Nurses are turning down chief nurse positions because they feel that cannot drive improvements for patients. Only an organisatinal shift will change this, writes Rhiannon Smith

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In the NHS the nursing career path can often lead to appointments in senior roles such as chief nurse or director of nursing.

Although this level of seniority brings with it greater responsibility and proximity to the board, we recently noticed a trend worth highlighting.

Keep in touch

Some nurses are turning down these roles in preference for operational roles, such as chief operating officer, because they want to stay in touch with nursing and ultimately patients.

Rhiannon Smith Hunter Healthcare

Rhiannon Smith

Nursing is close to their hearts and they feel that as a chief nurse, or director of nursing, they are less able to drive improvements for patients.

Operational roles appear to give them this opportunity whereas senior nursing roles are viewed as being primarily focused on performance monitoring and reviewing quality and safety.

We have recently been in touch with at least three senior nurses who have previously worked as directors of nursing and have chosen to move into chief operating officer and director of operations roles.

‘They felt they were less able to drive improvements for patients as chief nurse’

They all felt that being a director of nursing or chief nurse didn’t feel very much like being a nurse anymore. 

The question for NHS trusts is how they ensure these senior nursing roles are not too far removed from nursing.

Rather than reconfiguring senior roles, one approach is to make sure there is patient focus at every level within the organisation.

This is something every trust aspires to, but putting it into practice can often require a cultural and operational shift.

However, it is the only way senior nurses who are passionate about patients will still feel they can have an impact in senior nursing roles.

Rhiannon Smith is a partner and head of executive search for Hunter Healthcare