Major Challenges for Chief Nursing Officers in 2017

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Each year in my Introduction to Nursing Leadership graduate course, my students select a chief nursing officer in a health care agency to interview. The students have a list of questions that they ask and then add some of their own. I enjoy these reading these interviews because they highlight the changing challenges in today’s health care environment. Each year during the past twelve. I have had to opportunity to learn through the eyes of the CNO the major challenges that they face in their roles. The following is a list of current nursing challenges from 21 Chief Nursing Officers from healthcare organizations primarily in South Florida interviewed in 2017:

Recruitment and retention of staff
Managing the needs of Millennial nurses
Staff engagement
Implementing the many changes that occur
Staying connected to staff
Many competing demands for time
Reimbursement for care – heavy Medicare and Medicaid payer mix
Lack of resources to provide optimal care.
Physician-nurse communication
Maintaining a patient-centered approach in the face of financial constraints.
Ensuring patient safety, quality and good outcomes.
Integration of our organization with another organization that was recently acquired.
Standardization of practice
Lack of Mental Health resources in the community
Consumers posting reviews on social media of nursing care.

Recruitment and retention of a changing workforce represented a major challenge for most nurse leaders interviewed. The many changes in healthcare are challenging to implement and standardize in the organization. Declining reimbursement for care is causing financial constraints at a time when the costs of staffing have increased in many organizations. Lack of mental health services is new to this year’s survey and reflects the challenge in this geographic area with the opioid epidemic. These leaders are optimistic about the future of healthcare but see rough waters in the short-term in meeting the expectations of their many constituencies.