CNO Roundtable

Your Path to Leadership

Q: What is one aspect of your current role as chief nursing officer that you found especially challenging to learn?

Lori Burnell, RN, Ph.D., NEA-BC

(pictured above, with a patient)
Sr. Vice President / Chief Nursing Officer
Valley Presbyterian Hospital

One of the most challenging aspects of my role as the CNO of a safety net hospital has been shifting focus from the search for what’s right to the search for what could go wrong. Searching for what could go wrong does not come naturally to me; in the past, I made hospital rounds looking for people to compliment. However, after studying the characteristics of high reliability organizations (HRO), I have become more preoccupied with potential failures.

Adopting the HRO philosophy has changed my path and priorities. It has made me more reluctant to simplify processes and explanations, more conscious of how current situations can compromise safety and more sensitive to the concerns of frontline staff and subject-matter experts. Achieving high reliability takes an organizational mindset. As a result, we’ve changed or added several processes and practices, such as having executives review every incident report within the past 24 hours and personally follow up on events in their areas of accountability.

Jennifer R. Castaldo, RN, BSN, MSHA, NEA-BC

Vice President / Chief Nursing Officer
Henry Mayo Newhall Hospital

It was important for me to learn that the ability to lead is not something that you acquire by having your nursing degree or higher education. Leadership is about character, and the path to leadership in nursing begins with a strong sense of empathy and a desire to do what you can for others. The most effective and influential leaders begin their journey with a sense of purpose, humility and honesty.

Authentic nurse leaders understand that if our life’s work does not stand for something bigger than ourselves, our ability to lead others lacks purpose. Purpose is my north star. If you are interested in becoming a leader within the nursing profession, my recommendation is that you start with yourself. We all have the ability to transform circumstances, open up possibilities and create lasting value for ourselves and for others. The most effective nurse leaders I know are experts at this.

Derek Drake, RN, DNP, NE-BC, CNML, CNL

Chief Nursing Officer
St. Francis Medical Center

Nursing Education

One of the biggest challenges I had to overcome as a new CNO was meeting the demands of customers, including physicians and patients, while staying true to my nursing background and not overcommitting or straining my nursing staff. The best example of this is collaborating with physician partners to develop or expand upon existing service lines. As a hospital executive, I have a responsibility to satisfy the wants and needs of the physicians, but I also have an obligation to ensure that those wants and needs align with nursing scope of practice and that my nursing staff has the tools, resources, training and education to meet those needs.

Hospitals can be more successful in these areas if they invest time and resources in interdisciplinary training, education and team-building. This allows the various disciplines to gain knowledge and respect for the other disciplines’ daily roles, duties and responsibilities so they can work together effectively.

Patricia S. Matos, RN, DNP, NEA-BC

Chief Nursing Officer
Resnick Neuropsychiatric Hospital (UCLA Health)

It took some time and good mentoring for me to realize that as CNO, I cannot confine myself only to my area. Since UCLA Health is a large health system, the CNOs must collaborate with many other departments to reach operational and patient care goals. Sometimes, I have felt out of my element working with other specialties and departments, but I soon realized that when you are a nurse interacting with other nurses, there is always common ground.

Our professional governance councils help nurses address this issue by bringing together nurses from many areas and departments to improve patient care through evidence-based practice. These councils have produced a number of publications as well as professional conference posters and podium sessions. This collaboration instills a common sense of pride and competence, helping individual nurses feel validated and more confident working outside of their comfort zone.

Denise Robinson, RN, DNP, MPH, WOCN

(pictured above)
Chief Nursing Officer
Loma Linda University Medical Center

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Prior to becoming a CNO, I often traveled abroad to promote educational programs as a subject matter expert. One adjustment I’ve had to make in my current role has been cutting back on travel and spending as much time as possible within the walls of the hospitals I’m working alongside. I think this is a logical transition as we take on more responsibility; we have to let go of some things.

Gloria Sanchez-Rico, RN, BSN, MBA, NEA-BC

Chief Nursing Officer / Senior Vice President
Huntington Hospital

I have a responsibility to our nurses to create an environment that provides professional satisfaction, from offering educational programs to enhance and grow nurs­es’ skill sets to nurturing our hospital’s positive, just cul­ture. When I look at how our nurses care for our patients and what truly motivates them, I take their individual, cultural and generational differences into consideration. This approach can be a balancing act and a great challenge, but it has played a large role in my path to leadership.

Lauren Spilsbury, RN, MSN

Vice President, Patient Care Services
Redlands Community Hospital

A significant challenge for a CNO is reporting events to the hospital’s board of directors. As a clinician, I am used to speaking to others who understand medicine and healthcare. The board of directors consists primarily of community members. They are intelligent people who are experts in their respective fields, but they do not necessarily have a background in healthcare. This means that board members are reliant on precise information from the CNO to understand the clinical context of an issue. I always present information in clear, non-technical ways and include a healthcare glossary in each board packet.

My previous CEO taught me an important strategy: When you provide information to your board, communicate the problem and your solution at the same time. As C-suite executives, our job is to solve problems, which means we should never present a problem without also providing an appropriate solution.

For more from the CNO Roundtable:

2020: The Year of the Nurse and the Midwife

Lifelong Learning

Nurses in the Media

Staffing Challenges and the Silver Wave

CNO Reading List

New Grads at the Bedside

Exciting Innovations

The COVID-19 Pandemic

Chief Nursing Officer Roundtable 2020 (homepage)


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