Chief Nursing Officers (CNOs) have a demanding, complex role that commands\naccountability in leading the nursing profession and achieving quality patient outcomes. The purpose\nof this study was to understand the CNO�s view of meeting the needs of the Registered Nurse (RN) at\npoint of care and how this could affect quality patient outcomes. In two qualitative studies twenty-five\nCNOs were individually interviewed in eight states including: Florida, Tennessee, Kentucky, Maine,\nNew Hampshire, Vermont, Massachusetts, and New Jersey. The majority of these CNOs interviewed\nbelieved they were doing the best for their nurses and their healthcare facility. After analyzing their\nresponses, it was apparent that some CNOs actually encouraged peer pressure among nurses to\nachieve compliance and felt patient acuity is being addressed adequately, since most patients were\ndischarged within three to four days and those that were more critical were admitted to the critical\ncare units. The average length of stay, which is the number of paid days a patient remained in the\nhospital, was an important metric. A large amount of nurses felt they were unable to deliver the\ncare needed for their patients due to patient load, lack of collaboration among the health care team,\nhigher patient acuity and absence of decision-making and autonomy. Many of the CNOs trusted\nthat patient care outcomes, meaning relatively short hospital stays, demonstrated that the nursing\npractice was successful; rather than first having the nurse being set up for success to provide the best\ncare possible to their patients.
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