Validation of the Adams Influence Model (AIM)
Understanding Chief Nurse Executive (CNE) influence is essential for the discipline of nursing. There are approximately 5000 CNEs in the United States, all are tasked with being the primary identifiable leader representing organizations in which they are employed and the nursing profession of which they are a part. In this capacity, the CNE is the gatekeeper for the advancement of the majority of the 2.4 million nurses practicing in the U.S. Literature suggests that early CNEs lacked influence and often were not recognized members of organizational executive teams. Today, after two decades of struggle, CNEs are identified as essential executive team members. However, they still self identify as being less influential than their C-suite counterparts, leaving us to question, "Having gotten to the table, now what?" This study was designed as an initial step toward answering this question through Validation of the Adams Influence Model (AIM). The AIM is a framework that can be used to understand the influence of the CNE in the acute care setting. The study exposed the AIM to a qualitative data set collected as part of an academic medical center's Survey of the Professional Practice Environment. Directed content analysis was used to categorize survey responses and identify influence content toward validation and refinement of the AIM's operational definitions. Study results validated AIM influence factors and influence attributes with some refinement. In addition to development of a refined AIM, study findings also helped identify continued research opportunities. These research potentials included the exploration of; influence instrument development, the influence process, differences between influence and power, and the relationship between CNE influence, practice/ work environments and patient outcomes. As a discipline, nursing must continue to understand the influence of the CNE. These individuals are leading the profession, at what pace and in what direction cannot be left to chance.