Interview: Donna Havens

Why succession planning is critical to the future of nurse leaders

With a large number of nurse executives transitioning out of their current roles in the coming years, this exodus of key leaders heightens the need for succession planning to prepare the next generation of leaders.

The AONL Foundation plays a critical role in funding important research that addresses these issues. The recent study CNO Turnover – Is the crisis still brewing? is a great example of how the AONL Foundation is funding important research.

Recently, the AONL Foundation interviewed the lead author of the study, Donna Sullivan Havens, PhD, RN, FAAN, who is interim dean and a professor at Healthcare Systems & Outcomes, School of Nursing, University of North Carolina at Chapel Hill, and associate CNO for academic affairs at UNC Hospitals, Chapel Hill, NC.

AONL: Why is research critical to building a strong foundation for nurse leaders?

Donna Havens (DH): It allows them to practice based on evidence, based on the latest knowledge that’s available, and researchers need to develop that knowledge so leadership practice can be sound. There are researchers that help develop the knowledge, but I work closely with the nurse leaders to help them translate it into their everyday practice. There are a few nurse leaders, such as AONL members, who both develop and use the knowledge.

AONL: Where are you in the process of publishing your study on CNO turnover?
DH: My colleague, Dr. Cheryl Jones, also from UNC-Chapel Hill, and I have completed the data collection. We presented it at the last AONL annual meeting in March, and now we’re working toward publications and more presentations.

AONL: What are some of the key findings from your study and what are their implications on nurse leadership and career planning?

DH: The findings from our most recent study showed that CNO turnover is still a major issue, just as it was six years ago when we conducted our initial research.* Our latest study lays out a pathway for what nurse leaders are telling us they need to be successful. We asked them if they find themselves in a position where they are voluntarily leaving a position or being asked to leave a position, what kind of support they need and what kind of support works.

We asked them about the most important skills they felt would make them successful in their career. These nurse leaders reported the first one was knowledge about informatics and technology. That is not at all surprising when you consider what’s going on in health care organizations with technology today. That was one area they felt they needed more knowledge.The other top areas they identified were developing the ability to understand and deal with finances; teamwork, in particular being part of the C-suite team; and communication skills.

AONL: How do you think the results of your study will impact academia?
DH: We’re hoping that the findings are disseminated widely so that graduate and nursing programs will incorporate some of this into their curricula.

AONL:  Can you tell me about the role the AONL Foundation played in supporting this research?
DH: The AONL Foundation was the sole sponsor of the research, so they funded the conduct of the study. Without the AONL Foundation, this important study would never have taken place.

AONL: Could you describe how CNO turnover is evolving?
DH: There still is a fairly high number of nurse executives who are stepping down or retiring in the next 5 years. This may be partly due to age, but our findings also suggest that there are other possible factors driving this exodus of key leaders who direct the delivery of health care. We as a profession need to understand those factors and intervene when possible. This type of research will illuminate the key factors that need to be addressed.

AONL: Is there a line of leaders ready to take over those roles?
DH: We found that generally, succession planning is not happening to the degree that we might like.  There is a greater need for nurses in general in certain areas of the country and in certain practices. Some of our respondents didn’t know if their organization had a succession plan. There’s a need for well-planned succession planning. That doesn’t just mean filling the role but it also involves how a person gets ready to take over the role and how you support them once they have moved into it.

AONL: Why is it important for organizations like the AONL Foundation to support research in nurse leadership?
DH: They help us ascertain the important knowledge we need to have to improve the quality of patient care and the quality of nursing work. These are incredibly important foci and intricately related to one another. There are actually not many organizations funding this type of research. For instance, NIH or NINR does not fund this type of nursing research. So it’s essential that the AONL Foundation and other organizations support this important work.

AONL: What was the response from nurse leaders at the 2014 AONL annual meeting where you presented your key findings?
DH: The response by the nurse leaders at the meeting was overwhelmingly positive. Many came up to speak with us and offer encouragement about this important research after our presentation. My colleague, Cheryl Jones, and I invited the attendees to ask questions and offer insights to help us better understand what some of the findings meant. They enthusiastically suggested additional studies that they believed needed to be conducted.

We would like to conduct additional studies to better understand this important area. Six years passed between our first CNO turnover study, also sponsored by AONL, and this one. We feel it would be important to continue this particular line of inquiry more often, perhaps every 3 years. We would love to partner with the AONL Foundation to do this because every time you conduct research you learn how you could do the work better and what critical new questions are on the horizon.

Reference: *Chief nursing officer retention and turnover: a crisis brewing? Results of a national survey. Jones CB, Havens DS, Thompson PA. J Healthcare Management. 2008 Mar-Apr;53(2):89-105; discussion 105-6.