Future Healthcare Systems/The Nurse Executive Role
Over the past 3 decades, the Nursing Administration Quarterly has addressed topics forecasting the nature of future healthcare systems, leadership necessary for the future, nursing administration challenges, roles, relationships, and educational preparation for complex healthcare systems of the future. These thought-provoking, stimulating, and evolving futuristic prognostications for nurse executives bring new dimensions and meaning to whatever healthcare systems will require of the nurse executive. The touchstone of leading the caring enterprise, wherever positioned nationally or internationally, is the essence of the role of the nurse executive.
The best-positioned and overall nurse executive role in one of the most complex healthcare systems of today is that held by this issue editor: Cathy Rick, RN, CNAA, FACHE, chief nursing officer of the Veterans Health Administration (VHA), Department of Veterans Affairs. She provides leadership and guidance to VA's 61,000 nursing personnel who care for more than 5 million veterans each year. As the chief nurse executive for the VA, she is responsible for the development, implementation, and evaluation of national policy and strategic planning activities that support the missions of the VHA: clinical care, education, research, backup to the Department of Defense, and emergency preparedness.
Cathy Rick is responsible for administering the VA National Nursing Strategic Plan. National goals include strategies to enhance leadership development, evidence-based practice, technology and system design, workforce care coordination and patient self-management, and collaboration with academic affiliates and professional organizations. Significant accomplishments and future directions for each of the goals have emerged. Nursing staff members across the 1300 VA sites have been affected positively by the work related to these strategic goals. These accomplishments, under Cathy Rick's leadership, provide the profession of nursing with concrete evidence of the nurse executive role in a complex healthcare system postured for meeting future challenges. It is my special privilege to have Cathy Rick as a member of the editorial board and issue guest editor for the Nursing Administration Quarterly, as I was Chair of Nursing at Alverno College School of Nursing in Milwaukee, Wisconsin, when Cathy earned her bachelor of science in nursing. Her vision for the future and over 30 years of experience in clinical leadership and executive healthcare roles led to several awards: 1997 Nurse Executive of the Year, Wisconsin Organization of Nurse Executives; 2004 Marquette University Distinguished Alumni Award; and 2005 McGovern Award, American Association Colleges of Nursing.
While nurse leaders pursue excellence in developing future healthcare systems, I can review only historical precedents by visionary leaders who have participated in shaping where we are today. Nursing Administration Quarterly (Vol 25:4) Nurse Executives, Chief Operating Officers, and Chief Executive Officers:
* Each of us needs to thoughtfully plan our destination and map out the trip. We will then be capable of flexing and adapting to the detours and stop signs while successfully designing and contributing in our executive roles.-Rhonda Anderson, RN, MPA, CNAA, FAAN
* To create a new world order in anything you do, you've got to dare to dream. You need to visualize where you want to go and then figure out what will get you there. Whether you are charting your own career path or leading change in your organization, you've got to know where you are heading.-Jolene Tornabeni, RN, MA, FACHE, FAAN
* Success in a senior executive role is multifactorial and often relates to the overall success of an organization. There are times when a self-planned departure is the correct course of action in the interest of career mobility.-Karen S. Ehrat, PhD, RN
* Nursing is an extremely important societal function that has consistently been undervalued and made invisible because of sexism.-Barbara K. Redman, PhD, RN, FAAN
* The key to the executive suite has always been strategic, technical, operational, or financial expertise, not patient care proficiency.-Roy L. Simpson, RN, CMAC, FNAP, FAAN
* A complex vertically integrated system covers the continuum of care from primary preventive care through acute, long-term, and ultimately hospice care-the acquisition of leadership and managerial competencies in a dynamic process requires the executive to be ever open to new learning opportunities and environments.-Roxanne Spitzer, RN, PhD, MBA
* You have the wherewithal to be the visionary leader for the future of health care. You know how to surround yourself with the best people who have the strengths needed for success,-Nursing has every reason to want to be there for a better health care system of tomorrow. Remember, you will need that system for your own future and so will your loved ones. There will always be new challenges and the need to learn new technology and new skills to acquire. It just depends on how you want to play the game of health care delivery.-Barbara J. Brown, EdD, RN, FAAN, FNAP
As this issue is being finalized, I have returned from Doha, Qatar, and a Fulbright Academy of Science and Technology think tank and workshop: Human Health and Environmental Challenges in the Middle East, March 23 to 26, 2008. Hopefully, we will address "green" issues for nurse leaders in the future as environmental health becomes a more conscious effort globally. But, what excited me most is the forward thinking and nursing leadership growth of colleagues from around the world, and most especially in the Middle East.
A former staff nurse at the King Faisal Specialist Hospital and Research Center, Bothyna Z. Murshid, DNSc, has completed her masters at the University of Michigan and her doctorate at Yale University. I can recall, as I met with her during my time as associate executive director, 1987 to 1991, she was 1 of 2 Saudi nurses on the King Faisal Specialist Hospital staff. Today there are more of 100 of almost 2000 nurses. I counseled her about the importance of continuing her education and becoming a leader for the future for her country, and now she is Dean at the School of Nursing, King Saud bin Abdullaziz University for Health Sciences, in Riyadh, Saudi Arabia, a country where nursing is a social stigma and working as a professional woman presents its unique cultural challenges.
Our work group was small with only 30 invited international leaders and less than 100 regional and local participants. The outcome contributions charted a course of positive energy and enthusiasm for the future of nursing in a worldwide shortage. Exceptional concerns were discussed about the health of children in serious environmental circumstances that multidisciplinary teams could do something about. Therefore, as we envision the nurse executive role in multisystems, let us be reminded of the need for teamwork with all disciplines for a global healthier tomorrow.
Barbara J. Brown, EdD, RN, CNAA, FAAN, FNAP, Editor-in-Chief
Nursing Administration Quarterly