Chief Nursing Officers' Views on Meeting the Needs of the Professional Nurse: How This Can Affect Patient Outcomes.

Charlene Ingwell-Spolan

doi:10.3390/healthcare6020056

Abstract

Chief Nursing Officers (CNOs) have a demanding, complex role that commands accountability in leading the nursing profession and achieving quality patient outcomes. The purpose of this study was to understand the CNO’s view of meeting the needs of the Registered Nurse (RN) at point of care and how this could affect quality patient outcomes. In two qualitative studies twenty-five CNOs were individually interviewed in eight states including: Florida, Tennessee, Kentucky, Maine, New Hampshire, Vermont, Massachusetts, and New Jersey. The majority of these CNOs interviewed believed they were doing the best for their nurses and their healthcare facility. After analyzing their responses, it was apparent that some CNOs actually encouraged peer pressure among nurses to achieve compliance and felt patient acuity is being addressed adequately, since most patients were discharged within three to four days and those that were more critical were admitted to the critical care units. The average length of stay, which is the number of paid days a patient remained in the hospital, was an important metric. A large amount of nurses felt they were unable to deliver the care needed for their patients due to patient load, lack of collaboration among the health care team, higher patient acuity and absence of decision-making and autonomy. Many of the CNOs trusted that patient care outcomes, meaning relatively short hospital stays, demonstrated that the nursing practice was successful; rather than first having the nurse being set up for success to provide the best care possible to their patients.

Highlights

The demanding, complex role of Chief Nursing Officers (CNOs) today commands accountability in leading the professional nurse to help achieve consistent quality patient outcomes
Other CNOs concluded that most nursing bedside interventions take very little time and the work load of an acute care Registered Nurse (RN) is fairly reasonable, even though research has found many nurses believe they do not have enough time or staff to give the best care to their patients [1,2,3]
CNOs believed that patient acuity is being addressed adequately, as critically ill patients are in the critical care areas in spite of the research stating that the workload of the RN even in Medical/Surgical units has increased due to patients being more acutely ill and their conditions more complex [1,2]

Summary

Introduction

The demanding, complex role of Chief Nursing Officers (CNOs) today commands accountability in leading the professional nurse to help achieve consistent quality patient outcomes. CNOs were interviewed individually in two qualitative research studies from eight states including: Florida, Tennessee, Kentucky, Maine, New Hampshire, Vermont, Massachusetts, and New Jersey These phenomenological inquiries examined the CNOs’ perspectives of meeting the needs of the Registered Nurse (RN) at point of care and how they felt this affected quality patient outcomes. Today’s RNs’ experiences often include: job dissatisfaction; high patient acuity; lack of autonomy and decision making; plus bullying in the workplace [1,2,3,4] These barriers in the acute care setting result in a less supportive work environment and may prevent the RN from delivering quality patient care [5,6,7,8,9]. Showed that there is a relationship between a transformational leadership style and quality of care; facilitated through organizational and peer support, autonomy, and workload of the RN.

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Discussion

Conclusion