What should a chief nursing officer examine when a nursing organization is meeting its day-to-day responsibilities, but leaders are overwhelmed, roles are unclear, and work is being performed inconsistently?

In this episode of The Hospital Playbook, Dane Nardi speaks with Quanna Batiste, an experienced chief nursing officer, about assessing and reshaping nursing leadership systems.

Quanna reflects on entering an organization where the work was getting done, but unclear responsibilities, inconsistent processes, and imbalanced workloads were creating strain beneath the surface. She discusses why leadership redesign should begin with listening, observing the work on the units, and understanding the “ground truth” rather than simply moving boxes on an organizational chart.

The conversation also explores how spans of control, staffing matrices, role clarity, and leadership capability can influence productivity, accountability, burnout, and the experience of frontline nurses.

Topics include:

• Recognizing when a leadership structure no longer supports the work
• Examining the system before attributing problems to individuals
• Balancing spans of control and clarifying accountability
• Managing resistance and supporting leaders through change
• Aligning with the CEO, CFO, HR, and other executive partners
• Keeping frontline nurses and patient care at the center of redesign

This conversation offers a CNO’s perspective on looking beneath surface-level performance and creating conditions that help leaders and nursing teams work more effectively.