Nurses fill less than 25% of leadership roles at most healthcare organizations

Nurse leaders are critical to hospital care, but too few nurses enter the leadership pipeline, according to an NEJM Catalyst survey.

The online survey was conducted in August 2018 among more than 650 clinicians, clinical leaders and executives of U.S. healthcare delivery organizations.  

Here are five key findings:

1. Most respondents (79 percent) said their organizations had chief nursing officers. However, it appears nurse leadership is often sparse beyond that. Sixty-three percent of respondents said less than 1 in 4 leadership roles are held by nurses at their organizations.

2. Fifty-eight percent of respondents said the lack of nurse leadership may stem from a lack of interest among nurses. The survey authors noted nurses may not want to leave the bedside for leadership roles, or that the pathway to leadership may be unclear.

3. Respondents ranked the four biggest barriers to nurse leadership as follows:

  • It's nontraditional — 37 percent
  • Education — 31 percent
  • Perception of nurses as "doers," not "strategists" — 25 percent
  • No clear path to leadership — 25 percent

4. However, 64 percent of respondents said they felt the path to leadership for nurses was clear at their organizations. Forty-six percent of respondents said their organizations offer continuing education for nurse leadership and 40 percent offer mentorship.

5. Most respondents (72 percent) felt nurse leaders should be seen as physician leaders' equals when it comes to care delivery.


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