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The Skills CNOs Need to Advance Their Careers During a Pandemic

Analysis  |  By Carol Davis  
   February 08, 2021

Nurse leaders who are seeking a job change 'will find opportunities,' says one nurse recruiter.

Though the COVID-19 pandemic has created high unemployment numbers and otherwise stalled countless careers, Chief Nursing Officers (CNO) will find opportunities in the market right now, says Rachel Polhemus, a senior partner at WittKieffer, a global executive search firm headquartered in Chicago.

Senior-level opportunities are available despite an ongoing registered nurse (RN) shortage that, according to the United States Registered Nurse Workforce Report Card and Shortage Forecast: A Revisit published in the May/June 2018 issue of the American Journal of Medical Quality, is projected to spread across the country between 2016 and 2030.

Retirement or opportunities to take a job closer to home have created most of the openings—not because CNOS are leaving the industry, Polhemus says.

"They are not leaving their posts," she says. "They're trying to be there for nursing because they know how much they're needed."

CNOs who are looking for a change or Associate CNOs (ACNO) or nurse managers looking to advance will find opportunities—if they're the right fit, she says.

"This is the right time to stick your toe in the water and test your competencies and see how they measure in the market," she says.

But be mindful of the place and position you're considering, she advises. "Don't just jump at an opportunity because it's open," she says. "Find out as much about the organization as possible."

"Make sure it's a culture fit and the values there align with you as a person," she says. "Just because it's a bigger job doesn't mean it's the right job for you."

Must-have skills and knowledge

CNOs seeking a change or nurse managers looking to move up into a CNO role need good management skills to get noticed, Polhemus says.

"They need to be someone who knows how to engage their nursing workforce and who has been able to creatively look at recruitment and ways to recruit and retain staff," she says. "The ability to recruit and retain is tremendous right now."

The average national turnover rate for bedside RNs was 16.8% in 2017, according to the recruitment firm NSI Nursing Solutions, Inc. The 10-year RN Work Project study found 17% of newly licensed RNs leave their first nursing job within the first year, 33% leave within two years, and 60% leave within eight years.

"The clear need in organizations in having a strong leader to help drive recruitment and retention strategies is critical," she says.

Besides the nursing staff, an effective CNO must also possess the ability to build relationships with other medical staff, administration, and various teams throughout a hospital or health system, she says.

Knowledge and skills in finances and business are required of nearly any CNO, Polhemus says.

"You would hope along the path, someone would have some P&L and financial acumen and the ability to develop a budget," she says. "It's critical in managing resources and recruitment needs because the cost of recruiting a nurse is expensive and if you lose them two years later, you're losing money."

Indeed, the cost of turnover for a bedside RN ranges from $33,300 to $56,000 per nurse—an average of $44,400—which can result in the average hospital losing $3.6 million–$6.1 million annually, according to the 2020 National Healthcare Retention & RN Staffing Report.

Many ACNOs and other nurse managers on the rise have graduated from an MBA or other master's program, while nursing students have financial classes connected to their programs.

"But also, many times someone on the rise gets mentored by a CNO," she says. "Getting someone to guide you is critical."

CNO who meets needs, boosts staff morale is especially important

Getting to know an unfamiliar staff during a pandemic is a unique challenge to CNOs as they find their way in a new organization, Polhemus says.

"They're learning the teams in a different way, in a socially distanced way, through Zoom," she says. "Some are in person, but it's not in the same orientation as it's always been done before."

Figuring out how to manage and provide care during COVID-19 while developing a vision around other programmatic needs is a pandemic-particular challenge for CNOs, she says.

"They have to develop and maintain the COVID units but they have to figure out how to grow other units," she says, "whether they're recruiting for oncology or cardiovascular or L&D nurses."

Understanding staff morale—knowing where they are and how to meet their needs—is also critical for a CNO new to an organization, she says.

"Morale issues are a big part of [the pandemic]," Polhemus says, "and they have to build the relationships so [nurses] trust the CNO and feel like they can open up to them."

Good candidates not only must know how to boost staff morale, but they must also know when to realize that one of their nurses is approaching burnout and encourage them to take time off, she says.

"They want a leader who can identify mental health needs of their workforce in ways they could not two years ago," she says. "The amount of trauma these nurses have been exposed to through COVID is far different than any trauma in their career."

Mindful Recruiting

The pandemic and its effects have changed the way Polhemus has approached recruiting CNOs.

"We've been very careful," she says. "We've been thoughtful about not reaching out to CNOs in certain locations and waiting for things to even out and die down. As we approach any recruitment, we're recognizing that everybody is dealing with a very challenging time. We're recognizing their leadership and what they're doing for their organization right now, rather than just jumping in and recruiting."

One strategy WittKieffer is using in filling a specific position is to search for CNOs who may have been born or educated in that region and may want to return there, Polhemus says.

"There's been an uptick of all executive-level positions for leaders to go back home to be closer to family to take some stress away," she says.

Hospitals also are making changes in recruiting, with some choosing to reach slightly down the chain of command to plan for their future, Polhemus notes.

"Some organizations, and I commend them, are recruiting an ACNO and planning for succession, knowing the CNO will retire in the next year," she says. "The talent market is competitive right now and some organizations are being proactive for the future to make sure they have a succession plan."

Diversity and inclusion, which are critical to achieving health equity and reducing disparities in healthcare, are being embraced by health systems who are looking for CNOs, Polhemus says.

"There is a real focus around diversity right now," she says. "Organizations want leadership teams to look like the communities they serve. There is a real need for leadership across all ethnic, racial, religious, and all groups … which is excellent because it helps bring forth talent that we have not seen before."

“The talent market is competitive right now and some organizations are being proactive for the future to make sure they have a succession plan.”

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.


A CNO's ability to recruit and retain nursing staff, which contributes to improved patient quality and decreased financial costs because of staff turnover, is crucial right now.

Knowledge and skills in finances and business are required of nearly any CNO.

Diversity in nurse leadership is coming into clearer focus.

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