Nurses in the C-suite: leadership beyond chief nurse.

The US health care system is reaching a critical point. Consistent cost increases coupled with a struggling economy has illuminated the burden of more than $650 billion annually in health care expenditures. The ability to afford health care is a growing concern for individuals, businesses, and state and federal governments. In addition to costs, variability in quality, and utilization belie any claims of a rational and consistent system of care. Transformational change will require leaders to shape our future health care institutions. Nursing has historically not been considered as a leadership source for change of this magnitude. However, due to the sheer size of nursing, core skills, and competencies, nurses could be a viable resource. Competencies needed for nurse, health care, and physician executives were compared using the HealthCare Leadership Alliance data, which created a body of knowledge that identifies competencies in 5 domains. Findings demonstrate that nurses, health care executives, and physicians possess more than 80% of the competencies reviewed. To successfully take on the role of leading institutional response to the dramatically changing health care environment, nurses must not only have the requisite leadership skills and experience, they must also have an expectation of themselves to lead at this level.