Wanted: More nurses in the C-suite

More than 4 million registered nurses work in the U.S., more than any other kind of health professional.

But even with their diverse backgrounds, unique experiences and heavy responsibilities, nurses can face barriers to rising to the highest ranks of their organizations, healthcare leaders say.

Three hospital executives—Carilion Clinic President and CEO Nancy Howell Agee, WellSpan Health President and CEO Roxanna Gapstur, and Sammie Mosier, senior vice president and chief nurse executive at HCA Healthcare—agreed that advancing nurses’ careers requires a multifaceted approach. Board members and executives need to ensure opportunities for nurses exist, and nurses need to be willing to take chances, they said.

The leaders credited colleagues for helping them gain exposure both in and out of the clinical setting early in their careers.

“I had a physician executive who became a mentor to me over about four years and really taught me a lot, encouraged me, needled me, frustrated me and paved the way,” Agee said. “He put me in positions to meet people and to have new opportunities. He was a tremendous resource.”

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The three are among 14 executives with nursing backgrounds named to Modern Healthcare’s 2022 list of the 50 Most Influential Clinical Executives.

While some nurses move up through the ranks, obstacles remain for others. Nurses commonly lament they don’t command the same respect as medical doctors.

“We’re going to have to challenge C-suite leaders,” said Loressa Cole, CEO of ANA Enterprise, a coalition that includes the American Nurses Association, the American Nurses Credentialing Center and the American Nurses Foundation. “We have to step forward and take accountability and responsibility to move this agenda forward.”

Sexism remains an impediment for women across industries, and according to census data, 9 in 10 nurses are women. Of the 41 health-sector companies on the 2022 Fortune 500 list, five had female CEOs.

Women executives, like other women, generally aren’t paid as well as men in the same jobs. Women in C-suites at Standard & Poor’s 500 companies earned 75% of what their male counterparts made in 2020, according to a Morningstar report.

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Despite hurdles, Agee, Gapstur and Mosier said parents, grandparents and sponsors inspired them to strive for executive positions. Similarly, Mosier said it’s vital to instill the idea in nurses early in their career that their voices matter.

A drive to better serve patients propelled Agee to eye the C-suite. “My own experience, looking back, was acting out of a sense of frustration, believing I needed to get more done for patients than I was able,” she said.

Agee recalled a chemotherapy patient who was hungry after the cafeteria had closed. It prompted her to draft recommendations for enhancing the patient experience at her hospital. Her bosses encouraged her to implement the changes herself. “That was the beginning,” Agee said.

Mosier followed her mother’s example by becoming a nurse. After a decade caring for patients, she became the chief nursing officer at a Kentucky hospital before rising further through the executive ranks. In her current role, she aims to improve patient care and ensure the 98,000 nurses under her charge have the best resources, she said.

“I was able to quickly understand that I could make a difference for the patient through the leadership aspect,” Mosier said.

As a young adult, Gapstur worked as a nursing assistant in a local nursing home. She admired the difference the registered nurses made for patient care, propelling her to follow in their footsteps.

A self-proclaimed “accidental leader” after 20 years as a practicing nurse, Gapstur said her path from the ward to the C-suite required her to take risks and say yes to opportunities. By challenging herself, she was able to move up the ladder, she said.

“I have used my nursing knowledge in the way that I think as a nurse almost every day. It’s sort of part of me,” Gapstur said. “I do think it’s been invaluable for me because I’ve seen healthcare from so many different chairs.”

Meet Modern Healthcare's 50 Most Influential Clinical Executives- 2022