The highly complex role of the Chief Nursing Officer (CNO) requires the refinement of a multitude of competencies and leadership skills in this unprecedented time of healthcare reform. As the senior most patient advocate in our medical centers the CNO is responsible for translating research into practice, policy development and implementation creating value based patient-centric strategies to transform health care. The ability to sustain and thrive in this role is essential in repositioning nursing as a knowledgeable discipline actively contributing to the redesign of healthcare. This exploratory descriptive phenomenological study was designed to explore and describe the elements that contribute to the sustainment of CNOs in their practice of nurse executive leadership. Ray’s (1989) Theory of Bureaucratic Caring, Authentic Leadership Theory (Wong & Cummings, 2009), and Resiliency Theory (Earvolino- Ramirez (2007) provided the theoretical lens through which this study was grounded. Semi-structured telephonic interviews were conducted with twenty CNOs all with two consecutive years experience in their current role. Six themes emerged after thorough content analysis which describes the lived experience of sustainment. Each theme was supported by several subthemes. Themes emerged as: Loving the Profession, Having a Broader Impact Reflecting on One’s Own Work, Learning to Manage Conflict, Maintaining Work/Life Balance Working with Supportive Leaders. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection