Known for their compassion, nurses usually go into the field to help others. Most envision themselves doing that at the bedside, not behind a desk.

Yet in today's complex health care environment, nurses often are called to move beyond their clinical roles and become managers and administrators. Those jobs require different skills, but they also can provide additional career satisfaction.

BARRY WILLIAMS/Special (ENLARGE)

Brent Robinson, vice president of patient care services and chief nursing officer at DeKalb Medical, shares a laugh with nurse Mary Aiyejorum.

BARRY WILLIAMS/Special (ENLARGE)

Diane Chamberlain (left), director of nursing and patient care services for Kaiser Permanente of Georgia, goes over some planning notes with nurse Barbara Johnson.

BARRY WILLIAMS/Special (ENLARGE)

Melissa Sisson (right), director of women's services at Northside Hospital, talks with Lana Robinson, clinical supervisor in the high-risk perinatal unit.

Meet three nurses who have followed the call to lead others.

BRENT ROBINSON

Vice president of patient care services and chief nursing officer, DeKalb Medical

Robinson, RNC, MS, NP-C, CCRN, was headed for medical school when a couple of nurse practitioners invited him to spend a spring break working with them at a public health department. He was so impressed with the experience that he switched his focus to nursing.

In his 20-year career, Robinson worked in neonatal intensive care, established the first operating room in a Georgia prison, practiced in cardiac nursing and rehabilitation, was a traveling nurse and directed the medical-

surgical services at DeKalb Medical before being promoted. "It's been a wonderful journey," he said.

Nursing requires leadership, Robinson said. "Those in direct care are advocates for their patients — dealing with doctors, coordinating other care providers, while managing a full patient load. If they can do that, they can manage at a higher level."

Nursing school didn't give Robinson the financial and business skills he needed to function at the board level, but he learned them through reading, taking jobs with increased responsibility and finding good mentors.

"Any nurse who steps into management has to be self-directed," he said. "There's a lot of on-the-job learning. With your first management position, you'll know whether you want to move to a higher level and will quickly realize who you need to partner with to learn more."

When it comes to being responsible for 700 to 800 employees at DeKalb Medical's three hospitals, Robinson believes in leading by example and using a shared-governance model.

"I try to be very open and highly regard the opinions of my staff," he said. "I remember that, as a nurse, I didn't always see the big picture.

"I have a bright, competent staff, and my job is to keep them focused and to be a cheerleader. I want to be a leader who says we're going to find solutions, not complain. I'm a fix-it type of person."

Faced with staffing challenges, Robinson created a pool of nurses who float among the three hospitals, lowering the nursing vacancy rate and reducing the number of agency nurses who are needed.

"It allows us to coordinate care across the system and optimize the use of our resources," he said.

Knowing that patients are getting high-quality care gives Robinson the most satisfaction, but he's also proud to train future leaders.

"It's not always easy to persuade nurses into management," he said. "It's very important to all of us that we identify those people willing to lead and mentor them."

DIANE CHAMBERLAIN

Director of nursing and patient care services, Kaiser Permanente of Georgia

A nurse for 39 years, Chamberlain, MS, RN, C, has worked in many parts of the field, including pediatrics, urgent care, home health, education and case management. Chamberlain enjoys and embraces challenges and said that "every position was a learning lab" and preparation for her current job.

"We live in this world of change — changes in health care, changes in how it's delivered and changes in nursing itself," she said. "We must constantly evaluate how we manage change, and, sometimes, we have to stir the pot to make change happen if we want to move to the next level of excellence."

Responsible for the nursing and medical assisting staffs of 15 medical offices and specialty clinics in metro Atlanta (with two more being added), Chamberlain sees her role as having a vision of where nursing needs to go and influencing others to help her accomplish it.

"As my father, a lieutenant colonel in the military, told me, 'If you yell, "Follow me" and go charging up the hill and no one follows, you ain't a leader,' " she said.

Chamberlain believes in the team approach. "I prefer to involve staff, whenever possible, in the decision-

making process," she said.

For example, Chamberlain asked a team of telephone-advice nurses to find more efficient ways to use a new electronic medical records system. Hotline nurses and supervisors helped implement an internship program for first-year registered nurses. It not only gives nurses the skills and experience needed to move up but also encourages them to stay and grow with Kaiser Permanente.

"One of the fun things I get to do is involve nurses collaboratively with all other departments within the organization to solve problems, such as how to make it as hard as possible to make a medication error," she said. "People have to hear the impact that one department's change will have on another; it has to be a collaborative effort."

Chamberlain believes that nursing is an art, a science and a business.

"My generation didn't consider costs, but today's front-line nurses and supervisors have to balance service and quality with time and resources. They have to have a business sense," she said.

When she was a front-line nurse, Chamberlain was passionate about her patients. Being a director brings different rewards.

"I get personal satisfaction through my staff," she said. "I get excited when I see nurses excited about improving their performance and care.

"You have to stay connected, to remind yourself why you are doing this and that what you are doing makes a difference to patients. When the job seems overwhelming, I go sit for a while in the pediatric waiting room."

MELISSA SISSON

Director of women's services, Northside Hospital

Sisson, MN, RN, started out working in labor and delivery 30 years ago, and today she is responsible for Northside Hospital's Women's Center. With 18,000 babies born there every year, it's the largest infant-delivery facility in the country.

"I certainly didn't see myself here when I started," Sisson said. "I tell people that the best thing about nursing is that there are so many different things you can do with it. I've had a great career."

After becoming a clinical nurse specialist, Sisson developed programs for high-risk obstetric patients at Grady Memorial Hospital. Twenty years ago, Northside Hospital recruited her to help with similar programs. Later, when the labor and delivery manager's job opened up, Sisson got it.

"It was definitely a trial by fire, but, luckily, we were only delivering about 5,000 babies a year then," Sisson said. "I had a wonderful mentor in Janis Dubow, then vice president of patient care, and I wasn't shy about asking questions.

"I still listen and learn from the people around me. The people in the trenches have some of the best ideas."

Knowing how to negotiate and collaborate is important.

"One of the things I've learned is that, with 1,400 people working in women's services, every manager has a huge scope. As individuals, we can't get anything done alone. We have to do it as a team," Sisson said.

No two days are alike, but Sisson tries to make time each day for rounds with her staff, often wearing scrubs and sneakers. She knows that relationships and interaction are important.

"You have to have a broader vision but also be flexible and build consensus," she said. "Putting out fires is part of the territory. You learn how to shift priorities quickly."

Sisson is honored to have been a leader during an enormous period of growth for Northside Hospital.

"I'm excited to be able to design from scratch a new building and women's services program for Northside Hospital-Forsyth," she said.

Sisson became a nurse to help people. She still does that, but in a different way.

"I gradually shifted from helping patients to helping the people I worked with, but that still helps patients," she said.

Sisson enjoys helping employees find their roles in the organization.

"Every person has a unique talent," she said. "When I can discover what that is and match it with the right job, that's very satisfying."