From CNO to CEO: Over the Top
Sixteen years ago, Nursing Administration Quarterly featured an issue on Breaking the Glass Ceiling (Vol 19, No. 2, Winter 1995, Aspen Publication), so it is time to revisit the coming of age of nurse executives, as increasing number of nurse leaders are moving into CEO (chief executive officer) positions. Because we are predominantly in a female profession, we have traditionally viewed ourselves as gender limited, a sociological concept with a set of beliefs and perceptions about what is feminine and what is masculine. We have been socialized into compassion, passivity, compliance, following orders, supportiveness of others. The issue of advancing into top leadership positions has never been about leadership ability, but rather about the societal perception that women should focus on family and not be in top leadership positions.
In fact, when I was featured in a newspaper article about multipurpose women in the 1960s, and was in the midst of raising 6 children, while practicing nursing, I received hate letters from some women who wrote that I should not work and should be at home with my family. Well, that is a long time ago and our world has certainly changed as nurse leaders step up to the plate to accept chief executive positions. Leading CNO (chief nursing officer) to CEO, Nursing Administration Quarterly, as issue guest coeditor is Lois Napier Skillings, RN, MS, NEA, BC, newly appointed president and CEO for Mid Coast Health Services in Brunswick, Maine.
Mid Coast Health Services is an independent, nonprofit health care system, which includes Mid Coast Hospital, a 92-bed Joint Commission-accredited, Magnet-designated community hospital; Mid Coast Medical Group, a 50-bed primary care and specialty medical practice; Mid Coast Senior Health Center, a continuum of geriatric services including subacute care, long-term care, assisted living, and memory impairment; and CHANS Home Health Care, a Joint Commission home health and Medicare-certified Hospice agency. Lois leads the senior executive team and is responsible for the strategic and operational performance of the system. Just prior to this role she served as the executive vice president for Nursing and Patient Care Services for Mid Coast Health Services and was the senior leader responsible for patient safety and quality in the organization.
In 2008, Lois was selected as a Robert Wood Johnson Executive Nurse Fellow. She is past president of OMNE, Nursing Leaders of Maine. Awards include OMNE: Nursing Leaders of Maine, Leadership Achievement Award (1999); and Sigma Theta Tau, Kappa Zeta Chapter, Excellence in Nursing Leadership Award (2002). She has served as a board member for the United Way of Mid-Coast Maine and has served as chairperson of the board of directors, the community campaign, and the strategic planning committee for United Way. Lois is definitely a nurse leader on the move.
Another nationally recognized nurse leader on the move is guest issue coeditor, Phil Authier, RN, MPH, senior vice president, Verras Consulting, Chicago, Illinois. Phil has more than 30 years of experience in top nursing and health care leadership positions including CNO, COO (chief operating officer), hospital administrator, and vice president of patient care. He has more than 9 years of health care consulting experiences providing services in the area of organizational culture, leadership development, innovative leadership, coaching, and effective communications. His recent work involves helping physicians reduce variations by being consistent about their own best practices, while improving hospital processes that increase quality and reduces costs.
Phil has been actively involved in nursing organizations as a well-respected leader at both national and state levels. He has served as president of the American Organization of Nurse Executives and has participated in the South Dakota and Michigan Organizations of Nurse Executives and the American Hospital Association. He is a member of the Center for Nursing Leadership and has experience with value-based leadership and is a skilled facilitator working with consensus building and conflict resolution. If you are headed for the next level of executive position, you may need an expert coach or mentor, which is Phil's expertise.
When looking at model CEOs, Carly Fiorina, former corporate executive of Hewlett-Packard, has indicated several traits that were her guidelines:
* Find difficult challenges
* Develop a clear vision of goals for organization
* Avoid self-imposed limits
* Value the team
* Don't give in or give up
* Balance confidence and humility
* Have a passion for what you do.
Every nurse leader has a definite passion for patient care and the profession of nursing, but oftentimes we have self-imposed limits or acquiesce to other members of the administrative team. We tend to overvalue the ideas of others and undervalue the significant knowledge of the patients that we have, for both a business aspect as well as the caregiving mission. Successful executive leadership requires both an inspiration with passion and vision and a will and determination to achieve the goals of the organization. This takes courage, confidence, caring, and charisma with a special connectedness to be able to lead the entire enterprise. Certainly, there needs to be business savvy leaders and the Robert Wood Johnson Executive Nurse Fellow program has launched several nurse leaders in the best possible direction.
In today's health care milieu, a global perspective and cultural sensitivity can be achieved best by living and working in a foreign country. Learning other languages, although challenging, assists in communication and understanding of customs different from those of our own country of origin. This takes strength and confidence in one's self without losing authenticity and honesty to engage people and motivate them to give their best performance. I do miss the excitement of leading in a foreign country, as I did for 4 years in Saudi Arabia, but feel so blessed to be home in the United States, where family and friends are. Health care reform may be a vehicle for everyone to recognize the value of nursing as a strong leadership profession to keep the vision of caring for America moving forward into the best possible health care in the world.
-Barbara J. Brown, EdD, RN, CNAA,
FNAP, FAAN
Editor-in-Chief
Nursing Administration Quarterly