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St. Luke's Episcopal Hospital	More NurseWeek Features   Smoke-Free Zone   Nurses and patients tackle nicotine addiction   Bloodless Survival     Surgical techniques to use when transfusion drops out of the equation
Nurse leaders at St. Luke’s Episcopal Health System in Houston are (from left) Katherine Johnson, RN, BS, BSN, nurse manager, transplant acute care; Rosemary Luquire, RN, PhD, CNAA, senior vice president, patient care and chief quality officer; Lisa Cushman, RN, MS, CNA, nurse manager, coronary care unit and cardiac observation unit.

When a staff nurse in an oncology unit at Banner Desert Medical Center in Mesa, Ariz., came to Rhonda Anderson, RN, MPA, with a list of well-researched changes the staff could make to improve patient care, the chief operating officer and chief nurse executive could have seen a troublemaker or an upstart.

Instead, Anderson saw a leader.

Anderson told the nurse she wanted to mentor her, cultivate her skills, see what she wanted out of a career in nursing and to help her to achieve those goals. “You are absolutely a leader of the future of the profession of nursing,” she said she told the nurse. A leader she wanted to keep at Banner.

That’s what all nurse leaders should be doing, Anderson said. “That’s how we can encourage our future leaders, even if they’re not ready right now.”

Although it’s difficult to find surveys or exact statistics that address the issue, many nursing leaders say they wonder who will take their place when they retire.

The nursing shortage, past layoffs of middle managers, cuts in education programs and lack of support in some places for nurse leaders have created what some fear could be a growing leadership deficit unless hospitals and nursing groups take action.

Many nurse leaders say they see the trend changing. More hospitals and nursing organizations are providing training, encouraging further education and offering more support for their nurse leaders.

But much work remains to be done, they add, and in this, the leaders themselves must take lead—by identifying potential new leaders, by mentoring them and giving them resources and by being positive role models that newer nurses will want to emulate.

Growing gap

Statistics from the American Hospital Association show the average vacancy rate for RN managers in 2000 was 6.5 percent, with the highest rates in the Western and Southern regions and in urban hospitals. Compared to an average vacancy rate of 14 percent for critical care nurses, this does not seem like a huge crisis.

But the average age of nurse managers, 46 to 50, puts them closer to retirement than staff nurses, and some nurse leaders say they worry there may not be enough qualified people to fill in behind them.

Judy Sullivan, RN, is practice manager for the Boston office of Hudson Global Resources, a specialty staffing firm based in New York. Right now, she said, she doesn’t have much trouble finding people to fill nursing leadership positions. The tricky part of her job is finding the right leader to match the right culture. But in 15 years, when many current leaders are expected to retire and the pool of qualified nurses is expected to shrink, she said, making those matches may prove far more difficult.

Leadership roles have become increasingly stressful, said Pamela Thompson, RN, MS, chief executive officer of the American Organization of Nurse Executives, and other nurse leaders.