"Just a Nurse" in the C-Suite
Whether it’s your sibling, relative or friend, it seems like everyone has some connection to a Registered Nurse. This isn’t uprising when you realize that there are almost 3 million RNs in the US. Nurses don’t think about healthcare in the abstract, they live and breathe it every day or night they go into work. Many RNs have worked in a myriad of units, across age spectrums, often specializing in one area or another. So with such intimate knowledge of how to heal patients and improve outcomes, one would hope that RNs would be making an impact in C-Suites of hospitals across the U.S..
A Southern Illinois University Carbondale study from 2013 broke down hospital CEOs in the US with respect to education and workforce demographics. They found that 42% of CEOs had technical training or healthcare degrees, with Nursing being the most common. The other 58% were ‘trained managers’ either having MBAs or some type of Masters related to Healthcare Administration. Looking at the gender split, 31.5% of the CEO respondents in 2012 were female, which dwarfs the rate of general business CEOs that are women as noted by the Standard & Poor’s (S&P) 500 rate of 4.4% women. The Southern Illinois study noted that women in these positions make 19% less than their male counterparts which is cringeworthy on its own merits, but slightly better than the national average of women making 21% less than their male counterparts. Even while male nurses are outnumbered 10:1 in the workforce, they still make between $5,000-10,000 more than their female counterparts, a fact which speaks to the agregious nature of pay inequity more pointedly. Proof that this inequity is gender biased and not market driven was provided by Quantopian, a Boston-based trading platform. They compared women led Fortune 1000 companies to the S&P 500 company performance from 2002-2014, and found that the 80 female CEOs produced equity returns 226% better than the S&P 500 over the same 12-year period.
But there are other positions in the C-suite that aren’t the CEO; how are nurses fairing in those roles? Surprisingly, the data on nurses across the C-suite is pretty scarce. Pamela Cipriano, president of the American Nurses Association, noted in a 2016 article that “some nurse executives choose to leave RN off their resumes” some from letting the licensure lapse and others intentionally. Frustrated by trying to collect this data, Capriano heard “Well, I don’t want to put RN after my name because some people might not think that I know as much about business, or that it might be a detractor when I’m competing with others in the C-Suite, especially men.” I personally went back and forth on this issue when deciding what to put in my email signature as an RN/CEO, ultimately including it.
Connie Curran, RN and author of executive leadership books, estimates that only 2% of hospital board members are nurses, and notes the powerful insights and positive impact they could bring, if they were involved in decision making. Aside from Chief Nursing Officer positions, which for obvious reasons are RN dominated, there is a clear need for more data on Nurses in executive roles within hospitals.
There’s a phrase that I used to hear all the time, and to this day it still makes my skin crawl; “Oh, they’re just a nurse”. Whether from a patient, family member, or another hospital staff member, most nurses have heard this phrase. The reason those executives feel an impetus to leave the RN off of their resume is the same reason why this phrase is so common place. It perpetuates the stigma that nurses have an implied ceiling; a ceiling on your achievable business acumen, or a ceiling on your capacity to answer a difficult clinical question typically suited for a doctor. Nurses shouldn’t have to question whether our nursing experience translates into another career; we should be openly proud of our profession and communicate boldly that nursing experience translates across industries. We need more nurses and women in leadership roles to combat this stigma and reinforce that hospitals and companies excel when nurses and women are elevated to executive positions. And of course, the pay should be the same!