When people think nursing management, they think of the hospital, remarked Donna Cill, DNP, RN, FNP-BC.
"I think hospital nursing is integral to our profession, but there are so many other options in nursing management where nurses can make a great impact. I'm constantly reminding people that nursing is not in a box and that we can do anything in healthcare," said Cill, assistant dean for student affairs and director of continuing education at the University of Medicine & Dentistry of New Jersey (UMDNJ) School of Nursing, Newark.
As a nurse leader in academia at the nation's largest stand-alone healthcare university, Cill makes an impact on thousands of nursing students, alumni and advanced practice nurses seeking continuing education. She challenges them to think of innovative places where their skills are needed and make connections to lead.
"I take that job seriously. I think of everything as a business. I look at my product - students/nurses - and think of how to make the most attractive product possible," she said.
'Nothing Good Is Easy'
At the outset, Cill noted her career path was not purposeful. Without a mentor, she was forced to learn many things on her own. Throughout her path to management, four characteristic traits have never been far from her mind: resilience, commitment, unshakeable faith and a saying that she repeats to herself often, "Nothing good is easy."
That includes networking. Cill said networking is essential to grow one's career but remarked that it didn't come easy for her.
"I have a big, bright personality. I'll speak in front of a room of 5,000 people without an issue, but I struggled for a long time to meet and connect with someone unfamiliar one-on-one," she disclosed. "I had to change in order to grow, so I learned that to be a productive leader, you must be ready and willing to challenge yourself at all times."
Today, Cill looks at disappointments as "a blessing." Every time she feels disappointed, she prepares herself for something greater.
"As I look back on my disappointments, they've always been a way to prepare me for a greater task. So, although I never appreciate it at the time, I always prepare for something amazing," she said.
Aspiring to Management
When asked what makes nurses aspire to management roles, Cill said it's the desire to make a difference on a grand scale and the belief that they can make changes for the greater good. This was the case for James J. Farrell, MBA, RN, CRRN.
"It was a sense that things need to be done better by my leaders, and the sense that I could do it," he said.
The current chief nursing officer of Healthsouth Lakeview Rehabilitation Hospital in Elizabethtown, Ky., started out as a medic in 1983 and, through educational assistance programs, attended LPN and RN school. He's taken on various roles, including charge nurse, nursing supervisor, house manager, nurse manager and CNO. During the Persian Gulf War, he was a non-commissioned officer in charge of an ICU in Kuwait.
"I've had the benefit of being mentored by leaders at multiple organizations. I think the benefit of having different leaders at different locations has been the chance to see different leadership styles," he said, noting that not all leaders can pick up on everyone's blind spots.
Aside from his role as CNO, Farrell is also involved in the Association of Rehabilitation Nurses as a board member and is an adjunct professor for a healthcare-focused MBA program at Indiana Wesleyan University.
Challenges & Rewards
Farrell mentioned that the role of nurse manager isn't without challenges.
"Some staff members come to work, do a great job, but are reluctant to adapt to change. Some are excited about new ideas and latch onto anything new that comes out, but cannot understand why the change process is so slow. As leaders, we have to know how to lead and motivate all kinds of people," he explained.
Cill agreed that managing others is one of the most difficult parts of leadership.
"What I've learned is that if you create a culture of inclusion, it makes it less difficult to manage the people around you. When your team feels connected to the vision, it changes the dynamic of management," she said.
Though challenges do exist, they make the rewards that much more satisfying. Farrell said looking back on progress made and patients whose lives have been positively affected by decisions you were part of is the ultimate gratification. Patricia Hart, MS, RN, CPN, NE-BC, director of nursing, Children's Hospital and Women's Health, at Penn State Hershey Medical Center/Penn State Hershey Children's Hospital, Hershey, Pa., concurred. She listed "watching others be successful and growing in their professional development, improving patient outcomes, improving staff outcomes and satisfaction" as rewarding.
Born to Lead
Having spent 25 years at Penn State Hershey and moving through multiple roles there, Hart is currently responsible for the oversight of pediatric intensive care, intermediate care, acute care, hematology and oncology units, the NICU, women's health unit and radiology nursing.
When asked what it takes to succeed, Hart responded, "Dedication, hard work, respecting others and all they have to offer are critical to leading successfully. I believe it's important to embrace opportunities as they come, establish goals for yourself and view mistakes as learning opportunities that are also critical elements to success."
Having held multiple leadership roles over the years, including a clinical head nurse, nurse manager and most recently director of nursing, Hart believes leaders are born with the necessary abilities to lead.
"I believe you can learn skills that can make you a successful manager, but the best leaders I've ever worked with have an innate leadership ability that they are born with," she said.
Beth Puliti is a freelance writer.