If you ask a nurse leader why they moved away from the bedside and into leadership, there is a good possibility they will give a version of this answer: "Because I wanted to make more of an impact."
For the past few years, nurses have been leaving hospitals in droves. Some leave the profession altogether and some leave for better opportunities at other organizations or through temp agencies. Still others are leaving the bedside to take on C-suite roles where they can make the changes they want to see.
"Believe it or not, there's a lot to be excited about in healthcare right now, and I want to be a part of it," Stacey-Ann Okoth, DNP, RN, told Becker's. She recently became senior vice president and associate chief nursing executive at Jefferson Health in Philadelphia.
For others, tragic experiences drove them to be the change they wanted to see in the healthcare system.
"Healthcare disparities has been a lived experience that has fueled my passion to eradicate healthcare disparities, to fix the brokenness of the system, to ensure that no one else has to go through the experiences that I've gone through due to the inadequacy of our system," Airica Steed, EdD, RN, CEO of Cleveland-based MetroHealth, told Becker's. "I really believe that leadership and nursing is a calling and I consider this to be divine order. I've been destined to do it and I've been put in a position to advocate for the voice of others that often feel muted."
Being a leader in the field gives nurses the opportunity to make changes, improve healthcare and contribute to the field in a new way.
Regina Foley, PhD, RN, went from a bedside nurse to a leader within five years. She now is the executive vice president and chief transformation officer and interim chief nursing officer at Edison, N.J.-based Hackensack Meridian Health.
"With so many years at the bedside, I knew what the patients needed and saw myriad opportunities to improve areas such as patient experience, quality and cost," Dr. Foley said in an interview with Becker's. "I had the confidence and knowledge to pursue my passion, which is to build a better healthcare system for patients."
Leadership advice
Many nurses are looking for ways to advance into leadership, and many nurse leaders are eager to be mentors. Here are some of the pieces of advice leaders have for those wanting to move up the ranks:
Dr. Airica Steed: I would say stay encouraged. Continue to fight the good fight. Don't give up, because I can honestly say my life is full of twists and turns. It's full of adversity and it's full of various experiences that were presented as challenges, but I've turned those into opportunities to succeed and thrive. If you aspire to climb, just be courageous and believe in yourself. Be your best advocate and set a legacy for others to follow. By building other people, you're building yourself.
Kristin Wolkart, RN. Executive Vice president and Chief Nursing Officer at Franciscan Missionaries of Our Lady Health System (Baton Rouge, La.): Listen more than you speak. Listen to the voice of the bedside caregivers about what they truly need. And do your best to follow through or follow up. Sometimes we can't meet every request, but instead of saying no, try to find ways to meet the need, maybe differently than what they've asked for. The staff at the bedside know what works and what doesn't work, and they are our best voice to help guide us into the future.
Athena Minor, MSN, RN. Chief Nursing and Clinical Officer at Ohio County Healthcare (Hartford, Ky.): I've had a lot of great mentors over the years who have given me some really good advice, and I'm learning every day, but recently a co-worker sent me an article and it said, "Always ask yourself, what is it that you don't know?" So as you're leading, what is it you need assistance with? You know what you know, but what is it that you don't know? What is it that you can bring into that conversation to make things better? What support do you need to make things better because it's not your field of expertise?
Representation
Healthcare is dominated by white men, and many nurse leaders are paving the way to show more women and minorities it is possible to break into leadership.
"I also took on this role [as senior vice president and associate chief nursing executive] because of representation," Dr. Okoth said. "So many people of color and women have reached out to me to let me know that I am an inspiration to them. They feel comfortable bringing their concerns forward. We work together to solve them through our councils or through coming to the table and discussing meaningful solutions."
Dr. Okoth is not alone.
"I represent less than 1 percent of other leaders that look like me across the country," Dr. Steed said. "I was the first Black person, the first female and the first nurse to serve in this role at MetroHealth after almost 200 years."
Race and ethnicity are not the only characteristics that are underrepresented in healthcare leadership. Women, although closing the gap, still make up a small percentage of that demographic.
Here, five leaders from Hackensack Meridian weigh in on what characteristics female hospital leaders need to be successful.
Patricia Carroll, MSN. President and Chief Health Executive at Raritan Bay Medical Center in Perth Amboy, N.J., and Old Bridge (N.J.) Medical Center: I have always believed that everyone should be judged on their work, not on their gender. I am grateful for every opportunity that I have had and work to earn the respect of my leaders and colleagues. As a woman leader, I have learned to pivot and adapt to not only provide for my family but to meet every expectation in my work and career.
From my own experience, female hospital leaders need to remember to stay strong in their beliefs, to remember their viewpoint is a valuable contribution and to provide a role model to the women behind them. When I look back in history, I am in awe of what women have done to give me this opportunity, we must continue to go forward and show examples that women leaders can successfully rise to a position of influence.
Dr. Foley: We need humility, [the ability to] keep our ego in check, resilience and be grounded in the present moment.
Lisa Iachetti, BSN, RN. President and Chief Hospital Executive Officer at Hackensack Meridian Palisades Medical Center (North Bergen, N.J.): Confidence — having the feeling that you can trust, believe in and be sure about your abilities. Courage — the ability to do something that may frighten you at first. It is all about being brave and demonstrating your strengths while emulating empathy.
Caitlin Miller, BSN, RN. President and Chief Hospital executive of Bayshore Medical: There is an added level of persistence and resilience needed as a female leader. I think women have to work harder to show we can handle tough conversations and situations, and make difficult decisions.
I have noticed that female leaders, at times, are not allowed to simply be competent and effective. I've personally gotten feedback on occasions, from men, about my facial expressions and seriousness. Women are expected to be comforting, happy and smiling. It's an expectation only placed on women.
Michele Morrison, RN. President and Chief Hospital Executive of Southern Ocean Medical Center (Stafford Township, N.J.): Female leaders more quickly pivot with change. Perhaps this is mirrored from the many changes females experience during life with body changes, hormonal changes, childbearing and being care providers and moms. We are agile in the ever-changing landscape of healthcare, all while maintaining composure and leading our teams forward despite barriers. And we do it with compassion for patients, our team and the communities we serve.
As a nurse myself, I understand how patient care works and is delivered at the bedside. This gives me the opportunity to discuss operations on a different level with leaders and engage with our front-line team members.