Category Archives: Administration

May 11 2014

Florence Nightingale Showed Us the Value of Nurse Leaders Long Ago

Angela Barron McBride, PhD, RN, is a distinguished professor and dean emerita at the Indiana University School of Nursing, a member of the Indiana University Health Board, and chair of the National Advisory Committee for the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program.

Angela McBride, PhD, RN

As we celebrate National Nurses Week, which ends on Florence Nightingale’s birthday (tomorrow, May 12th), I have been thinking anew about why she is such a good role model for 21st-century nurse leadership. No insipid “Lady with a Lamp,” she pioneered the use of applied statistics to develop policy and other novel ways of displaying data to change minds. For example, she developed the coxcomb, a variation on today’s pie chart in which each wedge represents a month’s worth of mortality figures, and then made use of these graphic displays in arguing for how improved hygiene can dramatically result in decreased mortality.

The Robert Wood Johnson Foundation (RWJF) has been particularly encouraging of getting more nurses on boards, and Nightingale personified the skill set and abilities that we need on today’s hospital boards. While I wouldn’t presume to put myself in the same company as Ms. Nightingale, I do serve on the board of Indiana University Health, an 18-hospital network, and I have chaired the board’s committee on quality and patient safety for over nine years. That perspective has confirmed for me that the lens through which nurses look at health care, particularly as exemplified by Nightingale, is very much needed at the board level.

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The American Hospital Association lists a number of capabilities needed for board governance—an understanding of health care, business acumen, achievement orientation, community-mindedness, organizational awareness, a sense of strategy, innovative thinking, and team leadership. These are the competencies Nightingale had and so do her 21st-century sisters and brothers.

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May 8 2014

Nurses: Climb the Leadership Ladder, Call the ‘Circle’

Linda Burnes Bolton, DrPH, RN, FAAN, is vice president for nursing, chief nursing officer, and director of nursing research at Cedars-Sinai Medical Center in Los Angeles, Calif., and a member of the Robert Wood Johnson Foundation (RWJF) Board of Trustees.


When troubles arose in ancient times, tribal leaders, known as “circle callers,” called on villagers to discuss problems and explore solutions as they sat together around a communal fire.

We need more of this kind of inclusive decision-making in our modern hierarchical society, and in our health care system in particular—and nurses are in a prime position to make that happen.

Nurses, I believe, are natural circle callers. They assess health from all sides and all angles. They look at individuals’ symptoms and diagnoses, but also their diet and exercise habits, their living and working conditions, their neighborhood environments and personal resources. They spend more time with patients than other health care providers and develop strong, trusting relationships with them and their loved ones. They focus on patients, but they also work with family members, caregivers, providers, administrators, payers, and community-based supporters.

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In our health care system, nurses are masters of inclusive decision-making. We need nurses in positions of power so they can share their unique insights and help answer pressing and persistent questions like how to narrow deeply troubling disparities in health and health care; how to provide more coordinated and more patient-centered care; and how to improve the quality and safety of care while, at the same time, reducing costs.

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May 7 2014

Aspiring Nurse Leaders: Reach for the Future!

Jeannine Rivet, MPH, BSN, FAAN, is executive vice president of UnitedHealth Group.

“When you hold on to the past, your hands aren’t free to reach for the future.

-- Anonymous

I like to share that quote as a way to encourage the people I mentor to grow professionally.

I hope my fellow nurses, in particular, are listening.

I’m grateful for the life-saving work that nurses do at the bedside. Every day, no matter the task, they are helping people live healthier, happier, more productive lives. I started out my career more than four decades ago as a registered nurse (RN) in Rhode Island. I knew then, and I know now, that all nurses are leaders, regardless of their title, because of the skills they use to get their jobs done.  

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As a leader and mentor at UnitedHealth Group, I encourage all the people I work with, including nurses, to be the best professionals that they can be, and do the most that they can do with their careers. All nurses are leaders, sometimes without titles, in whatever they choose to do.

We need more nurses in the upper echelons of business. Nurses are vastly underrepresented in these kinds of roles in our health care system, and we could all—patients, caregivers, and providers—benefit from nurse executive leadership. I’m often the only nurse, and sometimes the only woman, at key decision-making tables at my own organization and on the many boards on which I serve. 

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Aug 9 2012

Women Underrepresented as Health Care CEOs

While they make up 73 percent of medical and health services managers, women account for only a small portion of CEOs at hospital and health care organizations, according to a report by RockHealth. The analysis of data from the U.S. Bureau of Labor Statistics and other surveys finds that just 4 percent of health care organization CEOs and 18 percent of hospital CEOs are women.

RockHealth’s report highlights a range of barriers to women’s advancement, including persistent gender roles in the workplace, a lack of mentors and role models for women, and more. To understand what women in the health care workforce thought, RockHealth conducted interviews with 100 women in the field. Nearly half the survey respondents reported that insufficient self-confidence was one of the biggest barriers to their career advancement. Among other reported obstacles: time constraints (45 percent) and the ability to connect with senior leadership (43 percent).

The Robert Wood Johnson Foundation has long championed leadership development, for women and men alike. Many of the Foundation’s programs offer leadership training for nurses, physicians and other health care professionals, to help advance their careers. Learn more about RWJF programs at

What do you think? Are females underrepresented in health care leadership? What can we do to increase their representation? Register below to leave a comment.

See the RockHealth Women in Health Care report.
Read coverage of the report from Fierce Healthcare and Forbes.