THE BUSINESS OF HEALTHCARE: STRATEGIES FOR A SUSTAINABLE NURSING WORKFORCE
I began my career as a nurse executive in the 1990s working for a major for-profit organization, and it was there that I learned about health care financial management. Strong operating margins were important to that organization, and I needed to learn fast how to read financial statements and manage my budget. We do not learn much about budgeting and health care finance in nursing school, so I decided to educate myself and write about these topics to help others and have been doing so ever since. Unfortunately, not much has changed since the 1990s in terms of education and training around health care finance and budgeting. Nurse leaders are often handed budgets and are held accountable for their numbers without any education or orientation around the subject, where documents are located, or what the expectations are of their role. Today, the American Organization for Nursing Leadership's (AONL's) nurse leader competencies highlight finance as a key competency, with "Business Skills and Principles" as one of the key domains.1 AONL has partnered with the Healthcare Finance Management Association to conduct training and education for nurse leaders to build skills in these areas. The American Association for Colleges of Nursing (AACN) has incorporated finance and budgeting into the new Essentials. This will help with curriculum development in graduate programs. For example, Domain 5, Quality and Safety, subdomain 5.1m states, "Lead the development of a business plan for a quality improvement initiative," and subdomain 5.1.n states, "Advocate for change related to financial policies that impact patient care delivery."2
Because of my passion and growing concern for nurse leaders developing the skills to present a business case for the value of nursing, this issue evolved. Dr Christine Delucas, our issue Guest Editor, secured articles that our readers can benefit from as they lead through change and develop the business acumen to articulate their needs and nursing's value to the finance team and administration. In this issue, you will read about workforce development, academic-service partnerships, faculty shortages, strategic planning, and more. Our Finance Matters column, written by Dr Pat Patton, details the value of virtual nursing from a financial perspective and shares a case study, and our Hot Topics column by Carol Bradley, "Engaging Governance in Workforce Strategy and Performance," delves into educating our governing boards. Bradley states, "There is no mission or margin without caregivers."
Ultimately, nurse leaders need the business acumen, financial skills, and executive presence to hold meaningful conversations with chief financial officers and chief executive officers regarding the value of nursing. They need to be able to construct comprehensive business plans and build their business case for change. Nursing is the largest group and should have the loudest voice and be heard.
Enjoy the issue and thank you for all you do for nursing, our patients, and our communities.
-KT Waxman, DNP, MBA, RN, CNL, CENP,
CHSE, FSSH, FAONL, FAAN
Editor-in-Chief
Nursing Administration Quarterly
REFERENCES