Board support critical to the success of executive nursing director role, says leading nurse academic

Executive directors of nursing need support from their boards to be successful in their roles, a leading nurse academic has said

RCN chair of nursing research Daniel Kelly carried out a study on stress and resilience in nurse directors in England and Wales.

At the RCN International Centenary Conference in London on Tuesday, Professor Kelly said ‘safe and supportive’ peer meetings were crucial.

‘A key finding was that the role of board was key to the success of the post,’ he said. 

‘Supportive boards had a clear understanding of the executive nurse’s role, and issues of care quality and safety were discussed in an open, robust manner.

High turnover 

‘Unsupportive boards had a consistently poor understanding of the executive nurse role, and issues of care safety and quality were marginalised or completely ignored.’

Professor Kelly, who is also a senior researcher at the school of healthcare sciences at Cardiff University, interviewed 40 executive nurse directors from England and Wales for the project.

He said the rate of turnover was high among the postholders and 53% had only been in post for 2 years.

One executive director of nursing quoted by Professor Kelly said it was sometimes possible to ‘find yourself in a conflict situation’ with board colleagues who prioritised finances over safe, quality care.

‘Fight to get there’ 

‘The reality is as a nurse director, you often end up in challenging conversations with your colleagues about having a cheaper workforce that’s not registered. I will tell the board I don’t think that’s the right thing to do,’ he said.

Another executive director of nursing said: ‘I’m quite lucky here. I’ve got a good chair and good executive and non-executive directors who pay attention to nursing, but what I’ve pick up on is that it’s not the case everywhere, and we have to fight to get there.’

The nurses told Professor Kelly that their strategies for coping in the role included having small treats, meeting inspirational people and protecting weekends and holidays.

Professor Kelly said improved preparation for the role, as well as getting an evidence base to support it, was needed.