By Jackie Larson

Chief nursing officers today face a new set of challenges – in the form of acronyms – that are changing the way many approach this highest level in the nursing profession.

ACOs, the ACA, P4P, and MU are all recent additions to the lexicon of acronyms in a profession already inundated with them. And those are on top of HIT and EMRs, which have also changed the day-to-day reality of CNOs, in addition to their strategic conversations.

While it’s easy to become overwhelmed by the new normal, much of which can seem light years away from what brought CNOs into nursing in the first place, it’s important to remember that at its core the aim of a CNO hasn’t changed: improve quality and patient safety, reduce costs where possible, and develop a leadership team. What has changed, however, are the tools and skill sets needed to achieve those aims.

Leaders from executive search firm, Witt/Kieffer, recently shared six healthcare leadership trends for 2015. Included in these trends was the changing role for CNOs, namely the need for business and finance acumen. This article also touched briefly on what might be the optimal degree for the CNO, whether that was an MBA, PhD or DNP.

As any nurse manager on the executive track will tell you, their performance on the job requires skills and aptitude well beyond their training as nurses. Even if they have completed BSN or MSN degrees, the curriculum they have completed typically does not contain enough, if any, of the business training they will need to perform and advance their careers. The bulk of that learning, at least initially, is done on the job and/or through a mentor.

In most cases this consists of increased attention paid to business intelligence, analytics, and savvy with software tools. The CNO and leadership below must become equal parts Finance and IT, while still carrying out the functions of a nursing leader.

The CNO’s seat at the table has typically been apart from those focused on the business of the organization. This can no longer be the case. Today’s CNO must be as comfortable talking about methods to improve productivity and reporting and the strategic importance (or lack thereof) of an IT initiative as they are about patient care initiatives.

The ability to take and master this role however cannot typically be gained solely with one of the degrees mentioned above. It takes a career of progressive learning for this line of thinking to be truly part of the mindset of the CNO, or anyone in a leadership position.

Part of this responsibility entails providing learning opportunities to the management structure below the CNO. This includes working with HR to identify and vet learning programs that leaders and those on management tracks can take part in to improve their capacity for operational and strategic thinking as well as their ability to see and understand the connections between different sets of data points and then how to act. Inherent in this approach also includes identifying opportunities to reach out to and close the knowledge and communication gaps between Finance, IT, and Nursing.

Finance and technology are obvious areas where the face of the nursing is changing, but another area where CNOs and the structure below them must become savvier is with regard to operational components of departments. This includes understanding and adopting lean protocols where possible as well as implementing best practice workforce strategies and tools that optimize labor and minimize time spent in management and administrative tasks, while creating economies of scale through reduced redundancies and standardization wherever possible. All of these are inherent in an enterprise approach to workforce management.

Sophisticated workforce management strategies, i.e., staffing and scheduling, coupled with the embracing of financial/productivity information and leveraging the capabilities of technology will provide CNOs and other nursing leaders with the means to tackle the world of constantly changing acronyms and other challenges central to the modern day nurse executive.

At the same time, however, it is just as important for the CFO, CIO, COO, and CEO to all have a solid education relative to the experiences of the nursing departments. Just as the CNO and nursing leadership must willingly step into previously dark areas of the map, their counterparts around the leadership table must be willing to chart the terrain and understand the lay of the land in the nursing world. It is only though shared perspective, shared tools, and open dialogue that organizations will know themselves and be capable of forging ahead confidently on shifting sands.