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“But those who came before us will teach you.They will teach you from the wisdom of former generations.”

Job 8:10 (New Living Translation)

Chapter Objectives

Describe basic business skills that are essential to sustained leadership success.

Provide an example of how unconventional strategic thinking may be key to future healthcare delivery models.

Harness the power of the balanced scorecard as a means to assess goal achievement.

Understand the need for business agreements and contracts.

This chapter is an acknowledgment of the business side to human caring and the basic business competencies all nurse leaders should describe as an expectation of their roles. In the following pages we highlight those tangible business skills that will help all nurse leaders, new or more seasoned, achieve professional goals faster, with fewer setbacks, and increase the value of contribution to the administrative team early on. Some of the skills are technical in nature, some are related to relationships, and still others are related to the importance of continually refining personal attributes.


No longer can nurse leaders rely solely on judgment, traditions, experience, and intuition to justify their decision-making. No longer can nurse leaders completely delegate finance, marketing, and budgeting responsibilities to someone else. Clinical skills alone won’t see us through the new paradigm we find ourselves in. The Affordable Care Act (ACA) is accelerating the need for reinvention of care delivery. There is more pressure on nurse leaders and other managers to increase efficiency while improving quality and patient outcomes. There will continue to be many changes in healthcare delivery, and nurse leaders will increasingly be asked to contribute to the strategic planning of new programs. These are skills that can and should be learned, but the business-savvy nurse leaders, who step outside of their comfort zones and learn new ways of working and thinking, will be ready for these challenges and be in the most demand to lead the way.

What follows are examples we have determined to be essential healthcare business knowledge—essential elements that you may not have yet recognized. In some cases, we learned them because of a need to know them, and had we acquired this knowledge earlier in our careers, we would have been a step ahead. In other cases, we discovered this knowledge was part of the core values or habits already entrenched in our DNA, and we now recognize how important those things have been to our success. As you read this chapter, it is important to understand your responsibilities as they exist today and be able to articulate those lessons learned so you can use them as stepping stones in reassuring new leaders as they transition to unfamiliar roles.


Whether you learn Microsoft Excel (or other spreadsheet software) by self-study or through ...

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