¶ … civilians think of the nursing department in any well-run hospital, they often don't consider all the structure, organization and guidance which is required to make this department run as smoothly as it needs to be and to achieve the highest level of patient-centered goals. One position at the top of the pyramid of the nursing department is the position of Chief Nursing Officer or CNO. The Chief Nursing Officer is the person who is responsible for overseeing the crux of the entire nursing operation, ensuring that the entire team runs like a well-oiled machine and that all members are responsible for pulling their weight, following policy and engaging in the most proactive and balanced measures for patient centered goals (Dickson, 2008). This is without a doubt an extremely demanding job and absolutely requires a person who truly enjoys working with patients and other nurses, and thrives on the challenge of offering up the highest available level of healthcare to patients. However, when one looks at the statistics and retention rates of individuals in these positions the rates are actually quite low: there is a tremendous amount of turnover in this position (Monroe, 2008). This points to a tremendous and nuanced problem: a high amount of turnover in this position indicates that there's an aspect of the job which is incredibly demanding -- so much so that it's unmanageable. The evidence indicates that real changes need to be made to nursing departments and the environment they create, in order for CNOs to desire to stay in such jobs (Austin, 2010) (Figley, 2013) (O'Brien, 2010).
The high amount of turnover in this position also points to the fact that there's something about the structure and environment of the job which is hard to maintain for many people. The high levels of turnover also suggest that there's an aspect to this job which creates a strong amount of burnout, which can be debilitating, but which can be fixed (Reese, 2008). This paper is going to take a more invasive look at the problems presented by the low rate of retention with CNOs and why those problems exist and how they can best be countered and prevented.
Background of the Problem
Chief Nursing Officers (CNO) refer to registered nurses that guide the nursing tasks in professional healthcare facilities all over the United States. The Chief Nursing Officer is depended upon by the entire nursing department to demonstrate fairness and leadership in an ever-changing field (Strommer, 2011). One of the most important elements of this job is that the CNOs work in conjunction with other chief executive officers to help push forth decisions for the healthcare agency at large: this is so crucial because CNOs generally have a better sense of what's essential for patient care, and what the real needs and priorities of patients actually are. These are certain decisions which can truly improve the level of care that patients receive, and the overall satisfaction of the staff. CNOs all over the nation are exhibiting a disturbing trend, of leaving their current positions as a result of career changes and personal commitments (Salmon, 2002).
This study will discuss and scrutinize all the elements which influence this trend in decision-making of chief nursing officers and all the interlocking factors which foster this abrupt career path.
Recent relevant research suggests that a problem is brewing in the works when it comes to the retention and turnover of CNOs. The marked lack of longevity in the profession as a whole is something to consider and for all involved parties to take active steps. A study conducted by Jones and colleagues looked at the CNO turnover using 622 CNOs from America who were all engaged in an online survey. One of the main findings was that "close to 40% of CNOs reported leaving a position as CNO during their careers. The majority (77%) left voluntarily with approximately 50% choosing to take another position as CNO and 30% pursuing other opportunities to advance their careers"(Jones et al., 2008). One of the more perplexing aspects of this survey was that many CNOs reported a high level of satisfaction, with just about half of all participants reporting satisfaction, and 37% asserting that they were very satisfied with their jobs. Regardless, over half of all CNOs involved in this survey asserted that they had the absolution intention to actively pursue other job opportunities within the next half of a decade (Jones et al., 2008). Thus, the problem clearly becomes even more aggravated than imagined. The data demonstrates that even though the bulk of CNOs who were satisfied with their jobs...
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