In the last three decades, Lois Skillings has risen from a staff nurse at a regional hospital to a high-ranking position at a major health care organization in Maine. She’s served as vice president of nursing and chief nursing officer of Mid Coast Health Services in Brunswick, Maine; headed up the state’s nurse executive organization; sat on the governing boards of a variety of health and business organizations; taught and consulted with hospital officials; and published numerous articles about health and health care.
Yet despite her vast administrative experience, research knowledge and clinical expertise, Skillings, M.S., R.N., never saw herself as a chief executive officer—at least not of a major organization like Mid Coast Health Services, a nonprofit system that includes an acute care hospital, a multispecialty medical group, a senior health center, a hospice and an independent retirement community. But that began to change a few years ago when she was selected to participate in a prestigious program funded by the Robert Wood Johnson Foundation (RWJF) that cultivates nurse leaders who aspire to lead and shape health care locally and nationally.
One year after she started the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program, Skillings began to see herself in a new light—and so did her employers. She was appointed to serve as executive vice president of the nonprofit community-based organization and groomed to become its new leader. In July, she will become president and chief executive officer of the multifaceted organization—which provides care for some 274,000 patients a year.
“I think the Executive Nurse Fellow (ENF) program had everything to do with my promotion,” Skillings said, calling it a “deep and rich” development program that boosted her self-confidence. “Before the ENF program I would not have given a thought to aspire to be a CEO. Even though I have always found myself in leadership roles, it just didn’t dawn on me to consider leading outside of traditional nursing roles.”
During the three-year fellowship program, she worked with a team to develop a plan to transform health care in the community served by Mid Coast Health Services. For the fellowship project, she engaged more than 1,000 people in her community—including patients and families as well as leaders from business, religious, government and health communities—in the new plan.
Called “2020 Vision,” the plan aims to improve health care quality and lower costs by placing a greater emphasis on prevention and wellness. It will also focus on improving patient experiences, meeting community needs, providing integrated and accountable care, and tracking health outcomes.
As She Looks Ahead to New Role, Skillings Looks Back to Her Years as a Nurse
Her nursing background, Skillings said, will come in handy in her new role. A former staff nurse and nurse manager, she has years of experience working directly with patients and working in teams. These experiences have deepened her commitment to patient-centered care, teamwork and interprofessional collaboration, she said.
Nurses comprise the largest group of health care professionals in the nation and spend more time with patients than other providers. Yet they are often left out of discussions about how to improve health and health care in the United States because they are considered to be subordinate to physicians and administrators.
More nurse leaders like Skillings are needed to share their unique insights into health and health care, according to a groundbreaking report released last year by the Institute of Medicine. The report, called The Future of Nursing: Leading Change, Advancing Health, states that more nurse leaders will improve the delivery of care and patient outcomes.
Initiatives like the RWJF Executive Nurse Fellows program are working to advance nurse leaders by helping select groups of highly qualified nurses strengthen their leadership capacity and improve their abilities to lead teams and organizations working to improve health and health care. Each year some 20 nurses participate in the fellowship, and many go on to serve as heads of health care organizations and academic institutions.
Under the program, nurse executives develop competencies in the areas of leading oneself, leading others, leading organizations and leading in health care. A key curriculum goal is to help fellows apply the knowledge and skills they obtain to the leadership challenges and opportunities they face in their work.
“Nurses have a deep understanding of health care that gives us a perspective that is underutilized,” Skillings said. “I’m so grateful to have been the beneficiary of the Foundation’s decision to invest in nurses.”