What does the next level really mean?

I'm a nurse, and I will always use my nursing knowledge to help make a difference in patients' lives, no matter what I do or what title I carry. I believe all nurses in executive, leadership, or management positions influence patient care, patient safety, and patient outcomes. I also believe that there are many career options for which nurses may choose to use their knowledge and expertise. Why would a nurse executive decide to choose a COO, CEO, or any other healthcare executive position? Is the next level really what one wants and does best? How does one decide where and how they can make their best contribution to health care, nursing, and patients? These are questions I would hope each of us thoroughly explores before journeying onto a path that is inappropriate or unsatisfying.