CNOs should focus on reducing burdens, including staff, and partnering with informaticists when implementing AI, according to these nurse leaders.
The door is wide open for AI in healthcare, and as nurse leaders determine the best ways to utilize it, it's important to focus on the goal.
At the 2025 HealthLeaders CNO Exchange, the participating members discussed how AI should exist in nursing to support the work that nurses already do, at the bedside and beyond. AI is capable of providing the whole picture in the EHR, which can lead to impactful workflow redesign.
Most importantly, staff must be involved in implementation. Technology integration is at its best when it happens with nurses at the helm, as they will likely be using the technology most frequently and are tuned in to workflow gaps.
With all of this in mind, here are five things CNOs should focus on when integrating AI.
CNOs must commit to continuing wellbeing programs once they invest in them, says this nurse thought leader.
On this episode of HL Shorts, we hear from Diane Sieg, Registered Nurse, Author, Coach, and Creator of the Well-Being Coaching Initiative, about what CNOs can do to continue their wellbeing programs. Tune in to hear her insights.
Targeting burnout and workplace violence can help CNOs lower nurse turnover, according to this CNO.
Nurse turnover rates have been high since the COVID-19 pandemic, and as the five-year anniversary passes, it's important for CNOs to reflect on what they can learn from that time.
During the pandemic, nurses were feeling burnt out, and according to Cheryl Reinking, CNO at El Camino Health, overburdened both emotionally and physically. Now, burnout is still a critical issue in nursing, along with heavy workloads, documentation burdens, and workplace violence.
"We're coming out of that," Reinking said. "We’re still challenged with continuing to address the needs of the workforce as it pertains to burnout."
Since the pandemic, there have been some positive changes in nursing. Despite the continued prevalence of workplace violence incidents, Reinking cited the increased focus on flexibility and work-life balance, which Reinking calls "work-life integration."
"I think [work-life integration] is a great new term because I'm not sure there's ever any balance," Reinking said."
However, turnover rates continue to be a significant issue for many health systems. While many CNOs are still working towards solutions, Reinking and the leadership at El Camino Health have found the path forward.
What happened at El Camino Health?
According to Reinking, El Camino Health had a turnover rate of less than 5% before the pandemic. That number increased to about 12.7%.
"That's the highest it's ever been, and I've been here for 37 years, and I've never seen it that high," Reinking said. "Now that's lower, in fact, than half of what the national rate was at the time. However, for us that was tremendous."
The health system's turnover rate has since dropped back to 5%.
El Camino is a relatively small to medium-sized organization, Reinking explained, so they wanted to understand the contributing factors and root causes of the spiking turnover rate. One of those factors was engagement and recognition.
"[We make sure] we have recognition programs in place to address those many important activities and care practices that nurses bring to patient care and to the bedside," Reinking said.
Workplace violence prevention is another critical piece of the strategy. Reinking also said they brought in a nurse retention specialist in 2024 to help build professional career development plans for nurses.
"What we found is that nurses want a trajectory of advancement…especially the Gen Z [nurses] who are now in our workforce, they want to know what's next," Reinking said. "We want to make sure we create a plan for them to know what's next in their career trajectory while staying at El Camino Health."
Improving retention
For CNOs who want to improve retention, Reinking believes the culture of recognition at the frontline is key. To help increase that effort, El Camino Health is leveraging Laudio's software platform so nurse managers can recognize individuals for their birthday, work anniversary, or for working an extra shift.
"That's been tremendously well-accepted and has really been seen as boosting our engagement of our nurses," Reinking said.
To combat burnout, the health system hired a licensed clinical social worker who is trained in mental health support. That way, when something traumatic happens to a nurse, there is someone on staff who can help them work through the incident.
"This employee support specialist can meet in the moment with our clinical staff and help to be that decompression that they need, and that person they need to talk to about what just happened during their shift," Reinking said.
To mitigate workplace violence incidents, El Camino Health also implemented the CALM team, to address patients who begin to escalate their behavior. The program brings in mental health professionals in a proactive way to help address any unmet needs the patient might have, which according to Reinking is usually the reason why patients begin to escalate.
"We can help make sure that we're providing that unmet need through that mental health support at the bedside," Reinking said.
Ultimately, Reinking believes it takes a combination of strategies to lower retention rates.
"I wish there was a magic bullet, but we've been trying to understand all the different things and what's made the biggest difference," Reinking said.
Two big challenges for expanding virtual nursing are staffing shortages and cost, says this nurse informatics leader.
Making progress towards a virtual nursing goal is not without its trials and tribulations.
While health systems might want to take giant leaps and bounds forward, it's more likely that progress will happen slowly and methodically.
Clair Lunt, chief nursing informatics officer and senior director of nursing informatics at Mount Sinai Health system, recently gave HealthLeaders an update on the health system’s virtual nursing progress over the past year.
Clair is part of the HealthLeaders Virtual Nursing Mastermind program, which brings together several health systems to discuss the ins and outs of their virtual nursing programs and what their goals are now and for the future.
From then to now
At the beginning of the Virtual Nursing Mastermind program in 2024, Clair told HealthLeaders that the purpose of virtual nursing at Mount Sinai is primarily addressing the documentation burden nurses carry by having the virtual nurses complete the admission and discharge documentation and patient education. Since then, Clair said the program remains on track.
"Our program has remained in status quo over the past year," Clair said. "We are looking into expanding the tasks to include drop-in rounds."
The health system uses high-resolution cameras that are placed above TVs in the patients' rooms. The next step is to expand the technology to other areas.
"We are investigating how to use the service in non-conventional areas like observation units," Clair said.
Building on the foundation
Right now, Clair said the biggest challenges to the growth of the virtual nursing program are staffing and the cost.
"Staffing shortages on the units [are making] it difficult to create an in-house solution, so we use a third-party vendor to supply the virtual nursing staff" Clair said.
Discussions about expansion beyond the hospital have also not taken place, but Clair anticipates that they will in the future.
Clair also reported that the nurses have really embraced the program and that they have provided good feedback. In terms of hard ROI, the health system tracks several metrics.
"We are using metrics related to number of admissions, discharges, and education sessions completed by the virtual nurse," Clair said.
The HealthLeaders Mastermind seriesis an exclusive series of calls and events with healthcare executives. This Virtual NursingMastermind series features ideas, solutions, and insights onexcelling your virtual nursing program.Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
CNOs must be equipped with the skills to advocate for policies that will improve the lives of their nurses and help them deliver the best quality care to patients.
Nurses across the country are faced with many challenges, such as workplace violence and staffing ratios, that have potential legislative components.
In a discussion about advocacy and policy at the 2025 HealthLeaders CNO Exchange, the participating CNOs had several areas of focus for nurse leaders wanting to get involved in the legislative process.
Here is a checklist of what CNOs can do to get involved in political advocacy.
The research facilitated by the Buckeye Paws program aims to discover the impact of the program on nurses and the therapy dogs, says this nurse leader.
On this episode of HL Shorts, we hear from Beth Steinberg, associate director of research at the OSU Center for Integrative Health and program director for Buckeye Paws, about the additional research being done on nurse wellbeing in the Buckeye Paws program. Tune in to hear her insights.
The next challenge for virtual nursing will be growing to scale, says this virtual care leader.
Health systems have made significant strides in virtual nursing over the past few years as technology opens the door to new possibilities.
Stephanie Johnson, executive director of virtual care for UnityPoint Health, recently gave HealthLeaders an update on the health system's virtual nursing progress over the past year.
Johnson is part of the HealthLeaders Virtual Nursing Mastermind program, which brings together several health systems to discuss the ins and outs of their virtual nursing programs and what their goals are now and for the future.
What's changed?
Last year, according to Sarah Brown, UnityPoint's CNO, the goal of the virtual nursing program was to improve the nurses' experience by offloading burdens and giving them time back at the bedside.
In the past year, Johnson explained that the biggest evolution is the shift from a decentralized, market-based model to a centralized leadership structure, with standardized workflows.
"Standardization of workflows is happening in parallel with the centralization," Johnson said.
The biggest challenge going forward, according to Johnson, is the investment in growing to scale. In terms of equipment, UnityPoint is adding in-room technology this year.
"This is happening on a single unit as proof of concept, with the intent to scale the technology system-wide," Johnson said.
Currently, the health system uses a separate vendor solution for their software platform. However, as offerings evolve, Johnson expects that to shift to the EHR.
"We anticipate more collaboration with Epic as their service offerings continue to develop in the future," Johnson said.
UnityPoint is measuring outcomes using a virtual nursing dashboard to track several quality and process measures.
"Some of the data, such as first-year turnover, is yielding the results we anticipated," Johnson said.
Future of care delivery
In terms of the program's impact on staffing, Johnson said their strategy is still in the infancy stages as they continue to focus on building strong foundations.
"The future will focus on a growth strategy where we can continue to support the bedside and in-house nursing staff," Johnson said, "by assessing new opportunities across a variety of care settings including the ED, L&D, and transfer center."
As for what comes next, Johnson said there might be some opportunities for integration into care programs that extend beyond the hospital.
"[We are] starting to consider opportunities to collaborate with bed placement and care coordination," Johnson said.
Lastly, Johnson is most surprised by UnityPoint's progress in virtual nursing as measured by nurse and patient reactions.
"The patient and nursing adoption and satisfaction has been overwhelmingly positive once given the opportunity," Johnson said.
The HealthLeaders Mastermind seriesis an exclusive series of calls and events with healthcare executives. This Virtual NursingMastermind series features ideas, solutions, and insights onexcelling your virtual nursing program.Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
Workforce, workflows, and work environment are all linked together in the journey to improve nursing, according to these nurse leaders.
Being a CNO in 2025 is more complex than ever, with higher patient acuity, different workforce expectations, and an onslaught of technological advancements that can make anyone's head spin.
However, a few workforce issues continue to rise to the surface as top priorities for many nurse leaders, including succession planning, workplace violence prevention, and leveraging technology to support bedside nurses.
The 2025 HealthLeaders CNO Exchange wrapped up on Wednesday after three days of enthusiastic idea-sharing and elevated discussion about these workforce concerns and more. Here are some of the CNOs' approaches.
Including non-acute spaces
There are many reasons why nurses come and go at the bedside, and many are choosing the option to work in the ambulatory space instead of the acute care space.
The Exchange members have noticed a migration from the inpatient to outpatient settings, even though there is typically less compensation. It's important that CNOs take a look at traditional models in the ambulatory space, and remember that many nurses are seeking better work-life balance.
The members also noted that many times, the nurses in ambulatory spaces often don't feel as included in the nursing team, even though they are a critical part of the workforce. CNOs must make an effort to extend awards and accolades to nurses in the ambulatory setting to celebrate the work they do for their health systems.
Addressing workplace violence
Workplace violence remains a top concern for CNOs, and the Exchange members shared many horror stories of what happens to their nurses because of violence from patients, other staff members, and even individuals from the nurses' personal lives.
There are major concerns about the lack of legislation regarding workplace violence towards healthcare workers. The members shared that they've heard many lawmakers say workplace violence is "expected" in nursing. CNOs need to be aware of what they can do to help advocate for policies and standards that provide protection and combat that stereotype.
The members recommended being proactive and implementing security measures such as weapons detection systems. CNOs should consider partnering with local law enforcement as well. For staff, nurse leaders should implement de-escalation training and encourage reporting when incidents do occur. Additionally, those protections should extend to the outpatient settings when possible.
Leveraging AI
The door is wide open for AI in healthcare, and as nurse leaders determine the best ways to utilize it, it's important to focus on the goal. According to the members, AI should exist in nursing to support the work that nurses already do, at the bedside and beyond. AI is capable of providing the whole picture in the EHR, which can lead to impactful workflow redesign.
Most importantly, staff must be involved in implementation. Technology integration is at its best when it happens with nurses at the helm, as they will likely be using the technology most frequently and are tuned in to workflow gaps.
Ethically, the members had some concerns about AI that are important for CNOs to consider. When bringing AI into nursing, CNOs must think about equity and disparities, information transparency, and data privacy and security. Patient safety must always remain top of mind and policies should be developed to ensure accountability and due diligence.
The goal is ultimately to reduce documentation burdens and time spent on administrative tasks, and CNOs have a major opportunity to improve their workforce through careful and intentional implementation.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Dogs provide a safe space for nurses to share how they're actually doing, says this nurse leader.
On this episode of HL Shorts, we hear from Beth Steinberg, associate director of research at the OSU Center for Integrative Health and program director for Buckeye Paws, about the benefits that therapy dogs have on nurse mental health and wellbeing. Tune in to hear her insights.
Nurses should be the ones advocating for nursing, say these CNOs.
Nurses across the country are faced with many challenges, such as workplace violence and staffing ratios, that have potential legislative components.
CNOs must be equipped with the skills to advocate for policies that will improve the lives of their nurses and help them deliver the best quality care to patients.
The HealthLeaders CNO Exchange is well on its way in Nashville as the participating members discuss everything from succession planning, leadership development, virtual nursing and AI, to workplace violence and nursing policy. On a panel about advocacy and policy, the participating CNOs had three areas of focus for nurse leaders wanting to get involved in the legislative process.
Issues to prioritize
According to the panelists, there are several key issues that CNOs should be prioritizing, with workplace violence policy at the top of the list. There has been a national push towards further penalizing those who assault healthcare workers, specifically with the Safety From Violence for Healthcare Employees Act, or the SAVE Act. Many have come to expect workplace violence in nursing, and CNOs need to counter that narrative and push for more legal protection for nurses.
The panelists made it clear that regardless of the viewpoint, mandated staffing ratio legislation is something CNOs must pay attention to. Reimbursement and full practice authority policies are also critical, especially for nurse practitioners, to demonstrate the value of nursing.
On a national level, nurse leaders now find themselves needing to defend Medicare and Medicaid, according to the panelists. There are several policies coming out of HHS that the panelists are concerned about and it's important that CNOs stay up to date with the newest proposals from legislative bodies at all levels.
Getting involved
The list of policies goes on and on, but the key takeaway from the panelists is that CNOs must be at the table during legislative discussions. Many policymakers do not understand the inner workings of the healthcare ecosystem, and by developing strong relationships with legislators, nurse leaders have the ability to make a real impact.
The panelists recommended that CNOs make appointments with local, state, and federal legislators outside of session, and make it clear that they can be a point of contact for when the legislator needs an expert. When the legislative bodies are in session, CNOs should make their presence known and engage as constituents.
CNOs should also develop relationships with their government relations teams at their organizations. Ultimately, the panelists emphasized that now is the time for nurses to advocate for nursing, rather than letting others do it for them.
Skills to employ
While advocacy might be new for some CNOs, it's necessary to take part in, and according to the panelists, there are a few key skills to work on that will improve advocacy efforts.
First, engage in storytelling. Everyone has been touched by a nurse or by the healthcare industry at some point in their lives, and by sharing those stories, CNOs can make nursing policies feel more personal to legislators who can prioritize them.
The panelists recommended following up with data to support the storytelling and emphasizing numbers that will stand out, such as vacancy rates. Nurse leaders should also get to know legislative aids and staffers who are doing a lot of the heavy lifting for the legislators as part of their team. Despite the overwhelming nature of politics and the constant change, CNOs should try to stay educated and be selective about where they can affect the most change.
The CNO Exchange continues, so stay tuned for more coverage.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
