Xavier University launched the Master of Science in Nursing (MSN): Direct Entry as Second Degree (MIDAS) in 2005 in response to the increasing need for highly skilled nursing professionals. The program’s vision is to develop holistic nursing professionals with the skills necessary to address the needs and challenges of 21st-century nursing. Our Jesuit values guide this mission. Since its founding, the program has produced nurse graduates who provide bedside care and leadership within their microsystems. Our founding faculty were forward-thinking in creating a strong, rigorous program that blended the prelicensure nursing requirements with the graduate-level MSN outcomes. The MIDAS graduates are prepared to sit for certification as a Holistic Nurse and a Clinical Nurse Leader (CNL). The program’s unique holistic approach to nursing care and clinical nurse leadership addresses the social determinants of health (SDoH) of underrepresented communities. Xavier’s MIDAS program has evolved over the past two decades in response to changing patient and population health needs.
Focus on Attributes of Population Health
Students in the MIDAS program explore and learn to care for the whole person. The Jesuit Ignatian values are reflected in this holistic approach to nursing, emphasizing service to others through social justice, intellectual competence, and reflection (Xavier University, n.d.). Patient-Centered Care is responsive to the patient’s preferences, values, and needs through effective collaboration with the healthcare team. Throughout the curriculum, students learn to assess determinants of health at the individual and community levels, connect to appropriate resources. MIDAS graduates use their bedside skills alongside their clinical nurse leader competencies to facilitate this collaboration between the care team members and the community to improve patient outcomes. The health of the population is improved when these attributes are considered and addressed during the care process.
Historical Perspective of the Clinical Nurse Leader Role
During the early 2000s, healthcare professionals were called upon to address patient safety and quality concerns in our health systems (Institute of Medicine, 2001; AACN, n.d.). Academic and clinical partnerships were formed and collaborated with to address the safety and quality concerns occurring in patient care environments. In response to this, the American Association of Colleges of Nursing (AACN) developed competencies for the CNL role to care for patients at the point of care, whether on a specific unit or in a community setting (AACN, 2013). The primary focus of the Clinical Nurse Leader (CNL) is improving patient health outcomes and overall population health through best evidence, collaboration, and advocacy. Over the last two decades, the AACN has affirmed the value of this role through updated competencies and calls for this role within our healthcare communities (AACN, n.d.). Across the nation, many healthcare systems adopted CNL positions to improve care at the bedside and meet the demands of safety and quality care initiatives.
Demand for Clinical Nurse Leaders
The need for strong clinical leaders within the health systems remains significant. Recently, the AACN (2025) updated the competencies for the Clinical Nurse Leader role at the Master’s and Doctoral levels. Nursing groups such as the American Nurses Association (ANA), AACN, and American Organization for Leadership in Nursing (AOLN) advocate for the benefits the CNL provides to patient health outcomes and meeting unit metrics. While there have been changes over time within health systems incorporating named positions for the CNL role, many are seeing their contributions in roles such as nurse educators, coordinators, quality improvement specialists, researchers, and nurse managers. The persistent challenges facing healthcare—such as the shortage of bedside nurses, the difficulty retaining nurse managers and leaders, and patient safety and quality patient concerns—have made the CNL role ever more relevant in our communities. The CNL provides the support needed in care and leadership to improve patient and nursing staff satisfaction and to increase the unit’s quality metrics (AOLN, 2023; Lose et al., 2025). The MIDAS program at Xavier University seeks to meet this call and address population health needs with our nursing graduates
References
American Association of Colleges of Nursing (AACN). (n.d.) History of the CNL. https://www.aacnnursing.org/our-initiatives/education-practice/clinical-nurse-leader/cnl-certification/about/history
American Association of Colleges of Nursing (AACN). (2013). Competencies and curricular expectations for Clinical Nurse Leader education and practice. AACN. https://www.aacnnursing.org/news-data/position-statements-white-papers/cnl-white-paper
American Association of Colleges of Nursing (AACN). (2025). CNL Master’s and Doctoral Competencies. https://www.aacnnursing.org/Portals/0/PDFs/CNL/CNL-Masters-Doctoral-Competencies.pdf
American Organization of Nurse Leadership (AONL). (2023). CNLs influence outcomes at the bedside and beyond. https://www.aonl.org/news/voice/november-2023/CNLs-Influence-Outcomes-at-the-Bedside-and-Beyond
Institute of Medicine (IOM) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press. https://doi.org/10.17226/10027
Lose, D., Lisk, J., Hunger, S. (2025). Transforming nurse manager roles: Success through strategic clinical nurse leader integration. Nurse Leader, 23(3), 249-255. https://doi.org/10.1016/j.mnl.2025.01.005
Xavier University. (2025). Master of Science of Nursing: Direct entry as a second degree (MIDAS) https://www.xavier.edu/msn-direct-entry/
Xavier University. (2025). Xavier’s mission, vision and values https://www.xavier.edu/mission-identity/xaviers-mission/xaviers-vision-and-mission-statements
