In healthcare organizations, Chief Nursing Officers (CNOs) play a critical role in shaping nursing practice and patient care delivery. The Institute of Medicine (IOM) report, “The Future of Nursing,” highlights the need for CNOs to have a more significant influence in the decision-making process to enhance patient care. This essay discusses the key areas where CNOs can positively impact nurses in their everyday duties, drawing on the insights from the IOM report and relevant scholarly sources. Through a focus on increasing involvement in decision-making, promoting board representation, and nurturing leadership among nursing staff, CNOs can elevate the quality of care and overall nursing practice.
Enhancing Involvement in Decision-Making
The IOM report highlights the declining trend in CNOs’ involvement in key decisions, limiting their capacity to influence patient care positively. As the nursing leaders with authority and responsibility for nursing staff, CNOs must move up in the reporting structure to contribute effectively to decision-making processes (IOM, 2010). This includes direct reporting to the institution’s CEO rather than to the chief operating officer, as reported by the American Organization of Nurse Executives (AONE) (Ballein Search Partners and AONE, 2003).
Research demonstrates that nurse leadership’s participation in decision-making directly impacts patient outcomes and organizational performance (Jiang et al., 2008). Hospitals with quality committees involving nurse board members experience lower mortality rates for common medical conditions (Jiang et al., 2008). Moreover, nurses possess unique expertise in quality and safety improvement, making them essential contributors to discussions on patient care and safety (Mastal et al., 2007). Therefore, CNOs should actively seek opportunities to participate in high-level decision-making committees to ensure that nursing perspectives are adequately represented and patient care remains a top priority.
Increasing Board Representation for Nurses
Nurse representation on healthcare institution boards remains disproportionately low compared to other healthcare professionals (Prybil et al., 2009). While boards often focus on financial and business matters, healthcare delivery, quality, and responsiveness to the public are also vital considerations where nurses can provide unique expertise (Center for Healthcare Governance, 2007).
Studies suggest that when nurse leaders serve on boards, organizations benefit from improved clinical input in deliberations and decision-making processes (Prybil et al., 2009). CNOs can contribute to addressing this imbalance by preparing themselves for board positions and advocating for nurse leaders to join boards at both internal and external levels (IOM, 2010). Increasing nurse representation on boards will ensure that nursing perspectives are integrated into strategic decision-making, leading to a more patient-centered and effective healthcare delivery system.
Nurturing Leadership Among Nursing Staff
Encouraging leadership development among nursing staff is another crucial role of CNOs. By promoting and supporting nurses to secure key decision-making positions on committees and boards, both within and outside the organization, CNOs can foster a culture of leadership and accountability within the nursing workforce.
Scholarly research indicates that empowering nursing staff to take leadership roles enhances job satisfaction, reduces turnover rates, and improves the overall quality of patient care (Duffield et al., 2011). CNOs should invest in professional development programs, mentorship opportunities, and leadership training for nurses to prepare them for leadership roles (IOM, 2010). As nurses ascend to decision-making positions, they bring valuable insights and frontline experience, contributing to evidence-based decision-making and patient-focused care delivery.
In conclusion, Chief Nursing Officers (CNOs) have a crucial role in influencing nurses’ everyday duties and, by extension, the quality of patient care. By addressing the issues highlighted in the IOM report, CNOs can positively impact nursing practice and healthcare delivery. Key areas of focus include enhancing involvement in decision-making processes, increasing nurse representation on healthcare institution boards, and nurturing leadership among nursing staff. These efforts will lead to a more patient-centered healthcare system, improved patient outcomes, and a higher level of job satisfaction among nurses. As healthcare professionals, it is incumbent upon us to advocate for these changes and work collaboratively to create a stronger, more effective healthcare system for the benefit of all patients and healthcare workers alike.
Ballein Search Partners and AONE. (2003). Will Chief Nursing Officers Hear the Call? American Organization of Nurse Executives.
Duffield, C. M., Roche, M. A., Homer, C., Buchan, J., & Dimitrelis, S. (2011). A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing, 68(12), 2714-2722.
Institute of Medicine of the National Academies. (2010). The future of nursing: Leading change, advancing health. The National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK209867/
Jiang, H. J., Lockee, C., & Fraser, I. (2008). Board oversight of quality: Any differences in process of care and mortality? Journal of Healthcare Management, 53(4), 254-268.
Mastal, M. F., Makic, M. B. F., Rauen, C. A., & Thompson, P. (2007). The role of the nurse on the governing board. Nursing Outlook, 55(3), 124-129.
Prybil, L. D., Kilpatrick, K. E., & Lilly, M. B. (2009). The role of nursing leadership in shaping health care in community health systems. Policy, Politics, & Nursing Practice, 10(3), 212-218.