I had the great privilege and honor to be asked to present at the Marcus Evans CNO Summit in March. In preparing for the presentation, it was nice to have some time to reflect on the role of the nurse executive in transformation. I know my invitation was based on my Emeritus Chief Nursing Officer role at Mayo Clinic in Jacksonville. I was thrilled and humbled to be in a room full of well-accomplished CNOs that had stories to share and were willing to listen and learn from each other.
Embracing Strategic Thinking and Ownership
I decided to focus my topic on the shifting and sharing of power and influence within Dyad and Triad leadership models in healthcare. The presentation was a great conversation with very experienced Chief Nurses (CNO) and we talked about how we are really good at “getting things done” and we have a strong affinity and pride in our strengths in operations. But I wanted to shift the mindset a bit. As an executive coach, I’ve learned to lean into the fact that “what got you there, won’t get you there.”
In my mind, if you are moving into a nurse executive role, it takes a new set of skills to start thinking strategically and owning your executive role. I mean, really “owning” your role. You aren’t just a representative of the nursing side of the health system. You are at the table and participating as a member of the C-suite team while still representing the perspective of the clinical staff. This is the opportunity to influence and guide transformation.
Understanding Dyad and Triad Leadership Models
To be clear, the Dyad and Triad leadership models have gained traction as a way for healthcare leaders to manage increasing complexities in our industry. These models emphasize shared leadership and interdisciplinary collaboration to improve patient care, operational efficiency, and organizational effectiveness. The Dyad model typically pairs a clinical leader, such as a Chief Nursing Officer (CNO), with an administrative leader, like a Chief Financial Officer (CFO), to form a team.
This structure combines clinical and management perspectives, providing decisions that reflect patient care and operational efficiency. For instance, combining a CNO and CFO can harmonize clinical needs and budgetary requirements.
The Triad model expands this collaboration by incorporating a third leader, often a Chief Medical Officer (CMO), creating a trifecta of perspectives: clinical, financial, and medical. This model improves decision-making by incorporating different perspectives so that more comprehensive solutions are found.
Building Leadership Presence
There are a new set of skills to start thinking strategically and owning your executive role. We often say in coaching, “knowing and doing are two very different things.” It takes practice building leadership muscle in these skills.
Here are 8 ways you can start building your leadership presence and harness your influence as a member of the C-suite team in the Chief Nurse role.
8 Ways to Build Your Leadership Presence and Influence
- Own your Power! – Power and influence should not have a negative connotation to it. Nurses have typically risen to administrative roles because of their referent power – their ability to influence, and expert power – their knowledge of nursing. This is still important power to leverage in an executive role. It’s important to note with Triad Models there is a perception that it’s still the administrator that is the lead person to make the final decision. The structure is designed to not only share perspectives but to create a common table of collaboration. If this feels foreign to you and you aren’t sure how to move from the old way to the new way in the structure, an executive coach can work with the three leaders to accelerate the path to higher-performance and collaboration.
- Identify gaps in knowledge or skills – Some things were not taught in nursing programs. You may need to learn more about finances, information technology, encouraging innovation, data management, etc. Go back to school, read journals and e-newsletters, attend conferences and keep learning.
- Find a coach, mentor, or advisor – Don’t be afraid to ask for help and have people around you to support this new direction and behavior changes you need. Build your network! An old saying: “your network is your net worth”. A coach, a strong trusted advisor, can help you build new leadership muscle, strengthen strategic relationships and be a catalyst for higher performance.
- Learn how to value different perspectives – Not just in lip service but in actions. Listen to new ideas, hire for diversity, and try new things you didn’t support initially.
- Learn to leverage your strength and the collaborative strength of others – Ask your CMO, CFO, CIO and other physician leaders – what’s keeping you up at night? How can nursing help? Focus more on providing strong data in meetings but remember to focus on why you do what you do every day. It always revolves around the patient in terms of quality, safety and experience.
- Collaboratively create solutions – Be a partner, not just two people who meet together regularly.
- Learn and unlearn – Some things that have been “how you’ve always done it” may need to be unlearned! It’s a new day with new challenges.
- Be courageous – It takes courage to innovate, change behavior, and step into new and broader roles.
Healthcare is in a perfect storm right now. This is the time for Nurse Executives to use their knowledge and expertise to help transform this complex business into value for its consumers.
Power Dynamics in Leadership
Power and authority are necessary elements of leadership roles. In the role of nurse executives, referent power (established through relationships and respect) and expert power (established through knowledge) can help create positive change.
To develop your referent and expert power, prioritize building strong relationships, practice level listening, and demonstrate your knowledgeable expertise with data and evidence-based practice.
Skill Development for Nurse Executives
Developing a diverse skill set becomes essential as nurse executives step into broader roles. Key areas include:
- Financial understanding: helpful in budgeting and resource allocation
- Strategic planning: important for setting long-term goals and navigating complex environments
- Data management: necessary for analyzing patient data and driving evidence-based decisions
To build these skills, consider enrolling in specialized courses or certifications. Professional development programs and industry conferences can also provide valuable insights and networking opportunities.
Focus on Innovation and Courage
Innovation and courage are pivotal in driving transformational change in nursing leadership. Embracing innovative practices, such as implementing new technologies for patient care or developing creative solutions to improve workflow, can enhance outcomes.
As we navigate the complexities of healthcare transformation, nurse executives must embrace innovation. Seek executive coaching to refine your leadership skills, join professional networks to connect with peers, and participate in leadership development programs to stay at the forefront of industry advancements.
Contact Medi Leadership for personalized support and more information on coaching and development opportunities.
