The chief nursing officer (CNO) is responsible for overseeing all aspects of nursing care throughout the healthcare organization. Chief nursing officers are healthcare leaders who operate at the executive level and typically report directly to the organization’s chief executive officer (CEO). They are committed to advocating for the needs of the nurses within the organization and the patients entrusted to their care.
What Does a Chief Nursing Officer Do?
Chief nursing officers are registered nurses (RNs) but do not work within clinical settings performing patient care. Instead, they are responsible for leading a culture of excellence in patient care that aligns with evidence-based nursing practice and adheres to local, state, and federal regulations. Additionally, chief nursing officers must ensure that departmental efforts align with organizational strategies and business goals.
Healthcare organizations are increasingly complex, and chief nursing officers must have excellent leadership skills and a strong clinical background. They must be adept at communicating both within their departments and across all levels of the organization. Business acumen is also a must, since chief nursing officers are responsible for overseeing the day-to-day business operations of the nursing department, as well as all aspects of patient care.
A chief nursing officer’s duties may include:
Developing departmental goals and objectives
Leading continuous quality improvement efforts
Helping to hone departmental efficiencies
Writing and revising policies and procedures
Ensuring departmental and organizational compliance with local, state, and federal regulations
Recruiting, training, and supervising staff members
Preparing and monitoring departmental budgets and spending
Tracking and reporting key metrics related to patient care
Communicating with members of the medical staff and department heads
Attending departmental and administrative meetings
The American Organization for Nursing Leadership (AONL) created a comprehensive description of the core competencies for a nursing leader—which would also apply to the chief nursing officer role. In a snapshot, they include “The Leader Within”—which the AONL says is the anchor for the five core domains of:
Business skills and principles
Communication and relationship building
Knowledge of the healthcare environment
Professionalism
Leadership
The AONL says the “leader within” is “the driver of motivation, beliefs, values and interests, and recognizes that the influence and significance of education, experience and understanding oneself is essential.”
How Much Does a Chief Nursing Officer Make Per Year?
According to salary data from the Bureau of Labor Statistics (BLS), the median annual wage for registered nurses was $77,600 in May 2021—with half of nurses earning more than that amount and half earning less. Wages of nurses in the lowest 10 percent were less than $59,450. Wages of nurses in the highest 10 percent were over $120,250.
The median annual wage for medical and health services managers was $101,340 in May 2021. The lowest 10 percent earned less than $60,780, and the highest 10 percent earned more than $205,620.
The setting in which medical and health services managers work also influences pay. In May 2021, the median annual wages for medical and health services managers in the top industries in which they worked were:
Hospitals—state, local, and private: $119, 450
Government: $117,000
Outpatient care centers: $99,540
Offices of physicians: $98,230
Nursing and residential care facilities: $83,550
The salary of a chief nursing officer is also influenced by factors such as education, experience, and geographical region of the country. Although the following map reflects RN salaries, it provides salary trends which may also apply to chief nursing officers.
The path to becoming a chief nursing officer depends upon the credentials involved. Chief nursing officers are registered nurses and must attend an accredited nursing program. A Bachelor of Science in Nursing (BSN) is typically a minimum requirement for leadership advancement.
RNs must also be licensed in the state in which they work. Licensure can be obtained by passing the National Council Licensure Examination (NCLEX-RN) and meeting any additional requirements of the state’s board of nursing. The National Council of State Boards of Nursing (NCSBN) offers a resource to determine state-based nursing licensure requirements.
Many chief nursing officers have risen through the ranks, pursuing additional education along the way. In addition to the BSN, many have obtained advanced degrees, such as a Master of Science in Nursing (MSN). Some organizations may require the chief nursing officer to hold a more advanced degree, such as a Doctor of Nursing Practice (DNP).
A chief nursing officer can also obtain specialty certification by meeting eligibility requirements and taking one or more of the exams offered by credentialing bodies:
What Are the Benefits of Being a Chief Nursing Officer?
Chief nursing officers can have a tremendous impact on the lives of the nurses they represent and the patients entrusted to their care. Although they have a great deal of responsibility, they also enjoy a lot of autonomy and possess the ability to address concerns, create positive change, and act as models of effective and compassionate leadership.
Two chief nursing officers who participated in a study about balancing the needs of nurses and patients captured some of that sentiment like this:
“That is why I round on patients, because that reminds me why I do what I do every day. … because I am a nurse first … I’m doing it for the patient in the bed … because my priority is the patient’s safety.”
“When nursing has a voice at the table at the board level and at the senior executive level, you can do good things.”
Additional Resources About Becoming a Chief Nursing Officer
To learn more about becoming a chief nursing officer, these additional resources may help:
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