooted in industrial-era management theory, this language no longer reflects the complexity of contemporary nursing leadership. These authors propose a shift to "span of accountability," a more accurate, empowering, and future-ready framework. This commentary explores the theoretical rationale, practical implications, and strategic benefits of updating this lexicon to align with modern healthcare realities.

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Publication Details

Journal
JONA The Journal of Nursing Administration
Published
2025-10-09
DOI
https://doi.org/10.1097/nna.0000000000001631
Citations
1
Primary Topic
Nursing Education, Practice, and Leadership
Type
article
Field-Weighted Citation Impact
5.53
Controls
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article

Time for a Change

Karen Drenkard, Brandy Mathews
1 citations
JONA The Journal of Nursing Administration
Nursing Education, Practice, and Leadership
5.53
article

Time for a Change

Karen Drenkard, Brandy Mathews
article en
1 citations

Abstract

In the evolving landscape of healthcare, nurse managers are expected to lead across systems, influence patient outcomes, and drive strategic priorities, far beyond the traditional scope of direct supervision. Yet, the term "span of control" remains a default metric for evaluating their workload and effectiveness. Rooted in industrial-era management theory, this language no longer reflects the complexity of contemporary nursing leadership. These authors propose a shift to "span of accountability," a more accurate, empowering, and future-ready framework. This commentary explores the theoretical rationale, practical implications, and strategic benefits of updating this lexicon to align with modern healthcare realities.

JONA The Journal of Nursing AdministrationVol. 55(10)
Good Samaritan Hospital (US)
Openalex Percentile: Top 4%
Nursing Education, Practice, and Leadership
5.53
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