Understanding Chief Nurse Executive (CNE) influence is essential for the discipline of nursing. There are approximately 5000 CNEs in the United States, all tasked with being the primary identifiable leader representing organizations in which they are employed and the nursing profession of which they are a part. In this capacity, the CNE is the gatekeeper for the advancement of the majority of the 2.4 million nurses practicing in the U.S. Literature suggests that early CNEs lacked influence and often were not recognized members of organizational executive teams. Today, after two decades of struggle, CNEs are identified as essential executive team members. However, they still self identify as being less influential than their C-suite counterparts, raising the question, "Having gotten to the table, now what?" The Adams Influence Model (AIM) is a framework to begin to answer this question and define expections of the CNE role. These are the individuals leading the profession and our healthcare system, at what pace and in what direction cannot be left to chance.