Balancing act

Personal responsibilities outside of the job could be one reason more nurses don’t think of entering upper management.

“I think management is really hard and there are a lot of competing demands even if nurses aren’t in the traditional family role at home,” says Theresa Carroll, RN, PhD, a professor at the University of Texas School of Nursing at Houston. “Women may be more likely to seek something that allows them to find balance in their lives. I think women do a lot more thinking about that.”

Carroll specializes in nursing workplace issues and is a career coach for Memorial Hermann Hospital in Houston. She believes nurses are uniquely qualified for the top leadership roles in health care. A recent study she conducted examines the attitudes of 169 women executives, 11 of them chief nursing officers. While all of the women had similar attitudes about what it takes to be a good leader, the nurses all rated personal integrity as the most important attribute of leadership. Those personal qualities and patient care experiences, she says, need to be bolstered by an understanding of business and finance for nurses to succeed as administrators. For many nurses, that means going back to school.

A head for business

“Nurse executives have to be bicultural,” she says. “They have to have one foot in the patient care arena and one foot in the business world.”

In 1986, Carroll, then associate dean of graduate programs in nursing at Duquesne University in Pittsburgh, started a combination master’s in nursing and business administration program. Nurses take courses in the business department and can either receive an MSN with a business certificate or study for both an MSN and an MBA degree. Either option gives them a foundation in financial administration.

“I think most nursing administration programs are seeing the writing on the wall that they need to include the MBA courses,” she says.

Going back to school can be a difficult choice for nurses, says Marilyn Stevens, BSN, MSA, MBA, founder and CEO of Procel, a health care staffing firm in Los Angeles. She’d like to see hospitals offer financial support for nurses who want to receive a business education.

Nurses need to know how to run a business if they want to move into a CEO- or vice president-level position, she says. They need to know accounting and understand cash flow, balance sheets, profits, and losses. The way to gain that understanding is through a business education.

Making that transition from patient care to high finance isn’t easy, Stevens says, but she’s never regretted it. Nurses who want to move into upper management need to find a mentor, someone they can emulate. If their employer doesn’t have a formal mentoring program, she suggests nurses take the initiative and find someone they can go to for career advice. Let someone in upper management know you are interested, she says. Nurses already in management positions need to scout for people who show leadership qualities.

“When you see someone who has the ability, give them some projects,” she says. “That’s what I used to do when I was a nurse manager. Let them head a committee or give a presentation. Maybe start them as a charge nurse. They have to get their feet wet so they can see what it’s like.”

The only people who don’t succeed, she says, are the ones who give up.

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Donna Hemmila is a freelance writer for NurseWeek.

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