From Chief Nursing Officer to Chief Executive Officer: Over the Top

Today's environment in health care requires more from our leaders than ever before. It calls for not just a strong leader but one who knows and understands the clinical, operational, and financial aspects of the organization. Because of our skill sets and wisdom, we are at a place in history where we are seeing more nurse leaders from the chief nursing officer (CNO) role moving into both the chief operating officer (COO) role and the top leadership role of the chief executive officer (CEO).

In this issue, we wanted to have discussion around the skill sets necessary to make the transition from the CNO role to the CEO role. We have wonderful articles written by nurses who have been through this journey and who are willing to share the learning they have gained from their process and experience. They highlight the skill sets they possessed for the CNO role and explain how they were able to expand upon those skills and wisdom while making the transition to the role of CEO.

As I read the articles in this issue, I see many things in common with the work done by the Center for Nursing Leadership around the Dimensions of Leadership. This work was published by Dr Mary O'Connor in Nursing Administration Quarterly, January/March issue, 2008.1 These dimensions included the following: (1) holding the truth, (2) intellectual and emotional self, (3) discovery of potential, (4) quest for adventure toward knowing, (5) diversity as a vehicle to wholeness, (6) appreciation of ambiguity, (7) knowing something of life, (8) holding multiple perspectives without judgment, and (9) keeping commitments to oneself. Encompassed within these dimensions, neither all inclusive nor prescriptive, are many of the skill sets and wisdom needed not just for the CNO role but for the CEO role as well. For the most part, the CEO skills are more involved and require a deepening of some of the dimensions.

To some extent, you can look at these skill sets and see many of the qualities necessary for each of us in our leadership roles. In many cases, it is the depth of incorporating these skills and wisdom that varies. Many of the authors talked about the need to view obstacles as challenges and growth opportunities. In these situations, they often discovered more about themselves and their potential while moving forward and continually striving to gain more knowledge to meet the next challenge. They were never satisfied with the knowledge they had and always wanted to learn more and put themselves into new positions that often required steep learning curves. The authors emphasize the ability to be open to not knowing, to ambiguity, and a willingness to hang in that spot for a while. It is the ability to trust that the learning is there in front of them. Learning through the situation with discovery, tapping the knowledge of others, and using each individual's strength are cited as key to making the team stronger. Many other skill sets, wisdom, and learning experiences are discussed by our authors as well.

We have an excellent set of articles in this issue, and the authors have done a great job in discussing about their journey. They shared not only what they learned along the way but also the skills, wisdom, and qualities that helped to make their transition to the top leadership role successful. I hope this issue helps you in your journey.

Enjoy.

-Philip Authier, RN, MPH

Guest Editor

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