The role of the Chief Nursing Officer (CNO) is changing fast — and no one understands that better than the nurse leaders living it every day.
Workforce shortages, new technologies, and rising patient acuity are reshaping how nurse executives lead. But instead of talking about these changes, we wanted to hear directly from those on the frontlines of nursing leadership.
We spoke with four experienced CNOs across the U.S. to learn how their roles are evolving, what skills are becoming essential, and how they see the future of nursing leadership. Their insights paint a clear picture: the next generation of CNOs will be agile, tech-savvy, strategic, and deeply patient-focused.
1. “We’re Moving from the Bedside to the Boardroom” – David Marshall, Cedars-Sinai
“One of the first areas where nurse leadership is progressing is interprofessional collaboration to enhance patient care. Another is building cultures that inspire innovation. As technology becomes more integrated, nurse leaders must manage change, foster innovation, and address resistance.”
David Marshall, DNP, RN, Senior VP and Chief Nursing Executive at Cedars-Sinai, believes CNOs will increasingly shape policy and strategy, not just operations. He also highlights the pivotal role nurse leaders will play in rethinking how care is delivered as workforce shortages grow.
Key takeaway: The modern CNO is a strategic change agent, not just an operational manager.
Interactive prompt: If you’re a nurse, how would you reimagine care delivery in the face of staffing shortages?
2. “CNOs Must Be Strategic, Not Just Operational” – Autum Shingler-Nace, Cooper University Health Care
“The CNO role is inherently dynamic — that’s what I love about it. Looking ahead, I believe it will continue to evolve into a more strategic leadership position. Digital transformation is one of the most significant shifts on the horizon.”
Autum Shingler-Nace, DNP, RN, CNO of Cooper University Health Care, emphasizes the strategic dimension of the CNO role. She sees AI and digital transformation as major drivers of change — but also opportunities for more connected, efficient care.
Key takeaway: Tomorrow’s CNOs must blend strategy, innovation, and empathy.
Interactive prompt: What’s one piece of technology you think could make nurses’ daily work easier?
3. “It’s About Enterprise-Level Leadership” – Vicky Tilton, Valley Children’s
“The role is shifting to enterprise-level leadership, where we’re looking across disciplines, workforce, innovation, and outcomes. We’re shaping long-term strategic and financial plans while staying connected to bedside care.”
For Vicky Tilton, DNP, MSN, RN, the CNO role is now broader and more collaborative than ever. Nurse leaders are key players in shaping organizational direction, not just department operations.
Key takeaway: CNOs must lead across systems—not just departments.
Interactive prompt: How do you see nurse leadership influencing hospital strategy in the future?
4. “The Future Is Beyond the Inpatient Unit” – Janet Tomcavage, Geisinger
“Traditionally, CNOs focused on inpatient care. But we need to lead more proactively in ambulatory settings too. Optimizing the care team — RNs, LPNs, and others — will be crucial to achieving high-value care.”
Janet Tomcavage, MSN, RN, Executive VP and Chief Nurse Executive at Geisinger, underscores the shift to outpatient and community care. CNOs must lead skill mix transformation, embrace AI, and drive efficiencies that improve quality and patient engagement.
Key takeaway: The future CNO is a systems thinker who connects inpatient and outpatient worlds.
Interactive prompt: Where do you see the biggest opportunity for nurse leaders outside the hospital walls?
5. New Skills Defining the Next Generation of CNOs
Our CNOs may come from different health systems, but their messages are strikingly similar. The CNO of tomorrow will need a powerful mix of skills:
- Adaptability & Agility: Navigating constant change with confidence.
- Tech Savviness: Understanding AI, digital tools, and data to improve care.
- Strategic Vision: Shaping the future of nursing and healthcare delivery.
- Emotional Intelligence: Leading with compassion and resilience.
- Strong Communication: Building trust across teams and communities.
- Collaborative Leadership: Working beyond silos to improve outcomes.
- Ethical Decision-Making: Always keeping patients at the center.
6. Through Change, the Patient Remains the Heart
Even with all this change, one truth stands firm: the patient comes first.
“We can never lose sight of the patient and family. That’s the center of everything,” Tilton reminds us.
Technology may evolve, care settings may shift, and leadership responsibilities may grow — but the mission of nursing remains rooted in compassionate, safe, patient-centered care.
Conclusion
The CNO role is entering a new era—one defined by innovation, strategic leadership, and community impact. Nurse leaders are stepping into boardrooms, shaping policies, and driving transformations that will define the next chapter of healthcare.
But the future of nursing leadership isn’t just shaped by CNOs at the top. It’s built by every nurse who shows up, speaks up, and leads change.
💬 We’d love to hear from you:
- What do you think the next generation of nurse leadership will look like?
- How can nurse leaders support teams better in this evolving landscape?
Comment below or share your thoughts with us. Let’s shape the future of nursing—together.
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