The Evolving Role of the Chief Nurse Executive in the Veterans Health Administration: Policy and Leadership Lessons

Abstract

This case study retrospectively analyzes the process of changing the role of Veterans Administration nurse leaders in Veterans Health Administration Medical Centers across the United States. Much has been written on the challenges and processes involved, particularly for women, in actualizing the metaphor “getting to the table” in health care arenas but few examples in actually how to get there. Nurses have a great deal to lend to discussions and evaluations of quality care, sensitivity to patient and family needs, and cost-effectiveness. It is essential to give voice to this increasingly vocal and sophisticated group of health professionals. Important policy making and political lessons learned in the course of upgrading the Chief Nurse position are discussed. Each nurse must begin a conversation within his or her own institution about politics, policy and nursing practice. This conversation, initially, may be perceived as only a ripple, but, in time, it can lead to a wave of changes that open doors previously closed.