From the Top: Voices of Nurse CEOs

Johnese Spisso

How did you translate your nursing skills to fit the CEO role in your organization?

J.S. - Patient care is the essence of health care. We need to understand what is important to patients and their families. I think that core to our training as nurses is understanding the needs of patients and families. I think being a nurse prepared me in understanding the needs not only of patients, but also the entire multidisciplinary team. Having this knowledge has prepared me to better deliver the services that patients would need. It was a natural fit. I think it may be more difficult to lead health care organizations without having the clinical background. Also, being a nurse gave me the skills to be more attuned to the needs of the health care interdisciplinary team. I believe that the nurse is the coordinator of the team.

As a chief executive, how has your perspective changed? Do you see health care delivery differently?

J.S. - I think the perspective now is more focused on health policy on state and federal levels. Having this knowledge is essential to run health care delivery systems today. It allows me to advocate for the right policies that impact how we deliver care to our patients intrinsically and extrinsically.

What advice would you give your younger self about leadership?

J.S. - I always give this advice: focus on the giving the best every time. Today, I think many younger leaders are always in a quest of the “next opportunity, or next role.” Rather than thinking of your next role, strive to always do your best in whatever you do. I have learned over the years that people will seek out the best. If you demonstrate great work, you will never search for a job, the job will find you. Opportunities will come to you. Don’t rush it, be patient. I have people ask me, “I want to be a CEO by the time I am 40, what do I need to do?” It doesn’t work like that. Enjoy and accumulate the experience, this will prepare you for your next job. Find joy in the workplace.

As a nurse, how are you leveraging your clinical perspective in the C-suite? What do you think are the advantages and disadvantages of being a CEO with a clinical background?

J.S. - It has allowed me to advocate for the things that our patients need. I think it helps me understand the importance of being creative and innovative in delivering the highest quality of care to our patients. Being a clinician allows you to quickly sort out details to make good decisions. It gives you a good understanding of the clinical needs of your patients.

What do you think are the advantages and disadvantages of being a CEO with a clinical background?

J.S. - There are many advantages, I have had no disadvantages. Formal education in business and operations has allowed me to be fluent in the languages of those disciplines. Also, I think any nurse leader aspiring to branch out beyond nursing leadership must do the homework involved in running organizations, such as being abreast of current trends in health care policies and financing.

Did you find the traditional hierarchy among nurses or physicians a barrier to achieving your organizational goals?

J.S. - I did not. I was always fortunate to have had worked in organizations with wonderful milieu that is built on understanding and mutual respect within the team. I think these are characteristics of teaching and academic medical centers. A lot of these organizations rely on the nurses to help teach new physicians and others. I believe that helps in making them see the value of nursing in an organization.

How would you describe your relationship with your CNO? What do you think are the pros and cons of having two RNs in the C-suite?

J.S. - It always has been very good. I think we speak the same language; it is easy to get the work done with the CNOs. I always make it a point not to micromanage. Being a CNO in my previous career allows me to have an appreciation for the job the CNOs do. My role as CEO is to support them in leading nursing. I am fortunate to have worked with many great ones.

At what point in your leadership career did you realize that you could be a CEO?

J.S. - When I was a CNO, an opportunity came to apply for a COO role. After a national search, I was selected. Initially I wasn’t interested. It was my discussion with my nursing executive team and the medical staff that made me accept the offer. They encouraged me, saying being a CNO prepared me well for these roles beyond nursing. I saw that by venturing outside nursing, I would be able to carry out the mission of ensuring great care is rendered in a broader scope beyond nursing.

What kind of education do you think nurses should possess or pursue that will enable them to thrive in executive leadership roles?

J.S. - I think a business degree can be very helpful. Education outside nursing can help expand your understanding as a leader and diversify your knowledge and skills. It also makes you a stronger candidate to possess clinical experience and business acumen.

What is your advice to nurses who have leadership aspirations outside nursing?

J.S. - Get involved as much as you can. This will help you gain experience and expertise. When I was a charge nurse in the unit, I volunteered and got involved with special projects. These are all great learning opportunities. Show your enthusiasm and people will notice.

Kevin Sowers

How did you translate your nursing skills to fit the chief executive role in your organization?

K.S. - I think my nursing skills allowed me to be a better leader. Being a nurse helps you understand the needs of the patients. It also gives you a perspective that health care is a team sport. I did not become a nurse to be president of Johns Hopkins. I became a nurse because I wanted to make a difference in the lives of my patients.

As a chief executive, how has your perspective changed? Do you see health care delivery differently?

K.S. - It has not changed. I still see the important role that nurses, physicians and allied health professions have in ensuring the best care is delivered to patients. People go into health care because they want to make a difference in the lives of others. It is core to who we are in health care.

What advice will you give your younger self about leadership?

K.S. - I would say, 1) understand the facts and listen to the emotions, 2), rise above the chaos; do not be a part of the chaos, because if you are part of the chaos you become a part of the problem, 3) understand when your greatest strengths become your weakness. Surround yourself with people who can give you feedback so you can grow.

As a nurse, how are you leveraging your clinical perspective in the C-suite?

K.S. - I do it every day. There is not a conversation that I do not use my clinical experience to inform a discussion. It is integrated with who I am and how I lead. I do not have to actively think about it, it is just a part of who I am.

What do you think are the advantages and disadvantages of being a chief executive with a clinical background?

K.S. - Being a clinical person in the CEO role, I have to spend a lot of time in knowing and understanding the financials and operations of health care. The same can be said of people who are non-clinical and are in leadership roles in health care. You may have the business acumen, but it is incumbent upon you to learn the clinical portion of health care. I think that what makes a leader successful, whether or not he or she has a clinical background, is understanding that he or she needs to still endeavor to learn.

Did you find the traditional hierarchy among nurses or physicians a barrier to achieving your organizational goals?

K.S. - No, I never had a problem with partnering with any provider in the organization. It is about not losing your ability to connect with another human being. Connecting with one another is an important ingredient to successful leadership, this is true from housekeeping staff to the providers. Health care is about human connection; it is the human experience. At the end of the day, it’s about building a partnership with everyone across the organization to deliver the best patient experience.

How would you describe your relationship with your CNO? What do you think are the pros and cons of having two RNs in the C-suite?

K.S. - I am clear with the roles. Even though I am a nurse, I am the president of Johns Hopkins Health System, not the chief nursing officer. I need the CNO to be over the practice of nursing. If the CNO asks for my advice as a nursing colleague, I will be glad to provide it. However, it is not my job to micromanage, or pretend that I am the CNO. The CNO is the CNO and I have great clarity on that.

What kind of education do you think nurses should possess or pursue that will enable them to thrive in executive leadership roles?

K.S. - I think Patricia Benner’s Novice to Expert describes this best. As a new nurse you need to focus on honing your clinical skills first. One of the great things for nurses today is that we have endless opportunities in our careers. If a nurse chooses to become a leader or an administrator, he or she must hone their skills and understanding about operations and health care financing. When I was a new manager, I took time to understand the financial aspects of health care. Identify where your gaps are. Going back to school is just one part of your preparation; find mentors who will be willing to teach you the practical things about leading. Surround yourself with people who will support you in your journey and development.

What is your advice to nurses who have leadership aspirations outside nursing?

K.S. - The rest of the world will change around us, technology will change, health care delivery will change, but one thing remains true: In the center of everything, there is a patient and a family. Never lose sight of that.

What is your advice to nurses who have leadership aspirations outside nursing?

J.S. - Get involved as much as you can. This will help you gain experience and expertise. When I was a charge nurse in the unit, I volunteered and got involved with special projects. These are all great learning opportunities. Show your enthusiasm and people will notice.

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