Running head: ANALYSIS OF A NURSE EXECUTIVE

NURS 440 Leadership in Nursing

Analysis of a Nurse Executive
Zach Holmes & Renee Ivers
Ferris State University

ANALYSIS OF A NURSING EXECUTIVE

Analysis of a Nursing Executive

Analyzing a nurse leader takes into consideration a multifaceted role. The roles and
responsibilities of the nurse leader, or nurse executive, encompass everything from relationship
building and business management to applying knowledge of the healthcare environment and
professionalism. According to Yoder-Wise (2014) The nurse executive has an outstanding
opportunity to shape the future of professional practice within a working environment by
creating opportunities for staff nurses and managers to have optimal input into organizational
decision making related to the future. (p.49)
The nurse leader in review is Ingrid Cheslek, the Chief Nursing Officer at Metro Health
Hospital. Currently, Ingrid states that she is responsible for the following: nursing practice and
maintenance of standards of care and evidence based practice in nursing, finance and the budget,
and being the voice for nursing at the executive table. Starting out her career in nursing as an
LPN in ICU at Metro, Ingrid states that although learning a lot, she felt this job was back
breaking and transferred to the surgery department and became a surgical tech. While in the role
of surgery tech, Ingrid decided to obtain her associate degree in nursing through Ferris State
University. While working in the surgery department as a registered nurse, she obtained her
Masters in Public Administration and was approached by executives at Metro for her current
role as CNO. She states that, at the time, she did not feel qualified for this role but was
encouraged by her husband to pursue it.
After being granted the role of CNO, Ingrid returned to Ferris to obtain her Bachelors in
Nursing, stating that she needed this degree professionally, in order to better lead nursing. In
regards to strengths and weaknesses, Ingrid remarks that she knows she isnt strong clinically,

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but she is surrounded by those who are, and is able to consult them when needed. When
speaking about her passions in this role, she highlights business and finance. Primarily her role is
to be responsible for the largest budget and the department with the greatest number of staff.
According to Balasco Cathcart (2008, p.89) The CNO sets the culture for nursing
practice and interprets that practice to the organization. Reporting to the Chief Operating
Officer, the nurse executive represents nursing at the executive table. Advocating for needed
change and promoting best practices, she is in charge of case management, clinical directors, and
is also in charge of social work. Ingrids role is to stay up-to-date on important issues going on
in these different departments.
The organizational structure is primarily nursing driven. Stating several times throughout
the interview that nursing has the largest number of staff delivering healthcare service, she points
out that nursing and appropriate allocation of finance and budgeting drives the organization to
where it is today. Ingrids views flow into the corporate goals and philosophy of providing the
best experience to the patient, employee, physician, and community. According to Yoder-Wise
(2014, p. 236) Nurses and nurse managers directly affect an organizations ability to make a
profit. Profits can be achieved or improved by decreasing costs or increasing revenues. Ingrid
highlighted that when the organization looks at nursing, and wants to make cuts in its
department, she advocates for appropriate nurse/patient ratios, acknowledging the effect of poor
ratios on patient outcomes and staff satisfaction. She raised the question, Does cutting staff
save money in the long run, is this directly related to poor outcomes?
Communication, according to Ingrid, is a valuable component to nursing practice. Being
in collaboration with nurse managers and clinical directors, allows her to receive input that she

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can take to upper management, affecting change in order to make improvements for nursing staff
and patients. In a recent article published in the Journal of Nursing Management, Pamela
Germain and Greta Cummings (2010) conducted research on how the role and behaviors of
nursing leadership affects performance and their perception of the healthcare environment.
According to their findings they state, The factors that nurses perceive as motivating them to
perform well include autonomous practice, working relationships, resource accessibility,
individual nurse characteristics, and leadership practices. (p. 438)
Utilizing the position of Chief Nursing Officer effectively, changes can be implemented
that overall increase nurses job satisfaction. This would impact professional relationships,
increase performance, and provide positive patient and organizational outcomes. By using her
knowledge of the healthcare environment, coupled with her knowledge of business and finance,
Ingrid brings her expertise to this role, striving to maintain professionalism and best practices at
Metro Hospital.
Metro Hospital looks up to Ingrid as a leader. She is valued as a resource and someone
that advocates for her nurses to all departments in the hospital. According to Yoder-Wise,
Leaders set a direction, develop a vision, and communicate the new direction to the staff.
(2014, p.58) Ingrid stated that management is all about relationships and explained that it should
provide an open relationship with the employee. She is able to communicate with all employees, not

just nurses, by building relationships with people. Recognizing nursing staff for contributions
they make is done by sending thank you notes, rounding on staff for their opinions, personalized
letters, gift cards and an annual Nurse Exemplar dinner and award. By recognizing staff Ingrid
has made nurses want to do their best and know that it is not gone without notice.

ANALYSIS OF A NURSING EXECUTIVE

According to Yoder-Wise (2014) a good leader:

Values commitments and relationships, provides a vision that can be communicated and has a
long-term effect on the organization that moves it in new directions, communicates the rationale
for changing paths, charts new paths that lead to progress, endorses and thrives on taking risks
that bring about change, demonstrates a positive feeling in the workplace and relates the
importance of workers. (p.58)
Ingrid uses these skills to represent nursing at the executive level down to the RN using
relationships based on trust. She explained that she chooses her words wisely, supports and advocates for
nursing and tries to be a good role model.
Changes are implemented based on relationships Ingrid has built with Clinical leaders. Clinical
leaders bring Evidence Based Practice research and ideas to Ingrid to begin the process of making
changes. One example of a change that was made was creating a Critical Care Nurse Rounder position.
This change was made after a Clinical Leader brought research articles and the idea to Ingrid. They had
meetings to work out details and eventually made that happen. Now the hospital has a Nurse Rounder
that responds to situations and is lowering the level of codes in the hospital. Ingrid explains that she stays
up with education by reading journals and being a member of many nursing and executive groups but
relies on those around her to bring ideas of change to her.
Ingrid explained that quality and safety is always a concern in her position. She is currently
working on decreasing patient falls and reducing hospital acquired infections. She works closely with the
infection prevention department to identify problem areas and then she works with the nursing
departments to see how these can be decreased. Catheter associated urinary tract infections are the most
prevalent hospital inquired infections currently. Patient tracers are being put in place to determine at what
point in the patients stay is the infection taking place. Quality and safety is monitored regularly based on

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patient outcomes via surveys and feedback. A nurse leader works with all departments to strive for the
best patient outcomes.
Nurse Managers must set an example of professionalism by being a role model to nurses that look
to them as a leader. This is be done by academic preparation and continuing education, their role and
relationships in the facility, and the overall way they hold themselves. Yoder-Wise explained,
Professionalism is all-encompassing; the way a manager interacts with personnel, other disciplines,
patients, and families reflects a professional philosophy. Professional nurses are ethically and legally
accountable for the standards of practice and nursing actions delegated to others. (2014, pg. 66) When
asked what professionalism meant to her Ingrid replied, Being accountable, honest, ethical, positive,
dont say no-say how, and just being present. Nurses know that they can go to Ingrid with issues
because she is around and willing to listen. Ingrid identified that even though she can be easy to talk to
she is not afraid to hold others accountable. This is an important ability of a true professional.

For nurse managers to be successful in the healthcare environment it is not enough to have
clinical expertise, they must also possess business skills, like strategic planning, budget development,
operations management, and organizational structure and policies. (American Sentinel University, 2014)
Ingrid agrees that healthcare needs to be run like a business because it is a service. In order to provide a
service to people you need to use business skills. She stated that business and nursing go hand in hand
and that business skills help with the nursing process. Ingrid admits that business and finance are her
strengths. Managers must also acquire expertise that allows them to apply technology, information
systems, and critical thinking to their jobs, while adapting leadership theory to their personal leadership
style. (American Sentinel University, 2014) Ingrid is able to use her business skills to stay within her
budget, critical decision making and create policies.

Analyzing a nurse leader takes into consideration a multifaceted role. The roles and
responsibilities of the nurse leader, or nurse executive, encompass everything from relationship
building and business management to applying knowledge of the healthcare environment and

ANALYSIS OF A NURSING EXECUTIVE

professionalism. Ingrid Cheslek has proven to be a leader that has all of the traits required for
her position. Her ability to build relationships, run the nursing department as a business, and be a
true resource to the nurses at Metro Hospital is inspiring. She is a good role model which she
herself identified as a necessary quality of a leader.

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References
American Sentinel University, Leadership skills for nurse managers: Develop your expertise. (2014).
Retrieved September 26, 2014.

Balasco-Cathcart, E. (2008). The role of the chief nursing officer in leading the practice; Lessons
from the Benner traditions [Electronic version]. Nursing Administration Quarterly, 32(2),
87-91.
Germain, P. B., & Cummings, G. G. (2010). The influence of nursing leadership on performance;
A systematic literature review [Electronic version]. Journal of Nursing Management, 18,
425-439.
Yoder-Wise, P. S. (2014). Leading and managing in nursing (5th ed.). St. Louis, MO: Elsevier
Mosby.