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Effective nursing leadership ensures a quality practice environment where staff nurses get the support they need to provide outstanding patient-centered care. Nurse administrators are found at all levels supporting a quality practice environment:
- Nurse executives at the corporate level
- Nurse directors at the mid-management level
- Nurse managers at the unit/department level
Regardless of the level at which they provide leadership, nurse administrators combine management, human resources, and organizational skills, and often draw from their own experience in the clinical environment to develop a vision for nursing practice within the departments or facilities they oversee.
Business Leaders Working Closely with Clinical Staff
The major focus of nursing administration involves managing change and leading the practice of nursing by:
- Assessing, evaluating and analyzing system and procedural issues
- Developing and implementing budget objectives and strategies for achieving them
- Developing and implementing human resource interventions
Nurse administrators possess a deep understanding of the business of healthcare and the many ways it influences nursing practice. They also inspire a spirit of inquiry in the workplace and a culture that supports staff feedback and the application of research findings and best practices.
The most effective nurse administrators develop a strong relationship with the nursing staff they support. They remain available to their staff nurses, working in partnership with them to achieve department-wide, facility-wide and system-wide goals.
Maintaining a strong relationship with nursing staff allows nurse administrators to stay in touch with the many issues affecting nursing practice within their domain, allowing them to develop strategies based on a real understanding of what’s going on at the clinical level.
Nurse administrators rely on their staff nurses to keep them informed and to implement their vision and strategies for delivering outstanding patient care, all while controlling costs. The information gleaned from frequent contact with nursing staff serves as the foundation on which nurse administrators build plans and interventions to create and support a healthy workplace that ensures an optimal patient experience.
Nurse Administrator Jobs at the Corporate, Mid-Management and Department Level
Jobs in nursing administration exist at all levels, from a nurse manager of a hospital unit to the CEO of a major hospital system. Though all positions require strong leadership, superb communication skills, an understanding of the business of healthcare and knowledge of the clinical environment, duties and responsibilities in nursing administration vary according to job title:
Nursing Manager/Supervisor
Nursing managers manage the nursing staff within a unit/department. Their expertise lies with coordinating patient treatment and care and ensuring the nursing staff meets patient needs. Nursing supervisors serve as the direct managers of the nursing staff. In addition to ensuring the nursing staff meets quality assurance standards, nursing managers also ensure the nursing staff’s needs are met and their concerns addressed. They often serve as a liaison between hospital senior management and the nursing team.
Other job duties of nursing supervisors include:
- Planning staff schedules and budget
- Overseeing nurse training and continuing education
- Collaborating with nursing directors to ensure high standards for the delivery of nursing care
- Monitoring and maintaining equipment and supplies
Nursing Director
Nursing directors manage and plan the nursing activities of a unit or department within a healthcare facility. They often oversee the standards of the department and provide general leadership to unit managers. The job duties of nurse directors include:
- Initiating, approving, and initiating policies and procedures
- Overseeing patient care and ensuring the nursing staff meets patient needs
- Ensuring the implementation of the nursing mission, philosophy, and goals
- Creating short- and long-term department/unit goals
- Developing and initiating a staffing plan
- Developing and initiating a budget plan
- Ensuring the unit/department meets state/federal regulations and compliance standards
- Collaborating with staff, management, and senior-level executives
Chief Nursing Officer
The Chief Nursing Officer (CNO), one of the highest nursing administration positions within a healthcare organization, oversees and coordinates an organization’s nursing department and its daily operations. This executive serves as the official spokesperson for nurses at the corporate level, communicating with the board of directors on their behalf and ensuring that the organization’s mission, values, and vision align with the resources and support nursing staff need to be successful in achiving organization goals within the clinical environment.
Their goals include ensuring successful collaborations and partnerships between nurses and physicians and cultivating relationships across departments.
CNOs are involved in nearly all aspects of nursing administration, including:
- Nursing recruitment, training, and retention
- The development of patient care programs
- The creation and implementation of nursing budgets
- The creation and implementation of new patient services
- The establishment of nursing policies and procedures
How to Become a Nurse Administrator: The Master of Science in Nursing (MSN) in Nurse Administration
RNs who want to become a nurse administrator must advance their education and pursue a graduate degree in nursing leadership or administration. Master of Science in Nursing-Nurse Administration degree programs draw from the disciplines of nursing, management, and business to prepare students to excel in leadership roles in contemporary healthcare settings.
Many nurse administrators have a clinical background, but some come from a background in public health administration, public administration and even business. Although traditional MSN degree programs expect candidates to possess a BSN and RN license, many institutions now offer alternative options that accommodate candidates with different professional and educational backgrounds.
Online programs have also increased in popularity in recent years. Online MSN degree programs, which may be either partially or fully online, offer students the flexibility to complete the required didactic components of the MSN through web-based study.
Graduates of MSN Nurse Administrator degree programs are prepared to become leaders in nursing practice, of nursing staff, and the broader healthcare organization.
Nurse Administrator Competencies
The American Organization of Nurse Executives (AONE) created the Nurse Executive Competencies to detail the skills and knowledge nurse leaders should possess, regardless of their educational level, title, or setting:
- Communication and relationship management
- Effective communication
- Relationship management
- Diversity
- Community involvement
- Medical/staff relationships
- Influencing behavior
- Academic relationship
- Knowledge of the healthcare environment
- Clinical practice knowledge
- Governance
- Delivery models/work design
- Healthcare economics and policy
- Risk management
- Evidence-based practice/outcome measurement and research
- Patient safety
- Performance improvement/metrics
- Leadership
- Foundational thinking skills
- Personal journey disciplines
- Change management
- Professionalism
- Ethics
- Advocacy
- Career planning
- Personal and professional accountability
- Business Skills
- Financial management
- Human resource management
- Strategic management
- Information management and technology
Courses and Practicum
The curriculum and practicum of an MSN-Nurse Administration degree program prepares students in the above competencies, providing them with the critical skills and knowledge needed to make a positive impact on healthcare organizations. Some of the courses within an MSN-Nursing Administration program that support these competencies include:
- Management Strategies for Healthcare Systems
- Advanced Nursing Leadership and Management
- Evidence-Based Practice in Health Promotion and Disease Management and Prevention
- Advanced Finance and Operations Management
- Healthcare Informatics and Technology
- Healthcare Quality and Safety Management
In addition to didactic coursework, students of MSN-Nurse Administration programs would complete a practicum that would include working alongside healthcare leaders in a variety of settings, such as:
- Nurse-managed clinics
- Managed care firms
- Hospitals
- Ambulatory care centers
- Community-based clinics
Professional Certification Available to Master’s-Educated Nurse Administrators
Professional certification allows nurse administrators to display to colleagues, employers, and patients their commitment to the profession. The American Nurses Credentialing Center (ACNN) offers two professional designations for today’s nurse administrators:
The Nurse Executive (NE-BC) designation is a five-year credential designed for nurses in charge of the daily operations of a unit or service line. To earn the NE-BC credential, candidates must take and pass a competency-based examination that provides a valid and reliable assessment of entry-level skills and clinical knowledge for nurse administrators.
To qualify to take the NE-BC, candidates must:
- Possess a valid RN license
- Possess a bachelor’s degree in nursing or higher
- Have held a mid-level administrative or higher position, OR a faculty position teaching graduate students in nursing administration, OR or a nursing management or executive consultation position for at least 24 months in the last 5 years
- Have completed 30 hours of continuing education in nursing administration within the last 3 years OR possess a master’s degree in nursing administration
Nurse Executive-Advanced (NEA-BC)
The Nurse Executive-Advanced (NEA-BC) credential is a five-year credential reserved for candidates who possess a higher level of education and experience. Candidates must take and pass a competency-based examination to receive the NEA-BC.
To qualify to take the NEA-BC exam, candidates must:
- Possess a valid RN license
- Possess a master’s degree or higher in nursing, OR hold a bachelor’s degree in nursing and a master’s degree in another field
- Have held an administrative position at the nurse executive level OR a faculty position teaching graduate students executive-level nursing administration for at least 24 months in the last five years
- Have completed 30 hours of continuing education in nursing administration within the last 3 years OR possess a master’s degree in nursing administration
Salary Outlook for Nurse Administrators
According to the Bureau of Labor Statistics, medical and health services managers earned an average annual salary of $92,810 as of May 2014, with the top 10 percent earning more than $161,150 on average that year.
Some of the top paying industries for medical and health services managers had the following average salaries during this time:
- Hospitals: $99,930
- Government: $98,310
- Physician offices: $86,050
- Home healthcare services: $81,940
- Nursing and residential care facilities: $76,730