Navigating the Leadership Ladder: CNO Gloria Carter Shares Insights on Career Advancement
By Carisa Brewster
For healthcare executive Gloria Carter, the journey from the fast-paced emergency department to leadership at CommonSpirit Health (formerly Dignity Health) as Chief Nursing Officer is a testament to ambition and mentorship.
Carter began her career as a staff nurse, content in the demanding emergency care environment. However, a close friend and colleague saw leadership potential beyond the bedside. She progressed to charge nurse and eventually assistant CNO as part of a succession plan orchestrated by the outgoing CNO, who stepped away to let Carter spread her wings. The COO became a supportive mentor, reminding her that she already made significant impacts overseeing the Emergency Department and ICU, the two largest departments in the hospital. She was simply adding the rest and had the tools and experience to be a success.
While over 85% of nurses and about two-thirds of CNOs are women, the numbers start to tilt in the opposite direction as you go up the leadership ladder. According to a report, “Women in Healthcare Leadership 2019,” 33% of senior leadership, 29% of COOs, 23% of CFOs, and 13% of CEOs are women.
No matter what arm of leadership women in perioperative nursing want to ascend to, Carter’s experience illustrates that breaking through barriers requires not only expertise and resilience but also the objective eye of peers and supervisors to see possibility and aptitude.
Q: How does the CNO actualize patient care?
GC: That is the ultimate accountability for nursing care in the role of the CNO. That also includes quality, patient, physician & staff engagement, including recognition and awards. All of those touchpoints are within my span of control. If someone has an idea that involves nursing, that person will reach out to me, and then I involve the key stakeholders at the facility level, which are the directors who report to me. We involve staff and line leaders to help make that decision. We also have surveys to gauge employee engagement and patient experience. We use that data to help us assess, plan, and adjust our practices to meet our metrics and provide and enhance services in our facility and the community we serve.
Q: Describe your leadership approach and its impact on organizational culture.
GC: I believe in two principles for leadership. One is being a servant leader, and the other is having key individuals involved in making the decisions. To me, being a servant leader is the most important. We exist because of the patients and staff we employ here at the facility. Open yourself up to having conversations with people regardless of where they are in the organization. Even though I sit in this seat, I’m still a nurse. If I’m on the unit rounding with patients and someone says they need another nurse or the CNA to pull the patient up in bed. I’m right here. I can help.
Q: How do you facilitate communication between executive leadership and staff?
GC: When I round on the units, I stop to have conversations with people. Sometimes, they share things about their personal lives, which I remember. I make it a point to ask, “How is your mother doing?” When you have those conversations, it lends itself to conversations with the staff about what’s going on with work. I’ll take that back to my team and tell them, “This experience was shared with me and is a concern from nursing.” The other way I get information is by our nurses filling out a report in our reporting system. I read each and every one of those comments, and then I present them to senior leadership to let them know this is where I need their help.
Q: How have your addressed nursing challenges like staff shortages and burnout?
GC: We have counselors available in our employee assistance program, wellness challenges, employee recognition, and employee engagement events. An example would be recognizing those who had what we call a “Good Catch.” This is when a quality or risk issue is discovered, and an employee takes immediate action. We also have Kudos Awards, where we recognize someone for going above and beyond and displaying excellence in handling a situation. We also use our engagement surveys to create action plans to ensure that we’re addressing the needs of the majority.
Tea for the Soul is another initiative (we’re a faith-based organization). The Spiritual Care Department meets with the team, with tea and a few treats, and is available to support and pray with the staff. We also have various community walks and events as a team.
Q: What is your advice for nurses who have their eye on leadership roles?
GC: One day, a nurse told me they wanted to do something different. We talked through some options, and they were hesitant. I told them they didn’t know until they tried. You have to think about the impact you want to have on nursing, and leadership is a great way to have influence. There are definitely other ways; leadership is not limited to certain roles. You can be a leader at the staff level. You can be an influencer in your unit. It’s about commanding the audience, engaging with them, and getting buy-in. However, I would say leadership is a pathway to wider influence. Look at your growth patterns and decide. If you want to be a CNO, COO, or CEO, keep expanding your scope of work. Be a charge nurse. Take on more responsibility to demonstrate that you can create change. My best advice is not to limit yourself and come from a place of wanting to advance the nursing profession.
Gloria Carter, MSN, RN, CENP, is the Chief Nursing Executive Officer at St. Mary Medical Center in Long Beach, CA, a facility within CommonSpirit Health, one of the nation’s largest nonprofit health systems.
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Carisa Brewster
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