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Promising Healthcare Leaders


Who are Your Most Promising Leaders? My Money’s on LPNs

Robyn's Read | December 18, 2017

It’s high time we recognized that C-Suite executives aren’t the only leaders in the field of long-term services and supports, writes Robyn Stone, Senior Vice President of Research, LeadingAge and Co-Director, LeadingAge LTSS Center @UMass Boston

High-quality, mission-driven CEOs, COOs, CFOs or CIOs are often regarded as the key to the success of aging services organizations. And rightly so.

But it’s high time we recognized that C-Suite executives aren’t the only leaders in the field of long-term services and supports (LTSS). Look carefully at every level of your organization, and I guarantee you’ll find promising leaders in the most unlikely places.

Who are the most promising leaders to emerge in recent years? My money’s on the licensed practical nurses (LPN) who supervise your frontline workers.

LPNs in the Spotlight

LPNs were in the spotlight recently when 4 of my colleagues—Douglas Olson from the University of Wisconsin-Eau Claire, Robert Burke from George Washington University, Barbara Bowers from the University of Wisconsin-Madison, and Elena Siegel from the University of California, Davis—joined me at the 2017 LeadingAge Annual Meeting to talk about developing tomorrow’s LTSS leaders.

Doug, Bob, Barb and Elena are researchers and educators who’ve spent years thinking seriously about this topic. They’ve raised the alarm about our ability to attract leadership talent to our growing field. They’ve developed, implemented and tested professional training programs for emerging leaders. Along the way, they’ve learned a great deal about the kind of leaders LTSS organizations will need in the future.

We didn’t spend too much time talking about the C-Suite during our 90-minute session in New Orleans. Instead, we focused on strategies for bringing workers like registered nurses, LPNs and certified nursing assistants (CNA) under the leadership tent.

Barb’s research should convince us to take on this task. Through many studies, over many years, she’s demonstrated that the ability of nursing supervisors to mentor and coach direct care workers is the single most important factor in determining whether those workers stay or leave a job.

Given our growing recruitment and retention challenges, it makes sense to take quick action to ensure that RNs and LPNs have the skills they need to supervise frontline caregivers. After all, those caregivers are largely responsible for carrying out our collective mission to provide high-quality services and supports to older Americans.

Fortunately, our Annual Meeting session produced a host of ideas for doing just that.

Rebrand our Field

Let’s start with the basics. We need a monumental, full-scale effort to rebrand our field so we can attract high-quality team members who will eventually become the leaders we’re seeking. We need people who:

  • Are excited about serving older adults;

  • Will make an intentional, not an accidental, choice to work in our field;

  • Want to use our career ladders and lattices to build life-long careers in our field.

This rebranding effort isn’t an option. It’s an imperative. It needs to focus on convincing the youngest Americans that the LTSS field offers a worthy and well-respected answer to the question, “What do you want to be when you grow up?”

Make a Good First Impression

Once we’ve convinced aspiring leaders to give our field a chance, we have a responsibility to provide good work experiences so they will stay with us over the long term. That means supporting all our workers from the start by offering them:

  • Competitive compensation,

  • A supportive workplace, and

  • Access to ongoing education that is relevant to the work they do.

In addition, LTSS providers must support the educational institutions that train future LTSS leaders. Those institutions need you to host administrator-in-training and nurse residency programs, and to compensate program participants for the work they do for you. You may think you don’t have the resources to make this investment in our future leaders. I would suggest that you can’t afford not to make this investment.

Don’t Ignore the Home Front

If you think it’s challenging to develop leaders among team members in residential care settings like nursing homes, wait until you see the challenges associated with managing our growing home care sector. We need to think long and hard about how to develop strong leaders who can guide front line caregivers who deliver care by themselves in homes that are spread out over a wide geographic area.

We also need to support emerging leaders in affordable housing communities, including the service coordinators who are playing an increasingly important role in helping low-income elders remain healthy and independent for as long as possible.

Managing workers in these new, home-based settings will take new kinds of leaders. We need much more research to help us identify the skills and competencies these leaders will need to do their very challenging jobs.

Let Workers Practice What We Preach

My colleagues and I have designed many training programs that looked good on paper, inspired and engaged students in the classroom, and then fell flat in the practice setting.

Why? Because the new leadership practices introduced through these groundbreaking programs were never implemented.

Why not? Because upper management didn’t support the trainees or their newly learned practices. The result? Wasted training sessions and frustrated team members.

It’s not fair to send team members to training programs just so they can learn theoretical concepts that get written in a notebook on then put on a shelf. Instead, we must empower these team members to try out evidence-based practices, and to learn on the job whether those practices are worth adopting permanently. Without those assurances, we’re simply wasting everyone’s time.

It Takes a Village

We’re all in this together. No single provider, educator or researcher can work alone to develop and implement effective strategies for developing tomorrow’s LTSS leaders. All of us need to participate actively in rebranding our sector and broadening our view of leadership so we can recruit, train and retain the next generation of LTSS leaders.

I believe those future leaders will want to make a difference in the world. Our job is to convince them that they can make that difference from within our field.


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