1. Section Editor(s): Alexander, Mary MA, RN, CRNI(R), CAE, FAAN

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In many of these editorials, I have encouraged you to take a leadership role in the nursing sphere. Yes, it's a lot of work, and sometimes you have to make sacrifices. But becoming a nurse leader can be tremendously rewarding, both personally and professionally.

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If you're looking for a role model, I am pleased to recommend Marilyn Tavenner, MHA, BSN, RN, who was approved on May 14 as administrator of the Centers for Medicare & Medicaid Services (CMS) by a US Senate vote of 91-7. Ms Tavenner is the first CMS administrator to be confirmed by the Senate since October 2006, when Dr Mark McClellan left the post. The position has been buffeted by political winds since then. Her predecessor, Dr Donald Berwick, formerly head of the Institute for Healthcare Improvement, was never approved by the Senate. He was given a recess appointment and served for 17 months before stepping down.1 Ms Tavenner proved able to surmount the political obstacles to her confirmation by proving herself to Congress since she became acting administrator in December 2011.


Ms Tavenner began her nursing career at the (Hospital Corporation of America) Johnston-Willis Hospital in Richmond, Virginia, in 1981. She rose through the ranks, becoming the hospital's chief executive officer, ultimately responsible for 20 hospitals as the company's president of the Central Atlantic Division.2


Her public service career began in 2006, when she accepted a position as Virginia's secretary of health and human resources in Governor Tim Kaine's administration. With a $9 billion annual budget, her office administered Medicaid, mental health, social services, public health, aging, disabilities agencies, and children's services.3 Governor Kaine praised Ms Tavenner by saying, "When I was governor, there was no one in my cabinet who was more creative and compassionate in trying to find ways to achieve savings. She is a whiz at this and yet never sacrifices her focus on patient care [emphasis mine].1 This is what nurses do. Even while climbing the professional ladder, nurses always put patients first.


As CMS administrator, Ms Tavenner will be responsible for an even larger portfolio. CMS not only manages Medicare and Medicaid, it also handles the State Children's Health Insurance Program (SCHIP), as well as standards for nursing homes, the Health Insurance Portability and Accountability Act (HIPAA), and clinical laboratories. And with the Affordable Care Act coming fully online in 2014, she will be in charge of carrying out the major provisions of the law, including Medicaid expansion and the creation of private insurance exchanges.1


Ms Tavenner's drive, knowledge, and skills have propelled her to the top of the nursing profession. As the most trusted members of the health care team,4 it only makes sense that nurses are assuming key leadership roles. We are proud that one of our nurse colleagues is in such a prominent position and wish her much success as she guides this influential agency with her capable leadership!


Mary Alexander




1. Pear R. Acting chief wins confirmation to run Medicare and Medicaid. New York Times. 2013:A13. [Context Link]


2. HHS Secretary Sebelius announces Senate confirmation of Marilyn Tavenner [news release]. Washington, DC: US Department of Health and Human Services; 2013. Accessed May 28, 2013. [Context Link]


3. CMS leadership: Marilyn Tavenner. Centers for Medicare & Medicaid Services Web site. Accessed May 29, 2013. [Context Link]


4. Enduring trust: nurses again top Gallup's poll on honesty and ethics. Robert Wood Johnson Foundation Web site. Published December 5, 2012. Accessed May 30, 2013. [Context Link]