From Nurse to CNO: What it Takes to Make the Leap

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By ANA Career Center Staff – May 2014

As you progress through your nursing career, there may come a point when you have the opportunity to move into the executive leadership position of chief nursing officer. CNOs have a wide variety of duties that may depend on the particular facility they work at, but most importantly, the position is responsible for supervising nurses and nurse managers. CNOs also oversee design and implementation of patient care delivery, and serve as a leaders in their facility’s pursuit to maintain outcome levels.

It can be a big change and a big challenge. Are you ready for it?

What it Takes

“It takes a desire and passion to make the leap from nurse to chief nursing officer,” says Debi Deerwester, chief clinical officer, chief nurse practitioner officer and vice president of clinical operations for WhiteGlove Health, an Austin, Texas-based national mobile health care provider. “You have to have the drive to not manage nurses, but to lead them; there is a big difference between the two.”

But doing so can give you a chance to influence others in meaningful ways. “The transition from clinical caregiver to chief nursing officer has been worthwhile from the standpoint that as a CNO, I have been blessed with a venue to significantly influence countless nurses and other professionals through my example and decisions,” says Lori Burnell, CNO at Valley Presbyterian Hospital in Van Nuys, Calif. “My greatest joy and what makes it all worthwhile is learning that someone I helped to mentor was able to actualize their dreams and achieve their professional goals.”

Challenges You’ll Face

Moving into a leadership position has its hard parts, too. “The greatest challenge in making the transition from clinical practitioner to clinical leader is to consider how all decisions impact the patient,” Burnell says. “Bringing every decision into the context of the patient experience keeps the team focused on their purpose and helps establish the desired organizational culture.”

Another difficulty is the change that comes when someone moves from the rank-and-file into a managerial role. “The biggest challenge is being a peer at the same time you are the supervisor,” Deerwester says. “This does not always go over well with some members of the team.”

What You May Miss

When you make the leap to CNO, prepare to miss some aspects of being a nurse, CNOs say. “The aspect of bedside nursing that I miss most is the element of surprise each day brought forth,” Burnell says. “Every patient’s clinical needs and life experiences are unique. Discovering a meaningful way to connect with them and make a difference in their life was rewarding. I miss these seemly ordinary experiences that were extraordinary to me.”

“I miss the direct patient care, but keep my hand in practice to keep skills up and be able to relate to what my team is experiencing,” Deerwester says. “It is so worth it to be a part of elevating our profession to new heights.”

It is a big step to move into a CNO position, but it can also be very rewarding. If you are looking to combine your nursing skills with your leadership talents, consider becoming a CNO.
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