A review of the literature on competencies for
the executive-level nurse leader and the professional
development needs for their role development revealed
4 studies from 2005 to the present, aswell as a
narrative of the evolution of leadership developmentand a description of a leadership program developed
for 3 levels of nurse leaders. The 1st study reported
assessing the leadership challenges and competencies
among executive nurse leaders and nonnursing
healthcare leaders who identified essentially similar
challenges among executive-level leaders with some
variation.7 Nurse leaders rated funding and budget
as the top challenge followed by workforce: recruitment,
retention, aging workers; patient safety/QI; time
management/handling workload; and change management.
In contrast, nonnursing leaders ranked funding
and budgeting last, workforce 1st, followed by strategic
planning/mission, and vision; patient safety and
QI; and managing relationships with medical staff,
whereas nurse leaders did not include strategic planning
or medical staff relations as a top 5 leadership
challenge.7 Although the samples (n = 54 and n = 27,
respectively) were not large, these findings do offer
some support for the unique role demands perceived byexecutive nurse leaders. Data were also collected to
identify the top 5 competencies forNEs using a 3-point
scale for those viewed as absolutely critical. The 5 competencies
were (1) building effective teams, (2) translating
vision into strategy, (3) communicating vision
and strategy internally, (4)managing conflict, and (5)
managing focus on patient and customer. Each had a
median score of 2.8 (total possible = 3) or higher,
indicating the high level of importance perceived by the nurse leaders