Chief Nursing Officer Research Paper
This paper is designed as a means for students to demonstrate a comprehensive understanding of specific leadership roles and performance expectations. References (in addition to those provided in the course materials) are expected and should be from scholarly journals, texts and interviews with relevant leaders. The paper should be no longer than 7 pages (double-spaced) not including attachments, references, or title page. Please utilize the most current version of either the American Psychological Association, American Medical Association or Vancouver formats when writing theses papers. An abstract is not required. Chief Nursing Officer Research Paper
Paper Grading Criteria:
1. In one paragraph, provide an overall description of a specific leadership position and the work environment/context in which you’ll be examining this role e.g., Clinical Director of Surgical Nursing in an acute care hospital, Quality Improvement Director in a cardiac service line within an acute care setting (5%).
2. In bulleted format, write performance standards* respectively categorized (e.g., those duties that fall under personnel management, those under financial responsibilities etc.) Do not include an institutionally developed job description (nor all the components of one) but rather your overall understanding of the requisite skills/tasks for this role (20%).
3. Describe the typical reporting relationship of this position and discern how this may differ based on employment setting types (e.g., small community hospital versus large academic teaching center or acute versus outpatient care delivery systems). Analyze the advantages/disadvantages of different reporting structures on role enactment. Propose, with rationale, an ideal reporting relationship given the selected context. Include an organizational chart as an appendix (25%).
4. Identify the criteria for successful role fulfillment which may include (but is not limited to): formal education, work experience, personality attributes, and leadership competencies, and substantiate with supportive rationale. This is not a repeat of performance standards but rather characteristics/factors required for success (10%).
5. Analyze the challenges incumbent to this role and how this impacts typical position tenure/turnover. Briefly postulate solutions to addressing these challenges (which need to be realistic and fiscally reasonable) (10%).
6. Provide a plan for transition into this role e.g., first 90 days, and what type of information, resources, etc. are necessary during this time period. In other words, how would you initially approach this position if you were hired into this role? Include how you plan to build an effective working relationship with your “boss” (15%).
7. Describe the overall job market for this role (is it in high demand or is the market saturated) and likely career trajectory for an individual in this leadership role (e.g., what position(s) does this role prepare one to do in terms of career advancement) (5%).
8. Provide an annotated bibliography (no less than 10 resources) included at the conclusion of this paper. Present your discussion in a cogent fashion** using aspects of scholarly writing including professional style, correct grammar and formatting (10%).
Chief Nursing Officer Research Paper
Description
The chief nursing officer (CNO) is responsible for organizing, planning, and directing all nursing and patient care activities throughout the healthcare organization. The CNO) reports directly to the Chief Executive Officer (CEO) and executive management as a senior member of executive management in the organization. The CNO ensures that patient care is compliant with the quality standards and maintains performance/quality improvement activities in the organization. The CNO also ensures that all nursing personnel are competent and helps in developing the budget and maintaining effective and efficient departmental operations while complying with all local, federal, and state regulations, standards, and procedures. A CNO is responsible for developing a nursing setting that facilitates excellent clinical care and research by supervising all nurse managers and nurses to ensure that the organizational practice standards are consistent (Ingwell-Spolan, 2018). The CNO will join a 100+ acute care hospital and will play the role of leading all the nursing departments during care delivery using employee safety and quality improvement initiatives that have earned the honors for clinical excellence. The hospital has been rated as being among the safest healthcare organization.
Performance Standards
Essential Functions
- To promote the organizational vision, mission and values
- Aware and practices and adheres to the set purpose, philosophy, standards and policies of nursing care services
- To organize and direct nursing care services in accordance with the current nursing standards
- Participates in the planning for the budgeting needs for the staff, equipment, and supplies
- Oversees cost controls to ensure utmost efficacy of finances spent from the approved departmental budgets
- Supports and designs nursing care services, work assignments, staff development and performance evaluations for these nursing/patient services
- Ensures maintenance of quality assessment initiatives and evaluation of care provision and communicates to the organizational management regarding the nursing care services
- Plans and proposes to the organizational management about new equipment or facilities required for effective provision of patient care (Ingwell-Spolan, 2018).
- Recommends and takes part in the development of education programs and training, as well as the orientation of new staff members
- Designs and take part in problem-solving and policy development programs for patient/nursing care services
- Collaborates with all departments to facilitate continuity of care and effective care coordination
- Takes part in the medical staff meetings, Board of Trustee and Administrative Counsel meetings
- Takes part in Administrator on-call rotation together with the organizational CEO and other senior management leaders
Leadership & Direction
- Fully and always updated within a challenging and dynamic environment
- Competency in analyzing the longer-term and wider issues regarding the delivery of better healthcare services and the capability to develop clear medium- and longer-term objectives
- Possess the appropriate leadership skills and vision to steer, manage and lead changes within a complex environment
- Has the ability to organize, lead and motivate the personnel to function competently and perform their duties
- Ability to the community the vision, ideas and information effectively and clearly sensitively about wider issues
- Ability to negotiate and advocate for favorable services for the unit, organization, and population (Roussel & Thomas, 2016).
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Critical Analysis & Decision Making
- Ability to analyze and assess objectively, rationally, consistently and systematically diverse and complex information and identify the important core issues
- Ability to critically analyze various available options, engage other parities appropriately and make prompt and balanced decisions
- Confident decision-making
- Demonstrates a strong level of self-sufficiency, ability to push for proposals, and recommend decisions proactively while actively recommending improvements and readily adapting to changes (Rundio, 2016).
Working with & Through Others
- Commitment to developing professional networks to remains updated and informed
- Ability to influence both external and internal politics
- Committed to working collaboratively with the senior management colleagues to achieve the designated agenda
- Possess excellent networking, interpersonal and influencing skills (McKinney et al., 2016).
Operational Excellence
- Ability to facilitate the accomplishment of medium-and-long-term goals and at the same time manage the short-term goals and priorities
- Ability to organize at an operational and strategic level the required individuals and other resources to ensure that the set objectives and goals can be met with the available resources (staffing, budget, etc.), within timescales and as per the quality standards
- Is innovative, creative, and demonstrates perseverance and resilience even during adversity (Steadman, 2020).
Communication and Interpersonal Skills
- Has the ability to advocate, explain and express ideas and facts convincingly
- Actively connects and liaises with people and groups both internally and externally (Steadman, 2020).
Personal Dedication &Motivation
- Personal dedication and motivation for the designated role
- Reporting Relationship of the Position
The chief nursing officer (CNO) reports directly to the Senior Management Team or the Chief Executive Officer (CEO) as a senior member of executive management in the organization. The CNO works collaboratively with all nurse managers and other organizational leaders. The CNO is involved in policy development and makes important contributions to decisions the healthcare organization and delivery of clinical services at the local and regional levels. The CNO also collaborates with all other departments to facilitate continuity of care and effective care coordination and also participates in medical staff meetings, Board of Trustee and Administrative Council meetings. The CNO also collaborates with the CEO and other senior leaders to participate in the Administrator on-call rotation.
Criteria for Successful Role Fulfillment
Professional Requirements
- Possesses a valid and updated RN licensure from the appropriate state
- Possesses the appropriate clinical credentials and competencies to work clinically
- Has completed the appropriate annual education and professional development requirements
- Respects patient privacy and confidentiality always
- Adheres to the required local, federal and state regulations and laws
- Ability to represent the healthcare organization positively and professionally at all times
- Adheres with the organizational standards, practices, and policies and upholds the ethical principals
- Takes part in continuous quality improvement and performance improvement activities
- Attends the required committee and administrative meetings appropriately
- Ensures adherence to the procedures, protocols, and policies about the department operations, infection control, safety and fire
- Ability to consistently and effectively communicate with the administrative and management directives to the staff and promote interactive departmental discussions and meetings. Chief Nursing Officer Research Paper
Qualifications
- A nurse graduate from an accredited nursing institution
- Updated licensure to practice as a registered nurse (RN)
- Must be a holder of a Bachelor’s nursing degree
- An MSN degree (Master’s nursing)
- 5-year experience in managing patient care services
- Previous experience in critical nursing care
- Knowledgeable about budgeting, resource planning, and evaluation methods and procedures
- Good understanding of the relevant laws and regulations
- Ability to illustrate effective managerial and leadership skills; ability to maintain excellent interpersonal relationships, and apply sound management principles
Knowledge, Abilities, and Skills
- Strong interpersonal and organizational skills
- Capacity to determine a suitable course of action in complex situations
- Problem-solving skills
- Critical thinking skills
- Effective communication skills
- Effective time-management skills
- Ability to work independently, attention to detail and maintain a positive attitude
- Capacity to manage numerous and simultaneous duties and prioritize work schedule
- Ability to ensure confidentiality of all financial, medical and legal information
- Ability to handle complex situations regarding patients, nurses, physicians, and others professionally (Persolja et al., 2020).
Challenges associated with the Role of a Chief Nursing Officer
The major challenge of being a chief nursing officer is the many responsibilities associated with the role. CNOs are expected to supervise nursing and patient care and at the same time fulfill their administrative roles and oversee quality improvement initiatives (Hughes, 2018). CNOs are also expected to take part in policy developments. CNOs work for more than 40 hours weekly and are also forced to work during evenings and weekends. It is therefore clear that being a CNO can be stressful and overwhelming. Generally, a CNO holds tremendous responsibilities regarding representing the nursing staff in the organization on the executive board.
To address the challenge, CNOs should collaborate with other leaders and garner support from professional colleagues. Teamwork involves getting support from the administration, nurse managers, matrons, and clinical leads. As indicated, CNOs have multiple roles and thus they face time limitations; therefore, they rely on distributed and shared leadership models to ensure effective service delivery (Daly et al., 2014). Therefore, teamwork and collaboration with various organizational leaders are very essential elements for clinical directors.
Transition Plan into the Role of a Chief Nursing Officer
By the end of the first 30-days after assuming the role of a chief nursing officer, I will have established a collaborative relationship with all senior administrative leaders, nurse managers, and the nursing staff as well. I will focus on establishing the relationships through trust and time and tap the internal resources of the individuals to help in strategies and anything else I may require to effectively take on the role of a chief nursing officer.
I will also set clear expectations and guidelines to assist in ensuring that all nursing units and departments maintain accountability. I will carve time to discuss my vision and organizational goals with the relevant stakeholders to accomplish effective patient care and organizational business objectives. Including all stakeholders in the planning process has been shown to facilitate shared vision and motivate team members and followers to put efforts towards achieving the vision. In addition, I will ensure that I am accustomed to the policies, numbers, and procedures in the organization. In case there is a need to review the policies and regulations in the nursing departments, I plan to ensure that within 90 days I will have reviewed the departmental policies and involve the nursing staff in the review process. I also plan to familiarize myself with organization, available resources, supplies, and the support structures in all nursing departments.
To ensure I acquire skills to successfully take on the role, I plan to enroll in the relevant training programs. For instance, I plan to participate in the leadership training program and collaboration program for nurse leaders. Such programs will equip me with the necessary leadership skills, teamwork, and collaboration skills (Joseph & Huber, 2015).
Overall Job Market
The demand for leadership roles such as chief nursing officer is becoming high due to the need to maintain the best quality care. CNO is the highest management position with hospitals for experienced RNs. The overall marker of a CNO is very high.
The average annual salary for a CNO within the US is $114,701, and this translates to the average hourly pay of $43. CNOs are eligible for benefits, overtime hours, bonuses, as well as other incentives; this, increases their total pay to approximately $143,368. However, CNOs with enormous leadership experience can approximately $200,000 annually (Top Master’s in Healthcare Administration, 2020).
The role of a clinical chief officer prepares a nurse leader to become the CEO of a healthcare organization. The role also prepares a nursing officer to take other bigger leadership roles such as managing groups of hospitals or becoming an active member in policy-making on health issues. This is because by becoming a clinical director, one gains the necessary leadership skills to steer and lead healthcare organizations and make important decisions affecting healthcare. Chief Nursing Officer Research Paper
Description
The purpose of the job position is to accomplish the best clinical patient outcomes using the available resources in the healthcare organization (Barbiani et al., 2016). The clinical director of surgical nursing will join a 100+ acute care hospital and will play the role of leading the surgical nursing department through employee safety and quality improvement initiatives that have earned the honors for clinical excellence. The hospital has been rated as being among the safest healthcare organization. The clinical director will be reporting directly to the Chief Nursing Officer. The clinical director in the surgical nursing unit will work with both surgical and anesthesia departments to ensure a collaborative work setting, high quality, and good financial performance. Will be responsible for the supervisory and administrative responsibilities in planning, coordinating, and managing resources and programmatic clinical services for the surgical nursing department. Responsible for coordination and developing goals and objectives of the program and well as coordinating with other directors to advance the clinical setting and techniques (Clavo-Hall et al., 2018).
Performance Standards
Leadership & Direction
- Fully and always updated within a challenging and dynamic environment
- Competency in analyzing the longer-term and wider issues regarding the delivery of better healthcare services and the capability to develop clear medium- and longer-term objectives
- Possess the appropriate leadership skills and vision to steer, manage and lead changes within a complex environment
- Has the ability to organize, lead and motivate the personnel to function competently and perform their duties
- Ability to the community the vision, ideas and information effectively and clearly sensitively about wider issues
- Ability to negotiate and advocate for favorable services for the unit, organization, and population (Roussel & Thomas, 2016).
Operational Excellence
- Ability to facilitate the accomplishment of medium-and-long-term goals and at the same time manage the short-term goals and priorities
- Ability to organize at an operational and strategic level the required individuals and other resources to ensure that the set objectives and goals can be met with the available resources (staffing, budget, etc.), within timescales and as per the quality standards
- Is innovative, creative, and demonstrates perseverance and resilience even during adversity (Steadman, 2020).
Managing in a Complex Environment
- Has the interpersonal skills to facilitate collaborative working within interprofessional teams and can work to ensure mutual understanding of purpose with others to facilitate effective outcomes
- Ability to work effectively across various service delivery units to integrate diversity into a comprehensive integrated plan
- Ability to set high standards, by being role models, for the administrative team, personnel, and motivating and enthusing personnel and establishing team dedication to the organizational goals
- Resilience and ability to cope with pressure and under stressful conditions
Critical Analysis & Decision Making
- Ability to analyze and assess objectively, rationally, consistently and systematically diverse and complex information and identify the important core issues
- Ability to critically analyze various available options, engage other parities appropriately and make prompt and balanced decisions
- Confident decision-making
- Demonstrates a strong level of self-sufficiency, ability to push for proposals, and recommend decisions proactively while actively recommending improvements and readily adapting to changes (Rundio, 2016).
Working with & Through Others
- Commitment to developing professional networks to remains updated and informed
- Ability to influence both external and internal politics
- Committed to working collaboratively with the senior management colleagues to achieve the designated agenda
- Possess excellent networking, interpersonal and influencing skills (McKinney et al., 2016).
Communication and Interpersonal Skills
- Has the ability to advocate, explain and express ideas and facts convincingly
- Actively connects and liaises with people and groups both internally and externally (Steadman, 2020).
Personal Dedication &Motivation
- Personal dedication and motivation for the designated role
Reporting Relationship of the Position
The clinical director of surgical nursing will be a senior member of the organizational executive management team that is led by the organizational Manager/CEO. The executive management/administrative team will also consist of the Director of Nursing/Midwifery. Additionally, the Clinical Director will work collaboratively with the head of other departments within the hospital. In events where the Executive Management Board/Management Board or comparable governance is present to provide oversight, the Clinical Director of surgical nursing will be a forum member. The Clinical Director will also make important contributions to decisions allied to the healthcare organization and delivery of clinical services at the local and regional levels. It is also expected that the Clinical Director of surgical nursing will work closely and in collaboration with their partners and colleagues within Primary and Community Care to facilitate an integrated response for clients and patients. Chief Nursing Officer Research Paper
Reporting Arrangements
The clinical director will be reporting to the CEO or the General Manager of the hospital and will be an executive member of the Hospital Senior Management Team. Before the appointment, the local professional or executive reporting relationships will be made clear. Depending on the local senior management structures in the hospital, the relevant consultants will be accountable and will report to the Clinical Director. From the onset, in some healthcare organizations, other non-medical personnel can report to the Clinical Director. With time, the expectations are that every staff member within the directorate will establish a reporting relationship to the Clinical Director, using their line manager.
Criteria for Successful Role Fulfillment
Clinical Director requirements
- MSN Nursing and MA in medical science, clinical administration, similar relevant field
- Previous working experience as a clinical leader such as a nurse head for at least 3 years
- 5 years of experience working in clinical supervision
- Knowledgeable about budgeting, resource planning, and evaluation methods and procedures
- Good understanding of the relevant laws and regulations
- Hand-on experience and competency in computer systems like electronic health records
- Effective and excellent leadership, communication and communication skills
- Outstanding time management and organizational skills
- Ability to research and foster a culture of research and teaching in the directorate
The Clinical Director will be expected to successfully deploy, organize and manage consultants, and other resources, plan the provision of service, take part in the process of strategic planning, and impact and respond to the organizational priorities. Therefore, this role expects the candidate to be competent in strategic planning and have effective organizational and resource planning competency (Lamb et al., 2018).
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Challenges associated with the Role of a Clinical Director
The main challenges associated with this role include financial issues; organizational politics; time management; heavy workload and dealing with the size and complexities associated with being a clinical director surgical unit. The main financial challenge is the ability to deliver services in the face of an ever-shrinking budget and at the same time make efficiency organizational savings (Rundio, 2016). Additionally, clinical directors face the challenge of balancing demands and competing interests from various individuals and parties. Moreover, clinical directors face heavy workloads because they have multiple roles and responsibilities within healthcare organizations. The multiple duties and obligations associated with the role make it difficult to manage time for clinical directors. Office politics have been shown to present a major challenge to organizational leaders, and thus the leadership position of a clinical director is not an exception.
To address such challenges, clinical directors require teamwork during leadership and support from professional colleagues. Teamwork involves getting support from other clinical directors, organizational management, nursing head, matrons, and clinical leads. Clinical leaders have multiple roles and thus they face time limitations; therefore, they rely on distributed and shared leadership models to ensure effective service delivery (Daly et al., 2014). Therefore, teamwork and collaboration with various organizational leaders are very essential elements for clinical directors. The top management should ensure that the clinical directors are provided with the required support functions, particularly during the early stages after the recruitment of the clinical directors.
Transition Plan into the Role of a Clinical Director
By the end of the first 30-days after assuming the role of a clinical director surgical nursing, I will have established a collaborative relationship with the relevant team members. The team members include organizational management, healthcare providers, as well as the desk staff. I will focus on establishing the relationships through trust and time and tap the internal resources of the individuals to help in strategies and anything else I may require to effectively take on the role of a clinical director.
I will also set clear expectations and guidelines to assist in ensuring that the surgical nursing unit maintains accountability. I will carve time to discuss my vision and unit goals with the relevant stakeholders in order to accomplish effective patient care and organizational business objectives. Including all stakeholders in the planning process has been shown to facilitate shared vision and motivate team members and followers to put efforts towards achieving the vision.
In addition, I will ensure that I am accustomed to the policies, numbers, and procedures in the organization, and particularly the surgical unit. In case there is a need to review the policies and regulations in the surgical unit, I plan to ensure that within 90 days I will have reviewed the unit policies and involve the nursing staff in the review process. I also plan to familiarize myself with the unit, available resources, supplies, and the support structures in the surgical unit, and the whole organization at large. Chief Nursing Officer Research Paper
To ensure I acquire skills to successfully take on the role, I plan to enroll in the relevant training programs. For instance, I plan to participate in the leadership training program and a financial training program for nurse leaders. Such programs will equip me with the necessary leadership skills and financial management skills that including managing the budget and resources at the unit successfully (Joseph & Huber, 2015).
Overall Job Market
The job market outlook is very promising within the US. U.S. Bureau of Labor Statistics (BLS) projects that clinical directors are likely to have their employment opportunities rise by 20% by 2026. The average salary for a clinical direct is $98,350 per annum. Clinical directors working in surgical units and general hospitals are likely to earn higher salaries than their counterparts because medical managers in healthcare organizations have higher pay when compared to managers in other sectors of the healthcare industry.
The role of a clinical director prepares an individual to become a CEO or the General Manager of the hospital. The role also prepares a nursing officer to take other bigger leadership roles such as managing groups of hospitals or becoming an active member in policy-making on health issues. This is because by becoming a clinical director, one gains the necessary leadership skills to steer and lead healthcare organizations and make important decisions affecting healthcare.
References
Barbiani, R., Nora, C. R., & Schaefer, R. (2016). Nursing practices in the primary health care context: a scoping review. Revista Latino-Americana de enfermagem, 24, e2721. https://doi.org/10.1590/1518-8345.0880.2721.
Clavo-Hall, J. A., Bender, M., & Harvath, T. A. (2018). Roles enacted by Clinical Nurse Leaders across the healthcare spectrum: A systematic literature review. Journal of Professional Nursing, 34(4), 259-268.
Daly, J., Jackson, D., Mannix, J., Davidson, P. M., & Hutchinson, M. (2014). The importance of clinical leadership in the hospital setting. Journal of Healthcare Leadership, 75-83.
Joseph, M. L., & Huber, D. L. (2015). Clinical leadership development and education for nurses: prospects and opportunities. Journal of healthcare leadership, 7, 55–64. https://doi.org/10.2147/JHL.S68071.
Lamb, A., Martin‐Misener, R., Bryant‐Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open, 5(3), 400-413.
McKinney, P., Evans, J. T., & McKay, R. (2016). Improve manager competency with experiential learning. Nursing Management, 47(10), 46-49.
Roussel, L., & Thomas, P. L. (Eds.). (2016). Initiating and Sustaining the Clinical Nurse Leader Role. Jones & Bartlett Learning.
Rundio, A. (2016). The nurse manager’s guide to budgeting & finance. Sigma Theta Tau.
Steadman, C. D. (2020). Role of the clinical director: cardiologist’s perspective. Heart, 106(7), 547-548.
