So You Want to Be a Chief Nursing Officer?

Laura A. Stokowski, RN, MS


March 26, 2015

In This Article

A Seat at the Table

"As a nurse executive, you have a seat at the table, and along with senior management, you help to drive the system," explains Rachel Polhemus, senior partner of the executive search firm Witt/Kieffer (Figure 2).

Figure 2. Rachel Polhemus, Senior Partner, Witt/Kieffer

Polhemus, whose firm concentrates on job placement of the systems-level CNO, adds, "The systems CNO is responsible for the professional practice of nursing and the quality of care." Polhemus expects to see the influence of systems-level CNOs grow as the role evolves. "These CNOs will ensure that care is uniformly delivered, because that has an impact on how healthcare systems are reimbursed, what they can offer, and what influences patients to come to their facilities rather than to another network's facilities."

Because of their broad influence, nurse executives are having a major impact on the practice of nursing, patient care, and clinical outcomes in our nation's healthcare delivery system.[5] Nurse executives are able to influence the work environment of nurses and other disciplines as well as the retention of employees in the facility or system.[6] They can empower frontline and junior management level nurses and other healthcare professionals to construct the solutions to barriers that may stand in the way of the twin goals of a satisfied and healthy workforce and quality patient outcomes.[7]

Nurse executives lead change within the facility or system. They are able to engage in partnerships with other disciplines and serve as role models for true multidisciplinary care. When Gordin first took the CNO and vice president position she holds now, she observed that the traditional hospital hierarchy—physicians at the top, nursing in the middle, and then everybody else at the bottom—was unhealthy. She set out to flatten the hierarchy and create a truly integrated, multidisciplinary healthcare team by restructuring the shared governance model into a shared leadership model that brought other disciplines to the table with nurses.

Although nurses still make up 60%-70% of each leadership council (which under her leadership also includes child life services, social work, psychology, pharmacy, radiology, laboratory, and other therapy services), each council is co-led by a nurse and a member of another discipline. "It has resulted in a much healthier climate among the employees and how they take care of patients," says Gordin. "We are a team in every sense of the word."


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