Would a Nurse-Run Hospital Work? 66% of Nurses Say Yes

Nurses all over the country are being pushed to the limit. There were 385 nursing strikes in 2022 alone, a 42% increase from the year before. Nurses are striking over unsafe working conditions, low pay, and other administrative issues that make it harder for nurses to do their jobs. Nursing unions are doing their best to negotiate with hospital management to resolve the crisis but there just aren’t enough nurses to go around. 

Nurses argue that increasing compensation would help bring more providers into the fold, which would then improve working conditions.

Healthcare CEOs earned an average of $15.5 million in compensation in 2020. They are compensated mainly based on the number of patients who pass through their doors, also known as “heads in beds.” That means CEOs have a financial incentive to maximize the number of patients. They earn an additional $550 in salary for every bed that’s filled.

But are Nurses equipped for the role of a CEO? If Nurses feel overwhelmed in their current position, the role of a CEO brings on a whole range of responsibilities and challenges by itself. Not only do they have to streamline and direct operations, but the role of a CEO is also to maximize profit for any private or public run business. Hence the idea of raising salaries and improving patient ratios simply may not be an option for investors and shareholders. 

There are other factors that can affect an executive’s pay, but volume remains the most influential.

What does a hospital CEO do?

They set the trajectory for the entire facility. In addition to running the finances of the business, they must provide adequate patient care and help departments comply with the latest federal regulations and guidelines. Nearly every hospital CEO also participates in charity or philanthropy causes to support the communities they serve. They interface with patients, staff, and the board of directors to ensure the company is headed for success. They also serve as the facility’s main representative when interfacing with the government, media, and local community. CEOs have the authority to implement new programs, establish a company philosophy and code of ethics, and adjust the kinds of services offered to the public.  

But a CEO needs to surround themselves with capable, qualified people who are responsible for carrying out the executive’s policies. The CEO works closely with the chief nursing officer (CNO), who oversees the nursing department. Both parties are responsible for creating a safe working environment for the nurses on staff.

You will need a master’s in public health administration to become a CEO with a strong background in business and human resources. Running a hospital isn’t the same as running a normal company. The hospital must meet minimum standards to receive federal funding and the facility has an obligation to care for everyone looking for care.

So, what would a nurse-run hospital look like?

Nurses spend the most time with patients and would likely increase the number of nurses on the floor if they were a leadership position. But a nurse CEO would likely face the same financial pressures as their predecessor.

We asked millions of nurses to weigh in. Overall, 66% of respondents supported the idea and 34% said no. Everyone agreed that nurses are essential to running a hospital. Some also shared their experiences of working in hospitals where a nurse went on to become the CEO.

(Responses have not been edited, hence grammar and spelling errors may be present)

“Of course, it can,” Donna said of a nurse-run hospital. “My huge level 4 trauma hospital used to be ran by a nun who was a nurse. The physicians respected her ability to run a tight ship as did the rest of us.” 

“My CEO is a nurse!! GREAT morale at our hospital!! Truly like a family,” Becky added.

“I was a patient in our local hospital. A man entered in scrubs. He said he was the CEO of the hospital and he’s a nurse and likes to go see every patient at least 1x every 3-4 days. He asked if I needed anything or if I had any issues that needed addressed,” Dana commented.

But some said having a nurse in charge did little to change the work environment.

“We were all so excited, thinking that things were going to change,” wrote Bev. “Things did change. And not for the better. The whole hospital is worse than it has ever been. Useless jobs being created, complete ignorance of how things should be running, treatment and respect of staff has decreased exponentially. Sadly, we all want the medical directorate to take over again. Things ran so much smoother.”

“I’ve worked in a hospital with a nurse who became CEO. She became just another bureaucrat, no improvement for nurses in the ranks,” Diane wrote.

Others said it depends on the nurse. “If you can find one who hasn’t forgotten what bedside nursing is all about, then yes. They’d be fighting tooth and nail with the board members and the accountants though. They’d have to suit up for battle everyday they left for work,” wrote Jim.

Nurse CEOs would likely face pressure to reign in costs while maximizing profits, but they would have a better idea of what it’s like to be a nurse on the floor. They might be more sensitive to the nurses’ concerns, while striving to improve patient care. Most respondents ultimately said having a nurse in charge would improve the staffing shortage.

The exact number of CEOs with nursing experience is unknown, but there are at least 33 nurses currently serving as CEOs in the healthcare industry and experts believe that number will only continue to grow in the years to come.