Chief Nursing Officer vs. Director of Nursing

A chief nursing officer holds a tablet.Nurses play an increasingly vital role in administering effective patient care. Each day, the need for senior nurse leaders grows more urgent. Employment statistics reflect the demand. According to data from the U.S. Bureau of Labor Statistics (BLS), two advanced nurse leadership roles — chief nursing officer and  director of nursing — are each expected to see a robust 28% job growth over the next 10 years.

Current and aspiring nurses may wish to consider the two roles, both of which involve not only high-level leadership but also some important distinctions. A chief nursing officer vs. director of nursing comparison can help you assess your career goals and give you further insight into whether to pursue an advanced nursing degree. A good starting point is to define both roles, noting their scope of duty as well as potential salary expectations.

What Is a Director of Nursing?

What is a director of nursing? Fundamentally, a director of nursing oversees all nursing staff and nursing services at a health care facility, such as a hospital, skilled nursing facility, or private practice. Note that some organizations will use the title nursing director, which is typically considered interchangeable with director of nursing.

What Is the Director of Nursing Salary?

Individuals considering this role will naturally have questions about the director of nursing salary. According to November 2022 data from the compensation website Payscale, the annual median salary for this role is approximately $93,900.

The specific compensation amount can vary according to a number of factors, including level of education, years of experience, and the size of the nursing environment in question.

What Does a Director of Nursing Do?

What does a director of nursing do on a day to day basis? Broadly speaking, the position is managerial,  involving little or no direct patient care, though some directors may work the occasional clinical shift to keep their nursing skills sharp.

The most common duties associated with this position include:

  • Team building. The director of nursing recruits, supervises, and trains the nursing staff.
  • Financial management. This position also encompasses oversight of the departmental budget, ensuring nursing resources are strategically allocated.
  • Goal setting. The director of nursing may also set goals related to safety, clinical efficiency, and continuous improvement.
  • Typically, the director of nursing is tasked with ensuring regulatory compliance.

What Is a Chief Nursing Officer?

Now that we’ve explored the director of nursing role, there is another question to ask. What is a chief nursing officer? At most health care organizations, the CNO role is considered to be a corporate-level position. In a health care system, the CNO might oversee multiple hospitals, clinics, practices, or facilities, each of which might have its own director of nursing.

What Is the Chief Nursing Officer Salary?

As for the typical chief nursing officer salary, data from Payscale in November 2022 notes an annual median compensation of roughly $135,600.

What Does a Chief Nursing Officer Do?

The chief nursing officer (CNO) job description combines nurse leadership functions with administrative duties.

Core responsibilities include:

  • Goal setting. As the executive in charge of all nursing functions, the CNO is tasked with setting performance and outcome goals.
  • Policy development. Another key CNO function is developing best practices and ensuring staff follows them.
  • Financial management. The CNO role involves overseeing the organization’s finances, including budgeting and purchasing.
  • The CNO may also serve as a liaison between company officers and heads of other departments.

How to Become a Chief Nursing Officer vs. a Director of Nursing

The paths for how to become a chief nursing officer and how to become a director of nursing are parallel in many ways, especially academically. For both roles, it is necessary to obtain an undergraduate nursing degree, become a registered nurse, then earn an advanced nursing degree such as a Master of Science in Nursing or a Doctor of Nursing Practice. Alternatively, enrolling in an integrated BSN-DNP program can provide the necessary academic foundation on a more aggressive timeline.

The two career paths differ when it comes to credentialing. The necessary credentials include the following.

  • For director of nursing: Certified Director of Nursing Administration (CDONA), offered by the National Association of Directors of Nursing Administration, or Director of Nursing Services (DNS-CT) from the American Association of Post-Acute Care Nursing.
  • For chief nursing officer: Certified in Executive Nursing Practice, offered by the American Organization for Nursing Leadership, or the Certified Medical Practice Executive, through the Medical Group Management Association.

Director of Nursing vs. Chief Nursing Officer: Which Role Is Right for You?

For nurses who wish to have a leadership role within a hospital or health system, either the director of nursing role or the chief nursing officer role can be rewarding. Both allow opportunities to shape nursing policies and procedures at an institutional level, and both roles generally include little or no direct patient care.

The director of nursing role may be better suited for nurse leaders who wish to spend more of their time working directly with other nurses, providing training, team-building, and professional development. By contrast, the CNO role can be more satisfying for nurses who are passionate about policy and administration, or who aspire to a C-suite role.

In terms of salary, the CNO role is typically more competitive, though these roles can also be harder to obtain, requiring more formal experience in nurse leadership or administration. In fact, many CNOs begin their leadership tracks as directors.

Learn More About Advanced Nursing Careers

While there are important distinctions between the chief nursing officer vs. director of nursing roles, both are essential to maintaining the integrity and efficiency of health care delivery. Those who aspire to either of these career trajectories can benefit from honing their nurse leadership skills.

Hawai‘i Pacific University’s online Doctor of Nursing Practice program offers the opportunity to cultivate high-level acumen of nursing policy and administration, making it a great way to prepare for effective nurse leadership at any level.

Recommended Readings

Servant Leadership in Nursing

Professional Boundaries in Nursing: Tips for Nurse Leaders

Tips for Time Management in Nursing


Indeed, "Director of Nursing Job Description"

Indeed, "What Is a Chief Nursing Officer and What Do They Do?"

Payscale, "Average Chief Nursing Officer (CNO) Salary"

Payscale, "Average Director, Nursing Salary"

U.S. Bureau of Labor Statistics, "Medical and Health Services Managers"