Voice of the President | July 2025

… today’s health care environment demands a new paradigm — one where nursing and finance leaders collaborate intentionally, share ownership of outcomes, and realize the goals of safe, high-quality patient care and strong financial stewardship are not mutually exclusive.

Building sustainable health care

At Mount Sinai Health System in New York, Wendy O’Brien serves as vice president and chief nursing finance officer, a role specifically designed to ensure that nursing has a strong voice in financial decision-making. Early in her leadership career, O’Brien recognized that emotional appeals about the realities of clinical practice often fell flat with finance leaders who needed data and a business case. Rather than grow frustrated, she built a bridge, learning the language of finance while teaching finance leaders to better understand the clinical realities behind the numbers. Today, she ensures nursing operations are not viewed simply as expenses, but drivers of organizational performance. Through partnerships with the chief nursing executive and the CFO, O’Brien works to ensure financial planning is based on authentic clinical insight. Her advice for nurse leaders is clear: Business acumen is no longer optional. Nurse leaders must see themselves as the chief executive of their areas of responsibility, combining clinical, operational and financial leadership to drive success.

Similarly, the partnership between the CFO and the CNO at the University of Kansas Health System, St. Francis Campus in Topeka demonstrates the possibilities when the relationship between nursing and finance is rooted in collaboration and trust. Interim CFO Michael Albers and CNO Adam Meier understand how vital their partnership is to building a sustainable organization. Together, they have created opportunities for co-learning, arming front-line nurse managers with the tools to better understand their impact on supply costs, staffing productivity and retention strategies. Investing in patient engagement, workforce well-being and professional governance is not a luxury — it is essential to financial health. Culture, retention and clinician engagement have massive financial impacts, but they are not always immediately visiable. Transparent communication, shared ownership of key metrics and a commitment to staff and patient well-being make the difference between organizations that struggle and those that thrive.

The alignment of clinical quality and financial stewardship is also evident in innovative projects like the neonatal intensive care unit initiative led by Cathy McCurley at the USA Health Children’s and Women’s Hospital, Mobile, Ala. Confronted with rising costs for pasteurized donor human milk and fortifiers — over $1.1 million in 2023 — the NICU team revised feeding protocols, increased monitoring of weaning practices, identified more cost-effective vendor partnerships and enhanced efforts to support mothers in providing their own milk. Despite significant barriers, including changes in federal guidance on probiotics and provider hesitancy around feeding risks, the team achieved more than 12 percent in cost savings while maintaining an exclusive human milk diet for their most vulnerable patients. The savings of over $136,000 in one year demonstrates how clinical excellence and financial stewardship can go hand in hand without compromising the standard of care.

Nursing-finance partnerships are equally critical when leading larger strategic initiatives. Dan Webel shares a five-year journey to expand the inpatient rehabilitation facility at Northwestern Medicine Woodstock (Ill.) Hospital. Beginning in 2019, Webel and his team systematically built the case for expansion by growing referrals, improving clinical outcomes, strengthening regional partnerships and demonstrating a clear business case for additional beds. With careful forecasting, alignment with hospital leadership priorities, and a relentless focus on both patient need and financial sustainability, Webel ultimately secured approval for a five-bed expansion set to open in late 2025. His story reflects the power of long-term strategy, persistence and a data-driven narrative grounded in trust and collaboration.

Building essential partnerships

The thread running through each of these examples is the essential partnership between nursing and finance that requires intentional effort. Nurse leaders must regularly include finance colleagues in team meetings, rounds and discussions involving operational or clinical investments. We must develop a common language and mutual appreciation for everyone’s expertise. Finance partners, in turn, must see the clinical value behind investments and understand that culture, safety, retention and patient experience are not “soft” measures — they are powerful levers of financial performance.

Financial stewardship is a nursing leadership competency. As outlined in the AONL Nurse Leader Competencies Model, understanding business skills, financial principles and operational strategies are essential to sustaining the mission and vision of health care organizations. AONL’s educational offerings, including Finance and Business Skills for Nurse Managers and Health Care Finance for Nurse Executives programs, provide critical opportunities for leaders at every stage to strengthen these capabilities and build strong nursing-finance partnerships.

Nursing finance does not have to be a mystery. When approached with curiosity, commitment and mutual respect, it becomes a source of innovation, resilience and sustainability. I have been fortunate to witness the power of this partnership firsthand, thanks to two extraordinary CFOs who shaped my understanding of what’s possible. Linda Pearson, a master’s-prepared psychiatric nurse who became a certified public accountant and CFO, helped me see how clinical and financial expertise can seamlessly align. And during the early days of the pandemic, Melinda Hancock walked through the halls with me, always focused on the workforce and the community we served. Their leadership, grounded in shared values and human connection, affirmed that when nursing and finance lead together, we build organizations that deliver outstanding care, foster exceptional workplaces and ensure that the magic of health care leadership is real, lasting and deeply felt by those we serve.