Powerful leadership, under-represented
Nurses are the largest group of employees, nurses are the largest budget item, and most nurses are women. They regularly run hospitals at nights, weekends, and holidays when no other executives and rarely any physicians are around. This adaptive workforce can produce powerful leadership at the top. Why aren't nurses in higher leadership positions?
"There are issues, I think, of enormous prejudice in the system at large. When CEOs say there should be more in leadership with clinical backgrounds, they don't mean nursing, they mean medicine," says Connie Curran, EdD, RN, FAAN, a healthcare executive strategies consultant.
Despite the ratio on the front lines of patient care, only 2% of nonprofit hospital board members are nurses while there are more than four times as many nurses as physicians in the United States. While 4% of hospital CEOs in the United States are physicians, according to the American Hospital Association, even fewer are nurses, approximately 10 out of every 1,000 hospitals.
Multiple barriers prevent nurses from achieving this leadership status, but the problem, at its root, is the hierarchical structure of medicine and prehistoric gender issues that persist in healthcare.
Curran has worked in the corporate world as well as in hospitals. "I saw lots of nurses holding the place together, and many nurses in the executive branches saying 'how many CEOs do I have to teach their jobs to?' Most of these guys had a business degree and had never been above the first floor of a hospital, and they had no clue what went on upstairs."