A Nurse’s Strategic Thinking

A professional nurse is many things: diligent, communicative, unflinching in her standards of professionalism; empathic, detail-oriented, quick-thinking. Effective nurses think strategically, aware of the long view even as they are laser-focused on the details.

Whether helping patients, improving workplace logistics, or ensuring that decisions align with long-range goals, nurses are strategic thinkers by nature, skilled at holding a sharp-eyed view of the future while embracing processes that propel their organization in the right direction as quickly and smoothly as possible.

Strategic thinkers use both sides of their brains — logical left and creative right — and develop both purpose and process to their professions. Lifelong learners, they are aware and perceptive, weaving flexibility into their workflow even as they clearly define its objectives. They understand the importance of taking care of themselves, and aren’t afraid to ask for help. They’re hard-working and honest. Sound like anyone you know?

Many of the qualities that describe an effective nurse are the same that define a powerful board member.

“Competency” is defined as the capability to apply a set of related knowledge, skills, and abilities required to successfully perform critical work functions. For nurses who are natural strategic thinkers, these competencies include the abilities to:

• anticipate change

Strategic thinkers must be able to clearly identify threats and opportunities to their organization and be proactive and realistic in addressing them.

• challenge assumptions

Strategic thinkers must be willing to evaluate the status quo and, where it’s appropriate, to embrace it, fine-tune it, or reject it and propose something new.

• interpret the environment

Strategic thinkers must be able to discern patterns that point to stagnation or change. They aren’t intimidated by data, and can recognize emerging needs long before they arrive.

• make tough, timely decisions

Many organizations err by not moving quickly enough; strategic thinkers know that decisions must be made at the right moment and for the right purpose.

• align stakeholders

Strategic thinkers find common ground with everyone involved with the organization and help them prepare for change. Truth-telling is key.

• look for lessons learned

Because they are continuous learners, strategic thinkers are able to honestly reflect on their own actions and decisions in order to become better at the next one.

Look over that list. Where in your everyday professional responsibilities can you find those competencies in yourself? Which do you recognize? The more of them you can identify, the better qualified you’re likely to be for board service. Don’t sell yourself short: Strategic thinking is strategic thinking, no matter where it’s applied.

If you’re a nurse set upon landing a board position, honing your strategic thinking skills is crucial to your personal leadership development. Spend time with other leaders; ask them to walk you through their internal processes and provide feedback on yours.

Once they’re fully seated, boards are also responsible for guiding an organization’s planning process, typically directed by a Strategic Planning Committee. In her book, Nurse on Board: Planning Your Path to the Boardroom, author Connie Curran clarifies the relationship between strategic thinking and strategic planning — essentially, that the first is needed in order to create the second. She outlines several steps in the planning process:

  • Gaining buy-in from key participants and other stakeholders, including the CEO, board chair, clinical leaders, and other stakeholders asked to participate
  • Conducting an environmental assessment, which helps those involved in the planning process understand both the external and internal environments facing the organization
  • Developing both planning and financial assumptions that guide the process, linking the plan with the resources necessary to achieve it
  • Developing a strategic framework that includes the organization’s vision, mission, and values, allowing participants in the process to set strategies to achieve them,
  • Establishing performance measures that allow board and leaders to collaborate, periodically assessing their progress towards achieving a bigger plan.

On its way to strategic planning, strategic thinking looks a lot like what most nurses do every day. Bringing it to the boardroom requires thinking metaphorically — thinking of the organization in the same way you’d imagine a patient on a path to healing, a unit (or a hospital) seeking to improve itself: aligned with its mission and open to opportunities that smooth its voyage along the path. It’s in a nurse’s nature to think this way; doing so on a institutional or organizational scale allows the nurse-director to elevate a board’s thinking, its planning, and its achievements as a health care leader.

In Nurse on Board, Connie Curran speaks with Linda Procci, a former hospital VP and COO who argues that nurses often possess valuable experiences they may not recognize — and may not apply to their understanding of their own skills as a potential board member. “How different is from the projects you’re doing on your nursing unit?” Procci asks. Adds Curran: “You know more than you think you know.”