The American Red Cross, which touts nursing as a cornerstone of the services it provides, has reinstated the title of chief nurse within the organization after completely eliminating the position earlier this year.
About three months after the Red Cross eliminated the stand-alone, administrative position of chief nursing officer (CNO), which was held by Nancy McKelvey, RN, MSN, the organization created a new position director for disaster, health, and mental health services, chief nurse.
One of nearly 1,000 agency-wide jobs cut through layoffs and attrition, the elimination of the chief nurse position was part of corporate restructuring driven by a $200 million budget shortfall, says Laura Howe, senior director of public affairs for the Red Cross.
The August decision to add the CNO title to a newly created disaster services position was in response to the agency’s need to have a paid, high-ranking nurse leader to oversee its core group of nurses, most of whom work in disaster services. “From a functional standpoint, [CNO] needs to be included in someone’s job description and those duties need to be absorbed,” Howe says. “It had to be within the spirit of streamlining when we reduced the size of the organization, but it still needed to be prominent.”
Following the layoffs, agency insiders and outsiders expressed concern that the removal of the CNO by the Red Cross devalued the relevance of nurses.
Howe says the nurse who will take on the new position will work hand in hand with National Chairman of Nursing Vivian Littlefield, RN, BSN, PhD, an agency volunteer for about 18 years, to ensure all of the CNO duties are carried out. Among those are supporting agency nurses, acting as a liaison with disaster services, managing the nursing field infrastructure programs, and representing the Red Cross to various professional and educational groups.
“It hasn’t been determined how we’re going to divide the responsibilities,” says Littlefield, who worked alongside McKelvey for the past four years and knows the requisite responsibilities of chief nurse well. “It will depend on her skills and priorities and my connections, but that gives us two people to represent the Red Cross, like there used to be.”
“I think the Red Cross responded to the view that there needs to be a paid leadership position and found a position that was at a high enough level and will have a well-prepared nurse leader to partner with me,” says Littlefield, former dean and professor emeritus at the University of Wisconsin at Madison’s College of Nursing. “I think it’s a compromise and the best thing that can happen at this point in these challenging financial times.”
No longer an organization insider, Cynthia Vlasich, RN, BSN, Red Cross chief nurse from 1992 to 1997, says the title reassignment is a move in a positive direction.
“This shows a responsiveness to the voices of both paid and volunteer nurses inside the organization as well as to the nursing community outside the organization,” Vlasich says. “Obviously they heard that eliminating the position of chief nurse was a major concern for many people and I’m pleased to see this responsiveness. The overall Red Cross leadership didn’t have to do this, so I think it’s a good sign that they heard and listened and responded to nurses’ concerns across the nation.”
Although the reassignment restores the prominent title to the agency, the elimination of the administrative position and concurrent restructuring led to speculation about the importance of nursing within the Red Cross.
“There’s a real role for nurses within the Red Cross, but I think part of what happened is just like with the general population many people don’t know what nurses do these days,” says McKelvey, who will continue to volunteer in an advisory capacity to the group. “People still think of nurses in traditional roles, and I’m not sure there is a traditional nurse anymore. With many of our chapters having smaller staffs, [the Red Cross] doesn’t recognize how nurses can add value to what [the chapters] are doing every day.”
Because the roles of nurses and the skills they offer have evolved, a restructuring of nursing leadership was inevitable, Vlasich says.
“Every organization goes through periods of how to be organized, structured, managed,” Vlasich says. “Is it worth rebuilding? Yes, definitely. Should it be rebuilt in a different way? Very possibly, because you always need to be pertinent and relevant.”
Vlasich believes a paid nursing leader is essential in disaster services, where the majority of the agency’s paid and volunteer nurses work.
“Before, [chief nurse] was a stand-alone position and I think this better integrates it into an area where nursing is most prominent in the organization,” Howe says. “We knew we had to find a spot for the position to live because it is an important position — it just needed to be streamlined like the rest of the organization.”
Unquestionably, the restructuring has had innumerable reverberations throughout the nursing community, shaking up long-held notions about the status quo.
“If there is any good in this it’s that the organization is looking at [nursing[‘]s role] in a new way,” McKelvey says. “We have a new CEO and a new vice president of the department of volunteer services who has not started yet. All of these new people as they come in are hearing what the issues are around nursing and it’s bringing [the issues] to the forefront of the organization.”