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Birmingham News: "Nurses' healing hands control hospitals' care"

January 25, 2004 -- Today Alabama's Birmingham News carried a positive, generally good article by Anna Velasco about three nurses who have become CEO's of major area health care institutions, suggesting that the rise of nurses to top hospital management positions shows that "[n]urses are becoming top leaders in health care." The piece does not provide much of a sense of where nursing as a whole is today--ignoring the current crisis completely--but Velasco deserves credit for pursuing the theme of nursing leadership, which is rare in the mainstream press, and for carefully relating the success of these CEO's to their nursing backgrounds.

The piece, which has a clear female empowerment angle, focuses on Mary Nash, who runs University Hospital, Alabama's largest hospital; Beth O'Brien, CEO of Baptist Health System, the state's largest hospital system; and Cathy Fickes, CEO at Carraway Methodist Medical Center, a large teaching hospital. Velasco notes that all three started their careers at the bedside, then became nurse managers and chief nursing officers before moving to overall hospital management. According to Velasco, the three believe they encountered more obstacles because they were women than because they were nurses. Velasco stresses that all three believe that "once a nurse, always a nurse," explaining how their nursing backgrounds are invaluable in their current positions, since nursing is the central function of hospitals and nursing itself requires significant management skills. This is an especially valuable point, as the press often describes nurses who move into health care management as "former" nurses--as if nursing were an unskilled job, rather than a profession--which it would be unlikely to do with physicians who had made the same move. The piece includes good quotes from all three nurses, as well as University of Alabama at Birmingham nursing school dean Rachel Booth.

Velasco also addresses some of the larger implications. She notes that 20 of the Alabama Hospital Association's 119 hospitals are run by women, nine of them nurses. She also reports that 19 per cent of hospital CEO's nationwide are women, though evidently there is no data on how many are nurses. At the national and state levels, we are wondering if any of the male CEO's are nurses; this possibility does not seem to have occurred to Velasco. Velasco also provides some historical context, suggesting that the apparent emergence of nurses in hospital leadership positions is really just a return to a century ago, when, according to Booth, women ran hospitals. Velasco also quotes Cathy Wright, president of the Alabama Women's Initiative, who says that nursing is now "one of the great unsung leadership opportunities" for women.

As in some other press features, the story's lead is a somewhat flippant hook that does a disservice to the remainder. Velasco's piece begins: "A generation ago, nurses took the orders rather than gave them. That is changing." Well...yes, no, maybe and not enough. To the extent hospital management is becoming more populated with nurses, which is not completely clear from the article, that is a positive development. And nurses today are in some ways more empowered than a generation ago. But this lead suggests that nurses "take orders" (presumably from physicians) unless they move into management, when in fact nursing is, and was a generation ago, a highly skilled, autonomous profession.

At the same time, this language--and the piece as a whole--might give the impression that nursing is doing great today, when in many respects it is in crisis, plagued by rampant short staffing, a critical global shortage, and power that is still not commensurate with nurses' training and responsibilities. None of this is mentioned. The Center salutes these nursing leaders for their achievements, but it might have been interesting to learn a little about the nursing situations at these CEOs' hospitals in the midst of the current crisis--perhaps through interviews with some actual bedside nurses there. Ms. Velasco might also have explored whether nurse-led hospitals provide better nursing care, which can be measured in part through factors such as error rates, staffing ratios and nurse turnover. She might have noted that one of the nurse-run institutions featured in the article (University Hospital) has been granted magnet status by the American Nurses Credentialing Center--a strong indicator of professionally satisfied nurses.

See Anna Velasco's Jan. 25th article: "Nurses' healing hands control hospitals' care" in the Birmingham News.

Anna Velasco may be contacted at



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