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“Chief Nursing Officer Executive Development” by Frederickson

The scope of nurses’ responsibilities and roles is expanding and evolving with time due to the involvement in administrative and leadership functions. In the contemporary times, nurses have been occupying executive positions, and this culture is developing in most hospitals across the United States. Therefore, these emerging roles require chief nursing officers (CNOs) to be trained on how to handle their new work frontiers because the conventional training does not cover these areas. Administrative and leadership roles go beyond the bedside skills that nurses achieve through learning and practice. In addition, leadership skills are requisite in any management position. Therefore, different nursing associations have managed to come up with curricula to equip executive nurses with management and leadership skills. However, the academic requirements for such courses are not defined under any universally accepted model. Therefore, the evolving health care system, which demands nurses to take executive positions, necessitates the need to have an acceptable and credited model for equipping nurses with the requisite management and leadership skills. Frederickson and Nickitas deal with these issues in their article. Without the necessary skills, nursing executives cannot deliver optimally and this aspect affects service delivery to patients. Governance and leadership require a thorough understanding of the nursing environment and all the elements that interplay to make a functional system that can deliver quality services to patients. The authors of this article insist that such knowledge can only be availed through proper training, which can only be achieved via the development of accredited curricula in institutions teaching nursing as a course of study. The authors argue that in a bid to have effective CNOs, nurses should be groomed for such responsibilities at an early stage of their learning.

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Currently, the United States has over 5,000 CNOs and they play a vital role in the management and operation of healthcare provision institutions across the country. Effective CNOs must understand the different elements that constitute a functional healthcare provision system including budgetary allocations, staffing, daily operations, employee management and motivation, quality service delivery, and patient satisfaction among other myriad of elements that surround management and leadership in any organization.

In the United States currently, healthcare provision challenges are growing by the day and Frederickson and Nickitas opine that trained CNOs can be of unparalleled use in dealing with the challenges. The escalating unemployment rates as occasioned by the slow recovery from the 2008/2009 economic meltdown coupled with the almost 50 million uninsured or underinsured citizens compounds the health care challenges in the United States.

Frederickson and Nickitas rue the widespread misconceptions surrounding the constituents of the requisite knowledge for CNOs. A study showed that most CNOs define requisite knowledge as the ability to meet financial targets. However, requisite knowledge entails management and leadership skills, professionalism, business insightfulness, proper communication skills, and the ability to make critical decisions on top of other aspects. Unfortunately, such requirements cannot be achieved via apprenticeship, which underscores the need for proper training courses for CNOs.

Unfortunately, the available research is lacking on how to prepare nurses for CNO positions. Therefore, more research is needed to highlight the best direction for having qualified CNOs in the United States. The research should utilize both qualitative and quantitative approaches in a bid to have conclusive and representative results. Business related courses like MBA should be incorporated in the CNOs’ curriculum with the minimum requirement being a master’s degree. However, the first degree should be in nursing. In addition, mentorship and fellowship programs should be incorporated in the learning process for CNOs.


Frederickson, K., & Nickitas, D. (2011). Chief Nursing Officer Executive Development: A Crisis or a Challenge. Nursing Administration Quarterly, 35(4), 344-353.

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