Executive nurse career progression: skills, wisdom and realities

There are seven absolutes in an otherwise evolving health care industry. First, despite the amassed property, plant, and equipment, the industry is dominated by, and grounded in, human capital and functions on the basis of intellectual capital. Second, owing to its specialized nature, collaboration among disciplines and supports is required to achieve desired outcomes. Third, technologic, pharmacological, and biogenetic advancements continue to change the face of health care delivery, significantly contribute to escalating costs. The fourth absolute--misaligned economic incentives among the providers and payers--breeds competition and conflict. Fifth, economics in general, and reimbursement specifically, is the industry driver. In times of economic scarcity, competition for resources intensifies. A sixth absolute entails the increasing knowledge of health consumers and their access to heath information. Finally, there is a growing gap in ability to pay and wide variation in health care coverage. It is within this general context that executive nurse role advancement will be discussed.