Bill Klaproth (Host): This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. And with me is Marie Prothero, Assistant Professor, Undergraduate Program Coordinator at Brigham Young University College of Nursing, and Tera Gross, Chief Nursing Officer at Mayo Clinic in Florida, as we talk about elevating nurse leadership, applying the updated AONL core competencies across roles and settings. Marie and Tera, welcome.

Marie Prothero: Bill, hey. Thanks for having us.

Tera Gross: Hey Bill, it's a pleasure to be here today.

Host: You bet. Thank you both for being here. Appreciate it. Looking forward to talking to both of you. Marie, let's start with you. So, the AONL core competencies have recently been updated. What prompted this revision and what is the most important thing for nurse leaders to understand about this new version?

Marie Prothero: The update was really a deliberate effort to modernize the nurse leader core competencies to reflect the realities and complexities of contemporary nurse leadership across the care continuum. The task force used an evidence-based/driven model, highly structured review process to ensure competencies are actionable, measurable, and future-ready.

As you know, healthcare is defined by complexity. Very adaptive systems that are complex and workforce instability and rapid digital transformation, widening the inequities, regulatory pressure and financial strain. And these revised competencies really brought forth the acknowledgement that nurse leaders are navigating all of this simultaneously.

So, what's really most important for nurse leaders to understand is just simply, it's not an updated wording, but really a reframing of leadership expectations and looking at the complexity of what nurse leaders are dealing with in today's healthcare environment.

Host: So, Marie, it sounds like—and you mentioned this—this update certainly reflects the realities that nurse leaders are facing today. Is that right?

Marie Prothero: Yes, absolutely. If you really reflect that nurse leaders are leading in volatility and not stability currently right now and, in addition, systems and complex thinking recognizes that leadership is no longer linear. It's ongoing and sometimes disruptive.

Host: Yeah, absolutely. So, good to update it then to reflect the current realities that nurse leaders are facing today. Tera, let me turn to you. What are the most significant shifts or enhancements in the updated competencies compared to previous versions?

Tera Gross: Yeah, absolutely. And as Marie and you just talked about, it really reflects on what the leaders are experiencing today. So, there are many. And I'll just highlight a few that really stand out. The first one is leadership begins within, and the leader within domain is not new. It's further enhanced, and it's really focusing on the personal wellbeing and professional identity as explicit competencies. This really signals that sustainable leadership requires self-awareness, resilience, and intentional growth, not just performance.

Also, innovation is no longer optional. Innovation and entrepreneurship are now named competencies, and our nurse leaders are experiencing that at a very high pace, and these competencies will help them with the tools that they need to really develop that in their profession.

Another one that I'll highlight is crisis leadership and resilience. Crisis leadership is formalized. It includes preparedness, coordinated response, and protection of the workforce wellbeing. And this really reflects lessons that we learned from the pandemic and also in recent cyber attacks situations that are happening across the country. Our leaders really need to be prepared for those unexpected activities to happen.

And the last one I'll highlight is digital health AI and organizational stability. Digital health is at the forefront for our leaders. They're expected to strategically manage technology, data, and resources for that long-term sustainability of not only themselves, but of the staff that they're supporting as well.

Host: When you talk about digital health, could you talk about that just a little bit more on what you're expecting nurse leaders to understand and know today?

Tera Gross: Yeah, absolutely. So, I'm happy to give an example. Our competencies are really for all settings. So, acute care, academia, even industry and nurse leaders in these settings are being asked to deploy new technology to help them and the staff to deliver care in a more efficient way to really use that technology to run in the background so that they can spend more time with the patient's in acute care.

For example, they might be deploying AI algorithms to send triggers to the staff to alert them if something's happening with the patient or they might be using tools to help them as nurse leaders to do their work at their desk, to get literature that's available to them or to get new information that'll help them as they make strategic decisions to lead healthcare to today.

Host: So, that's basically being up on all the potential digital tools that can help them maximize their job functions today. Would that be right?

Tera Gross: Yes, absolutely.

Host: And Marie, was there anything that surprised you when you were putting this all together?

Marie Prothero: I think one of the things that we sort of focused a little bit more on is psychological safety and elevating that from a leadership standpoint.

Tera Gross: Yeah. I would also add is we're preparing to share these competencies at the upcoming conference. And one thing that surprised me as I'm developing that presentation and reflecting back, there are more changes to the sub-domains or these different statements that I just shared, like innovation, psychological safety, crisis leadership, and resilience. There was even more rewording or modifications of those, which really reflects that today's environment is different than in the past when we developed the previous version.

Host: Yeah, absolutely. So, the title of this episode focuses on applying the competencies across roles and settings. So, how should frontline nurse leaders, directors, and executives think differently about using these competencies in their day-to-day practice?

Tera Gross: So really, the important principle is that these competencies are consistent across all levels. So in the past, we had competencies that were written specifically for different roles, and now our competencies are going to be the same and they're going to be foundational. And what our leaders and our frontline leaders, our directors, our executives are going to see is different behaviors. So, applying the competencies in different ways, depending on their roles and what they are responding to on a day-to-day basis. For example, our frontline leaders operationalize these competencies daily, building on psychological safety, they're managing conflict, they're applying evidence-based practice. Our directors scale these competencies across multiple service lines. They're integrating governance, sustainability, workforce optimization. And then our executive level, CNOs, CNEs, they're applying these at a broad level, so maybe their enterprise or their system level, their shaping policy, influencing strategy, ensuring regulatory foresight. They're driving that crisis preparedness and aligning innovation and then organizational sustainability. So, the shift is from what do I manage to what system influence I have, depending on their role that they are working in.

Host: Yeah. You said, it's now foundational, right? So, that makes a difference and it sounds like a great move to do that.

So, Marie, how can nurse leaders in diverse settings such as acute care, ambulatory long-term care or community environments adapt the competencies to meet their unique challenges?

Marie Prothero: I think this is one of the things that we really talked a lot about is that we wanted this to be a framework that is adaptable across settings. You know, in acute care, crisis leadership, high reliability and digital integration will be most visible. In ambulatory or community environments, population health, equity care model transformation, and community partnerships may take priority.

And then, again, in rural or in global context, they might be looking at resource stewardship, adaptability, and oversight. That becomes very critical. And even in academia, as you know, I'm in academia. We are looking at how are we using these core nurse leader competencies to shape the future nurse leaders and really providing tools and skills so that, as nurses are emerging into leadership roles, they know what those competencies are and can utilize those across whatever setting they work in. The competencies don't change. It is the expression of them that shifts based on patient population, regulatory environment or system complexity.

Host: And Tera, for organizations looking to operationalize the updated competencies, where should they start?

Tera Gross: Once our tools are out there, I would recommend that they start with an alignment and assessment. So, take their current leadership expectations and map those against the new domains, and then really conduct a leadership self-assessment or even a 360 evaluation aligned to these competencies. And then, have conversations with their leaders on how they personally develop those, as well as how they personally develop those at the organization level.

And I would recommend that they avoid trying to implement everything at once. So, take maybe their top three that they need to focus on as an individual or as an organization, and focus on developing those, and then moving on to the next ones that they think are the top priority for their organization.

Host: That seems like a really smart measured approach to this. And Tera, how can these competencies be integrated into leadership development, performance evaluation, or succession planning?

Tera Gross: The leaders can take these competencies, look at their job description, and really compare and see if their job descriptions are aligned and then making modifications if they need modifications to their job description, to align in that leadership development across the domains, and using these competencies as a framework for succession planning conversations. So as they're meeting with people, as they do those 360 or self-assessments, really having those conversations intentionally with the leaders and focusing on what they need to develop, and then developing those action plans for the individual so that they can work on those action items in their practice.

Host: Right. And then, Marie, how can individual nurse leaders use the updated competencies to assess their own growth and identify development opportunities?

Marie Prothero: I think, as individual leaders, this becomes a framework as a structured mirror to sort of look at myself and ask where am I strongest and what domain maybe do I avoid because it feels uncomfortable. Maybe finance or policy or digital health or conflict management are uncomfortable for me. And so, I may avoid those areas. And the competencies become a roadmap for intentional growth, not reactive development. I think leaders can seek targeted mentorship in weaker domains and really look for people in their organizations that can help mentor them as they try to strengthen areas where they feel uncomfortable or less likely to be successful, pursue education aligned with specific competency gaps. And then, really create a personal development plan tied to measurable behaviors so that, as they are looking at the competencies and thinking about their own progression, I think the beauty of this is any leader in any role, whether I am an emerging leader or a well-established leader can use these competencies to really develop a professional growth plan.

Host: So, no matter what level you're at, it sounds like take a self-assessment and then these competencies become a roadmap, as you said, for internal growth. So, it seems like a good way to go about this. Would that be right?

Marie Prothero: Yeah, exactly.

Host: Absolutely. So, Tera, if listeners take away just one action after hearing this discussion, what should it be?

Tera Gross: Yeah, I would say review the competencies and then pause and reflect on one domain that they want to intentionally focus on, whether it be personal wellbeing, digital leadership, crisis preparedness. Take one of them and make one concrete step this month to further develop that. Because one thing that the 2026 competencies make clear is that modern nurse leadership is not about maintaining operations. It's really about shaping systems that are resilient, inclusive, transformative, and adaptive. And that begins with intentional growth.

Host: So, it sounds like, as you said, take one step this month, so break it down to make it easier.

Tera Gross: Yeah. Break it down and do one thing at a time and then focus on that, celebrate progress, and then move on to the next domain that they want to focus on.

Host: I like it. Sounds good. Celebrate that progress. Well, Marie and Tera, I want to thank you so much. Before we wrap up, I'd like to get final thoughts from each of you as we finish up discussing the updated AONL core competencies across roles and settings. Marie, let me start with you. Any final thoughts or something you want to add?

Marie Prothero: Well, I just want to remind listeners that this has been a very thoughtful process where a very diverse group of nurse leaders across the country have come together and have worked on these for really the previous, last 12 months. And what you're seeing with this rollout is that worked. And we've looked to evidence and the literature to make sure that we are being thoughtful about the wording and the complexity of the categories and domains and we're excited to roll this out and get reactions from others.

Host: Absolutely. You've certainly put a lot of work into this. So, that is exciting to see all your work come to fruition. So, thank you for that. Marie and Tera, how about you? Any final thoughts?

Tera Gross: Yeah. So, it's really, really exciting work and I've had the honor to work with Marie as the co-chair of this task force to develop these competencies for our leaders, really across the country and the globe really. And I would say that this is just the start. So, we're releasing these core competencies, and then we're going to go back and continue working and developing more behaviors for more roles. So, we're excited to get these out there and then to get back to work.

Host: Well, when you say go back and keep working, these are always evolving, right? Things are always changing.

Tera Gross: Things are always changing. Absolutely.

Host: Absolutely. And I'm glad people like you and Marie are on this to continually update all of this for us. Marie and Tera, thank you so much. We appreciate it.

Tera Gross: Thank you.

Marie Prothero: Yeah. Thank you, Bill. It's been a pleasure.

Host: You bet. And once again, that is Marie Prothero and Tera Gross. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you at aonl.org/nursing-leadership-podcast. This is Today in Nursing Leadership. Thanks for listening.