James Fenush, MS, RN, as director of nursing, clinical support services at Penn State Milton S. Hershey Medical Center, is responsible for designing, directing, implementing, and evaluating clinical programs and conducting performance improvement for all areas of clinical practice in collaboration with department chairs and administrators. He develops and approves operating and capital budgets for assigned clinical programs and areas, along with developing new programs and community service outreach in collaboration with physicians and administrators. He also determines and recommends appropriate staffing based on patient acuity and patient needs. His clinical and nurse leadership experience afforded him the opportunity to serve as the executive champion for the department of nursing’s staffing strategy.