CEO- CNE Relationships: Building an Evidence-Base of Chief Nursing Executive Replacement Costs

OBJECTIVE: Explore professional relationships between Chief Nurse Executives (CNEs) and Chief Executive Officers (CEOs); CNE ethnic diversity; and CNE replacement costs. BACKGROUND: Theoretical frameworks - Marilyn Ray's Theory of Bureaucratic Caring, and Turkel's Theory of Relational Complexity espousing economic as well as caring variables. METHODS: Exploratory mixed-method descriptive design using CNE mailed survey. RESULTS: CNE- cited opportunities for maintaining a positive relationship with the CEO: respect for CEO; goal- sharing (r=.782, p<0.01); having a strong relationship (r= .718, p<0.01); co-problem-solving (r=.437, p<0.01); having an interesting job (r=.406, p<0.01); having similar interests with CEO (r= .346, p<0.01); CEO and CNE maintaining specific roles (r= .261, p<0.05); satisfaction with CNE income (r=.251, p<0.05); willingness to improve relationship with CEO (r=.254, p<0.05). CNE positions demonstrated an ethnic diversity factor of 0.03%. CNE replacement costs to healthcare facilities were over 1.5 million dollars. CONCLUSION: CNE/CEO relationships have identified cohesive factors that may contribute to CNE longevity in position; an ethically diverse CNE deficit exists; and, CNE turnover and vacancy rates impact an organization's financial health and quality of care.