Chief Nursing Officer in a Nursing Unit Term Paper

Download this Term Paper in word format (.doc)

Note: Sample below may appear distorted but all corresponding word document files contain proper formatting

Excerpt from Term Paper:

Chief Nursing Officer in a Nursing Unit

What is the role of today's Chief Nursing Officer (CNO) in the medical workplace? Are there issues that need resolution within the CNO purview? Is there a turnover problem in the field when it comes to the CNO position? What leadership styles prove most effective for CNOs? These matters and others will be examined in this paper.

The Literature on Chief Nursing Officers -- Leadership Styles

As to leadership styles in nursing management, Jesus M. Casida published his dissertation for a Doctor of Philosophy at Seton Hall University on the subject of "Nurse Managers' Leadership Styles" in acute care hospitals in New Jersey. Although Casida did not use the term Chief Nursing Officer, he did employ the term "Nurse Managers" (NM) in reference to their leadership styles on "nursing units' organizational culture" (NUOC). His research included a self-administered measurement tool presented at four acute care facilities; those surveyed included 37 NMs (18 in critical care and 19 in non-critical care), and 278 staff nurses (148 in critical care; 130 in non-critical care) (Casida, 2007, p. 12). The results show that there were "positive moderately strong correlations" between transformational leadership (TL) and NUOC measures" (Casida, 12).

In fact transformational leadership was found to be a "strong predictor of mission trait culture"; on the other hand, there was a weaker correlation between transactional leadership (TR) and the nursing units organizational culture, Casida reports. And as to laissez-faire leadership, there was an overwhelming "negative" response from managers and nurses. Supervising nurses in the survey showed a preference for transformational leadership in the context of nurse managers (Casida, 12).

Mary Elizabeth O'Brien explains that nurses in the UK are comfortable with transformational leadership and servant leadership. Transformational leadership works when empowerment results "…in which all parties are allowed to work together, to the best of their ability, to achieve a collective goal" (O'Brien, 2011, p. 18). Change is needed in nurse management, O'Brien asserts, and for change to occur, CNOs and other nurse managers need to "…move away from traditional leadership practices and behaviors" and embrace transformational and servant leadership (the first duty of the manager under servant leadership is to "serve" in order to fully relate to those tasks that are expected and assure their completion by those the leader is responsible for) (O'Brien, 18).

The Literature on Chief Nursing Officers -- Turnover Problems

An article in the Journal of Healthcare Management argues that the turnover problem (with the CNO position) is very real and reflects dissatisfaction on the part of CNOs. The article presents results from a survey that got responses from 622 CNOs employed in hospitals and other healthcare facilities in the United States. The results of the survey show that 38% of those CNOs responding had left a CNO position (13% within 2 years; 25% of those within 5 years), and of the 38% some one-fourth had been asked to resign, had been "terminated," or had lost their jobs "involuntarily" (Jones, et al., 2008, p. 89).

Delving deeper into the issue of turnover in the CNO position, an earlier survey (Kippenbrock, 1995) found that there were two key reasons for CNO turnover: a) "lack of power"; and b) "conflicts with the chief executive officer" (Jones, 90). As to the survey these authors conducted, the great majority (73%) of respondents "expressed real concerns about the 'slipper slope' of CNO turnover" (Jones, 98). As to why the CNOs in the survey had left their positions, 50% were taking another CNO position; 29% wanted advancement and weren't getting it; 26% had conflicts with the CEO; 21% were simply dissatisfied with their job; and 20% said they left for "family/personal reasons" (Jones, 100).

The Literature on Chief Nursing Officers -- Key Issues They Face

According to an article in the peer-reviewed journal the International Nursing Review (Salmon, et al., 2002, p. 136) very little research has gone into the roles that the CNO must play or into the issues they face. In the first place, there is a "scarcity of literature" that relates to the role of a CNO in the global context, which is problematic, according to the authors, because the decade of the Nineties has been "…among the most chaotic ever with respect to cost-driven health reform around the world" (Salmon, 137). Given the emergence of new "and previously more controllable diseases," many civil conflicts, changing demographics and more, the CNO's task in grabbling with these issues is made more difficult because CNOs work "…largely in isolation from one another" (Salmon, 137).

The World Health Organization and the International Council of Nurses have held meetings for CNOs but as to frequent / regular opportunities for CNOs to connect with one another, these opportunities are not presented, Salmon continues (137). Hence, the authors of this article conducted a survey by sending out a questionnaire to health officials in 89 countries. The questionnaire sought to learn: a) the roles and responsibilities of CNOs; b) key issues facing CNOs; and c) those skills and that knowledge that are key to CNOs being effective. There were responses from 50 countries of the 89 approached; and as to the priorities that the CNOs listed, the following were given, with the most critical issues listed first: a) nursing and midwifery workforce planning; b) policy analysis and development; c) strategic thinking and planning; d) healthcare planning; e) written communication; f) program development and evaluation; g) public oral presentation and personal effectiveness; h) interdisciplinary and cross-sectoral collaboration; i) budget and finance; j) analysis and use of statistical data; k) development of proposals for funding; and l) epidemiology (Salmon, 140).

The authors conclude with the thought that given the "enormously complex" roles of CNOs, and the "significant breadth and depth of knowledge and skills" required to be an effective CNO, it is "alarming that so little research has been carried out" to help the CNOs advance their roles in the sense of helping the health of people "worldwide" (Salmon, 142).

The Literature on Chief Nursing Officers -- What Power do they Exhibit?

Certainly the CNO has a great deal of power in the sense of leadership and oversight in his or her workplace. However, the power of CNOs is sometimes "constrained by board members' limited understanding of quality care and patient safety in general," according to an article in Nursing Economics (Mastal, et al., 2007, p. 324). The CNO has to report to the board of directors, and there is a "huge knowledge gap" between the governing leaders (board members) and those leaders such as CNOs and other nurse managers, Mastal explains (324).

This knowledge gap actually reduces the CNOs ability to operate within the context of patient safety and quality of care, Mastal asserts. In fact there are "differences in perception" among the three groups -- hospital CEOs, board chairs, and CNOs -- as to how to deliver quality care and patient safety. Mastal and colleagues conducted a survey of 73 hospital leaders (CEOs, CNOs, and board chairs) representing 63 hospitals across the United States. The questions focused on: a) important issues facing boards in terms of improving patient safety and quality of care; and b) the actual quality of nursing care that is being provided to patients.

The results show that when asked "what one thing would most positively impact the quality of nursing care," the CNOs listed the following: increasing nurse-to-patient ratios; increasing hours of care; finding sufficient quality staff; reducing turnover and yet hiring new nurses that have fresh ideas; less paperwork; fewer interruptions; increasing nurse satisfaction; and "enhanced communication" (Mastal, 326). Given the situation that CNOs face with boards and with the need for additional resources and more innovative nurses, the power of CNOs can be seen (in general) as limited by circumstances and bureaucracy.

How does…[continue]

Cite This Term Paper:

"Chief Nursing Officer In A Nursing Unit" (2011, December 05) Retrieved October 24, 2016, from

"Chief Nursing Officer In A Nursing Unit" 05 December 2011. Web.24 October. 2016. <>

"Chief Nursing Officer In A Nursing Unit", 05 December 2011, Accessed.24 October. 2016,

Other Documents Pertaining To This Topic

  • Nursing During World War II Pearl Harbor

    Nursing during World War II Pearl Harbor, and the United States' subsequent involvement in World War II, had a lasting impact on the country, much as the events of September 11, 2001, had, and will continue to have, a lasting impact on this nation. In particular, this paper will focus on the impact that Pearl Harbor and World War II had on the nursing profession. The events of Pearl Harbor and other

  • Nursing Administration Specialist

    Nursing Administration Specialist Dr. M's dilemma Strengths The hospital has a very strong reputation within the community and an over hundred-year history. The hospital has just been purchased by a university hospital system with an equally stalwart reputation. The new management seems committed to changing the hospital for the better and restoring it to its former glory. There is a commitment to change amongst Dr. M. Patients desire change. Weaknesses The hospital has rapidly grown in size from 50

  • Military History of the Chief

    In April of 1893, petty officers were reclassified and the ranking of chief petty officer was established. Until 1949 ranking badges were worn on the right or left sleeve, depending on whether the person in question was on the starboard or port watch. Since February 1948, all unique marks have been worn on the left sleeve between the shoulder and elbow (Navy Uniform History, 2010). The command at sea pin

  • Organization Project Intermountain Was Started as a

    Organization Project Intermountain was started as a small healthcare nonprofit organization, situated in Salt Lake City. With its well-crafted mission, a clearly stated vision, patient's oriented philosophy and a strategy to manage the organization effectively; it was soon able to manage over 32,000 employees. Helping the acute healthcare needs of Southeastern Idaho and Utah's residents, Intermountain's well-managed system of about 23 hospitals, clinics, physicians and health strategies; deliver clinically exceptional medical

  • Nursing Care Facility s Information Technology IT Improvements

    Improving Health Care Delivery by Integrating Information Technology In order to modernize the operations of their medical facility, Pleasant Manor nursing home should consider contracting to implement the Epic System of electronic medical record (EMR) and practice management throughout their campus. A pioneer in the march towards digitization of health care records, "Epic makes software for mid-size and large medical groups, hospitals and integrated healthcare organizations" using proprietary software that efficiently

  • Nursing Shortage and Quality Care

    Inadequate Staffing in Nursing Explain the nursing/patient care concern, problems, issues observed at the senior level clinical practice During the past decade, there certainly has been a rapid decline in quality patient care in the healthcare industry. This has been proven by cutting down the staff in hospitals, nurses working overtime along with quite a steeped nurse to patient ratio. The hospital staffing issue has driven great controversies. On the up side,

  • Community Health Nursing Emergency Response

    Disaster in Franklin County Emergency Management is the organizational protocol that prepares for disaster response, supporting and rebuilding systems and society after natural of human disasters occur, and a continuous process in which groups from the community level up manage potential hazards and the impact of any possible trauma. EM is visible when events occur (hurricanes, flooding, bombs, etc.) but is really only as powerful and effect as its pre-Crisis planning

Read Full Term Paper
Copyright 2016 . All Rights Reserved