The Adams Influence Model in Nursing

Updated on October 31, 2022
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The Adams Influence Model (AIM) is the name given to a framework for understanding the attributes, factors and process of influence. The model is grounded in the nursing profession as well as organizational literature and offers a road map for nurse leaders to develop an effective strategy that can help them gain influence with groups and individuals. 

Chief nurse executive

Understanding the influence of a chief nurse executive is vital for the nursing discipline. There are estimated to be around 5,000 chief nurse executives within the US, all of whom have the task of being the main leader that represents their employment organization as well as the nursing profession. 

A chief nurse executive is essentially the gatekeeper for advancement for most of the 2.4 million nurses who are currently practicing in the US. According to information, early chief nurse executives had little influence and in many cases were not even recognized members of executive organizational teams. However, after struggling for more than 20 years, they are finally seen as being vital members of executive teams.. 

The Adams Influence Model is the framework designed to understand how chief nurse executives can actually use that influence and to define the expectations of the role itself. Chief nurse executives are the people who are leading the nursing profession and the healthcare system, and so it is vital that the direction in which influence moves, and the speed at which it moves, in both are not left to chance. 

The role of the chief nurse executive

Nurses and other frontline medical personnel perform tireless work every day to make sure that patients receive the best-quality healthcare, and nursing is one of the healthcare industry’s most important jobs today. 

For healthcare facilities, including hospitals, to run in an efficient manner, nurses have to be properly trained and given all the resources they require, and this is the job of the chief nurse executive. Chief nurse executives are also responsible for shaping the next generation of nurses by ensuring that they set a good example by demonstrating ethics and values and serving the leaders of their facilities and their teams.

The leadership position of a chief nurse executive includes the overseeing of a number of different facets of the operations in a healthcare organization. They have to make certain their facilities are fully staffed and that their nursing teams have access to all of the resources they will need to be able to do their jobs. 

A chief nurse executive can be referred to by several different titles, including chief nursing officer, director of nursing or vice president of nursing, but the core job function always remains the same: to ensure that their facility, be it a small private clinic, a large hospital or a nursing home, has the resources and teams necessary to provide the highest-quality patient care. All chief nurse executives start their careers in the position of staff nurse. 

The best way for those interested in becoming a chief nurse executive to achieve their goal is to pursue a nursing degree and then enter one of the online DNP leadership programs. This is a graduate-level nursing program designed to get students ready for upper-level nursing management positions. 

Being a leader

There are many duties involved in being a chief nurse executive, but their primary duty is to serve as the leader to nursing teams. This makes it vital for them to be able to effectively communicate the goals, mission and values of their organization to ensure that all team members are working toward the same vision. 

Chief nurse executives and their team members also have to share the same commitment to following all laws and regulations pertaining to the healthcare industry. 

While chief nurse executives do not directly work with patients, their nursing teams do, which makes it their responsibility to deliver patient care by proxy. 

As well as working with nursing teams, chief nurse executives must also undertake regular collaborations with other healthcare leaders within their organizations to ensure the effective execution of the mission and the following of best practices. The chief nurse executive is both a role model and leader, setting the tone for their nurses by leading by example.

The best chief nurse executives are those who can inspire others, particularly during difficult times. To succeed in this role, a chief nurse executive must have clinical experience, highly developed leadership skills and nursing education. 

Team management

Chief nurse executives have to manage nurses as well as other inter-professional team members within their area, usually handling an array of different duties, including hiring and training employees, shift scheduling and performance reviews. 

They are responsible for mentoring new members of their teams, facilitating collaboration and communication, and designing strategies to provide support to their staff’s professional development. They also need to create a welcoming team environment to new starters.


Chief nurse executives are also often responsible for overseeing their healthcare organization’s finances. They may be tasked with developing a budget that encompasses everything from improvements to IT and equipment for patient care to employee salaries. Sometimes it is also the job of the chief nurse executive to propose and implement methods of reducing costs and to keep an eye on insurance reimbursements. 

The creation of new policies

Chief nurse executives also get the chance to improve, shape and even be responsible for the creation of new policies within an organization. These policies can be related to communication procedures, patient care workflows and recordkeeping, and other organizational processes. 

Representing their healthcare organization

The chief nurse executive also has to represent their healthcare organization on committees and at professional conferences, where they can advocate on behalf of staff members as well as patients in regard to public health policy matters.

The chief nurse executive role offers individuals the opportunity to massively influence their healthcare organization and the industry in general, and can be an excellent step to take for those wishing to develop as a professional and as a leader.