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Charting the Course

Nurse-trained CEOs balance clinical connections with operational aptitude

Judging by the number of nurse-trained CEOs springing up on the recent healthcare landscape, it's clear the days of choosing nursing for the flexible hours are over.

While their clinical backgrounds differ, nurse CEOs in the Midwest are united in the firmness of their belief in the power of an advanced degree and a passion for delivering quality care. Though these industry leaders don't have the crystal ball for forecasting the effect of healthcare reform on the landscape, they're confident the traditional nursing education is an ideal core for any job with a corner office.

Communicating From the Top

Supervising employees can be the most challenging part of any manager's job. Even when the employees are educated enough to have an MD after their name, communication is key.

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After 9 years on the job, Mary Lou Mastro, MS, RN, FACHE, CEO at Linden Oaks Hospital at Edward, is still taken aback when one doctor calls her "boss." She prefers to think of the clinicians at the 101-bed behavioral health facility in Naperville, IL, as part of a team combating eating disorders, anxiety disorders, chemical dependency, self-injury and geriatric conditions.

Because of her years as part of the team that opened Edward's renowned heart hospital, Mastro understands the importance of communication and visibility. She places a high premium on keeping the information exchange as fluid as possible by holding focus group meetings with staff, rounding on the unit, sitting on clinical practice councils and conducting staff meetings. Mastro's considering keeping a live blog so employees can learn her thoughts in real time.

Incoming president at University of Minnesota Amplatz Children's Hospital and University of Minnesota Medical Center, Fairview, Carolyn Wilson, MBA, RN, was asked point-blank in the interview process why she'd be a better candidate than a physician.

"I told them my nursing background serves them better and I believe it," she said. "I know how to talk to doctor, listen and work with them. Nursing taught me how to be part of a larger team of many disciplines, as well as lead a team."

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Mary Lou Mastro, MS, RN, FACHE

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Carolyn Wilson, MBA, RN

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Peggy Troy, MSN, RN

As one of a growing number of nurses working as CEOs of children's hospitals, Peggy Troy, MSN, RN, Children's Hospital of Wisconsin, Milwaukee, makes sure she gets out of her office and chats with patients, families, doctors, nurses and as many of the 575 employees indirectly under her supervision as possible.

"People are always surprised that my background is nursing, not an MBA," Troy said. "When they find out that I've been a nurse, doctors always say 'then you understand what it's really like.' Regardless of whatever new computers or monitoring devices we're working with, you still have a family with an ill child who needs your support. There's a whole bond we have as providers."

Though Troy is sensitive to nurses' concerns and has firsthand experience with staffing and scope of practice, she quickly learned every discipline has its own hot-button issues.

"I strive to balance sensitivity to nurses' needs with that of pharmacists, social workers, nutritionists, etc.," Troy said. "In today's environment, clinical disciplines have to work together as a team. You have to be aware of the challenges in the clinical environment and what it takes to balance the right care at the right time with economic constraints. I hope I've created a work environment where they can do their best for kids every day."

Developing Business Acumen

These nurses, many of whom graduated in the era of white nursing caps, never imagined their future would include so much time developing reimbursement policies and crafting hospital economics.

Mastro, who chose to pursue an MSN rather than an MBA had to learn financial processes on the job. Her habit of voracious reading, though, paid off as she felt quickly up to speed on the differences in mental health reimbursement (versus acute care), aggressive care management and promoting access to care.

Earlier in her career, Troy considered pursing an MBA but opted against it because she was raising a young family. Though she has no regrets on her decision, she's worked hard to amplify her understanding of business issues specific to running a children's hospital.

"We are 50 percent Medicaid and it's a huge business issue for every children's hospital," she said. "None of us are sure how this is going to play out in the future."

She credits surrounding herself with knowledgeable people, including her staff, as well as reading and taking classes, with filling in the gaps in her formal business education.

Bedside Connection

Just as important as reading The Wall Street Journal is staying connected with patient care, which can be a challenge as emails, meeting requests and forecasting occupy the lion's share of a CEO's schedule.

Mastro and Wilson swear by the power of rounding with staff to provide that critical interaction. In her previous position at University of Chicago Medical Center, Wilson took her community service one step farther and participated in medical mission trips to Haiti and other community health events.

"Giving back keeps us real and connected to the patients we serve," she said. "For one, it gave me the chance to work in a different way with our employees. When you're gardening together, they see they can communicate with you more directly. I also feel more connected to the community. I don't want to lose what nursing taught me."

In pediatrics, Troy has found many worthy projects include child abuse prevention, immunization and community health fairs in low-income neighborhoods. Not only does it provide her the personal patient connection that's sometimes lacking in hospital administration, but it promotes the hospital's objectives as well.

"Our mission at Children's Hospital of Wisconsin is to have the healthiest children in the nation," she said. "Children's is an integral part of the community and half our patient population lives in poverty. We need to be there for our kids when they're undergoing cancer treatment but also in the wellness mode. It's our best and most effective contribution to keeping kids healthy."

Robin Hocevar is senior regional editor at ADVANCE.


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