Shouldn't Nurses Run The Business Of Healthcare?


By Joel Theisen, BSN, RN

I started out as a nurse because I was more interested in people than numbers. As the son of a blue-collar lumberyard worker in rural Wisconsin, I was expected to help out when family and friends needed it. My grandpa and aunt moved in with us, and I learned to appreciate the wisdom -- and medical challenges -- of people as they grow older.

Helping people with life challenges was so rewarding that I pursued it as a profession. As the first in my family to graduate from college, I was grateful for the academics but soon realized that some of the most important lessons on campus were about life. I was the only male in my nursing school graduating class. It was normal for me to be surrounded by women and led by women -- it is such an eye-opener to work in a field dominated by another gender. Frankly, it made me a different man.

At the Mayo Clinic and as a critical care nurse in Rochester, Minnesota, I learned to work under intense pressure with many patients in highly structured institutional settings. The work challenges were great, but I missed working every day with seniors in the community -- the deep, honest conversations, their advice, and their fun, silliness, and grace.

In 1992, I decided to change my role and started learning the business side of healthcare. My mother-in-law -- an RN herself -- had started her own home healthcare company in the 80s and grew it to over 40 locations throughout the country. It was a great opportunity to join her business and get mentored by someone who was breaking the traditional rules.

In that new role, I missed working with patients, but I gained the perspective of what was going right and what was going wrong in the world of senior health. Business skills gave me an opportunity to use my nursing know-how to change healthcare and how seniors experienced it. As a nurse, I knew I could make life better for my own senior clients. But as the leader of my own healthcare startup, I knew I could make life better for many more seniors and their families.

The Argument for More Nurse Executives

America needs more nurses. Not just nurses to help patients, but nurses to run the business. Especially nurses to run the business.

As an RN who also is CEO of a complete senior health company, I have attended meetings too numerous to count with executives who define medicine by dollars and cents. Their view of healthcare is through spreadsheets, profit-and-loss statements, and claims management metrics.

Nurses are different. We aren't all about numbers. We are wired and trained to focus on people -- what people want, what people need, and how we can make their lives better.

To borrow a phrase from the business world, nurses are customer-driven. Our job is to view life through the client's eyes. Based on what the customer tells us, we solve, we adjust, and we adapt. We must earn the customer's trust and then deliver results. The key skill for nurses is the ability to listen.

After a combined 30 years of focusing on direct patient care as an RN and seeing mostly business issues as a CEO, I can say without reservation that healthcare would be much better with more nurses in the C-Suite. Nurses might even provide an edge for savvy leaders looking to improve their businesses.

With so much frontline experience, nurses know that healthcare must be about more than just sick care. Though we know that traditional prescriptions and clinical treatment are lifesavers, nurses also understand that addressing social determinants of health -- loneliness, family conflicts, diet, exercise, poverty, and life purpose -- can significantly boost overall health through prevention.

By now there's hardly a healthcare corporation in America that has all the nurses it needs: The U.S. is projected to be short 900,000 nurses by 2030. And the Bureau of Labor Statistics projects 203,200 job openings for nurses each year through 2031.

Making matters worse is the fact that nurses, overworked and over-stressed because of the COVID pandemic, have been leaving the profession in droves. A study found the total supply of RNs plunged by more than 100,000 in 2021 -- the biggest 1-year drop in the past 4 decades.

I believe that encouraging nurses to work the business side of healthcare can serve as a motivator that keeps good people in the healthcare profession -- and makes the overall industry better, too.

Despite my healthcare executive position, I keep my RN certification active. I don't work with clients every day, but I definitely rely daily on the skills that nursing gave me -- the psychology, sociology, empathy, grit, flexibility, tirelessness, unflappability, and fearlessness needed to survive in our profession. Being a nurse made me a better business leader.

As we think about the role of the nurse, we need to think beyond traditional roles to what nurses really want and open the doors for leadership and C-Suite potential -- what they bring to the table is their innate ability to be human and that changes everything. We need to encourage more nurses to see the versatility of this profession and its untapped potential to be bold learners. Yes, we need more nurses on the front line, but we also need them leading the change in business.


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