Nursing is the largest profession in the U.S. health care industry, with 3.9 million practicing registered nurses nationwide, according to the World Health Statistics Report. With nursing’s enormous contribution to delivering care, nurse leaders will play a critical role in managing the challenges of pandemic fallout, staffing shortages, and changing patient needs.
The COVID-19 pandemic has shined a spotlight on the importance of leadership in this field, as nursing professionals often have struggled with staff shortages and a lack of resources even as they work to treat patients effectively. The highest nursing management position in a health care organization is the chief nursing officer (CNO). CNOs direct efforts to balance the management of resources with the delivery of high-quality patient care.
Nurses ready to lead their profession’s work to meet the challenges facing the medical community should consider pursuing a Doctor of Nursing Practice (DNP). The highest degree in practice-based nursing, a DNP can prepare nurses with bachelor’s degrees and nurses with master’s degrees to pursue careers as CNOs.
The Role of the Chief Nursing Officer
The chief nursing officer job description focuses on both nursing leadership and organizational administration. A CNO’s responsibilities are typically related to setting patient care standards, establishing processes and protocols for achieving those standards, and managing the work of nurses who care for patients. Most chief nursing officers work in hospitals, clinics, or rehabilitation centers or with government agencies.
As administrators, CNOs generally don’t have as much interaction with patients as other nursing professionals, but their importance in patient care is just as significant.
They work closely with a health care organization’s nurses and senior management to help shape a facility’s care practices. Sometimes, CNOs alternate their shifts with each other to ensure full coverage for patient care.
Nursing Leadership
CNOs’ leadership responsibilities range from hiring staff to departmental oversight, including:
- Directing nurses
- Supervising nurse managers
- Hiring new nurses
- Facilitating training opportunities for nurses
- Monitoring and managing the work of nurses and their departments
- Overseeing administrative departments, such as transcription and medical records
- Making disciplinary decisions
Organizational Leadership
The role of a CNO in guiding a health care organization’s practices goes beyond work with nursing professionals to encompass efforts with a variety of medical professionals. Organizational leadership duties can include:
- Working with other health care professionals
- Serving as a liaison between nurses and administrators
- Maintaining compliance with government and facility regulations
- Recommending strategies for improving care
- Providing guidance regarding a facility’s budget
- Promoting the mission of the facility
- Offering nursing expertise to government officials
How to Become a Chief Nursing Officer
A chief nursing officer’s job description includes duties of both nurses and managers — which means they need skills in business operations and management, as well as an understanding of nurses’ needs and patient care best practices. CNOs typically are registered nurses (RNs) with an in-depth level of education and experience.
Education Requirements
Most CNOs hold a Bachelor of Science in Nursing (BSN), with many also having earned advanced degrees such as a Master of Science in Nursing (MSN) or DNP. Most nursing education programs offer courses in anatomy, microbiology, physiology, psychology, and social and behavioral sciences. They typically also include clinical requirements.
Nursing professionals who are RNs may pursue advanced nursing degrees. These graduate programs typically offer students the opportunity to tailor their education according to the advanced practice registered nurse (APRN) specialty they want to pursue, such as family nurse practitioner (FNP), adult-gerontology acute care nurse practitioner (AGACNP), or psychiatric mental health nurse practitioner (PMHNP). DNP degree programs generally also include advanced courses in leadership, business and finance, and quality improvement, as well as doctoral projects.
DNP graduates — such as those progressing directly from bachelor’s programs — may need additional experience before qualifying for CNO roles. However, a doctoral degree may help them advance more quickly toward top-level roles.
Licensing Requirements
Licensing requirements for RNs vary by state but typically include completing an approved nursing program and passing the National Council Licensure Examination (NCLEX-RN) from the National Council of State Boards of Nursing (NCSBN). Nurses with advanced degrees might pursue state licensing as an APRN.
APRN licensing requirements differ by state as well but often include holding an RN license, completing a graduate-level program, and passing a national certification exam. FNPs, PMHNPs, and AGACNPs, for example, might hold a license through the American Nurses Credentialing Center (ANCC).
Required Skills
The skills that the CNO role requires reflect the job’s focus on both nursing and administration. Successful CNOs typically have expertise and skills in:
- Leadership
- Empathy
- Medical and clinical procedures
- Nursing
- Health care policies and regulations
- Health care technology
- Training
- Flexibility
- Attention to detail
- Critical thinking
- Multitasking
Chief Nursing Officer Salary and Job Outlook
The median annual chief nursing officer salary was approximately $135,223 as of September 2021, according to PayScale. The top 10% of earners received $203,000 or more in salary with bonuses and profit sharing.
The U.S. Bureau of Labor Statistics (BLS) projects 16% growth in health care jobs between 2020 and 2030 — more than any other occupational group. The employment outlook is even more promising for nursing professionals with graduate degrees, as the BLS anticipates 45% job growth for APRNs and 52% job growth for nurse practitioners.
A nursing shortage is driving demand for leaders in the field. The NCSBN’s 2020 National Nursing Workforce Survey showed that 22% of RNs planned to retire or leave the profession in the next five years. The median age for RNs is increasing, with nearly 20% of RNs age 65 or older. The COVID-19 pandemic has exacerbated the problem, with turnover linked to burnout from the demands of extra hours, complex responsibilities, and scarce resources.
The nation’s population is aging as well, with U.S. Census figures in 2019 showing the number of people age 65 and over had grown by more than a third in the previous 10 years. This population will require more care for illness and complex medical conditions. The BLS also reports a greater demand for preventive care.
Lead the Way to Top-Quality Patient Care
You can develop the expertise to pursue in-demand nursing leadership roles such as chief nursing officer through Hawai‘i Pacific University’s online BSN to Doctor of Nursing Practice and online MSN to Doctor of Nursing Practice programs. These programs can help you gain advanced-level knowledge of patient care standards and practices while also honing your leadership skills. Furthermore, you’ll enjoy the flexibility and convenience of online learning, along with strong student support.
Discover how Hawai‘i Pacific University’s online Doctor of Nursing Practice programs can help you reach your professional goals.
Recommended Readings:
Nursing Advocacy: The Role of Nurses Advocating for Patients
Patient Rights and the Essential Role of Nurses
Transcultural Nursing in Remote Areas
Sources:
American Association of Nurse Practitioners, Nurse Practitioner (NP) Certification
American Nurses Credentialing Center
American Organization for Nursing Leadership, AONL Nurse Leader Competencies
Consultant 360, “The U.S. Nursing Shortage: Opportunity to Close the Gap”
Indeed Career Guide, “What Is a Chief Nursing Officer and What Do They Do?”
Indeed, What Does a Chief Nursing Officer Do?
National Center of Biotechnology Information, “Nursing Shortage”
National Council of State Boards of Nursing, Results From the 2020 National Nursing Workforce Survey
National Council of State Boards of Nursing, NCLEX FAQs
PayScale, Average Chief Nursing Officer (CNO) Salary
Relias, “Nursing Leadership: What Is It and Why Is It Important?”
U.S. Bureau of Labor Statistics, Health Care Occupations
U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
U.S. Bureau of Labor Statistics, Registered Nurses
U.S. Census Bureau, “65 and Older Population Grows Rapidly as Baby Boomers Age”