A nurse administrator is an experienced registered nurse (RN) with a leadership position in a hospital or other healthcare facility. There are several job titles within nursing management and administration, such as director of nursing, chief nursing officer, clinical nurse leader, patient care director, and nursing director of specific specialties, such as critical care.
What Does a Nurse Administrator Do?
Nurse administrators daily tasks will vary by location, but most nursing leadership roles include the following:
Interviewing potential employees
Conducting performance evaluations
Teaching staff new protocols
Developing workflow and patient safety policies
Creating and managing departmental budgets
Enabling and encouraging the professional development of staff
Collaborating with committees to reach performance goals
Ensuring legal compliance among staff
Nursing administrators are also responsible for advocating for the needs of their nurses and support staff. For example, a chief nursing officer (CNO) is an executive-level manager and may report to the chief executive officer (CEO) or medical director of a facility. CNOs are responsible for representing the needs of nurses at the executive and leadership board levels. CNOs are in a unique position to advocate for nurses and explain bedside care needs to executives who may be more removed from bedside patient care and its challenges.
How Much Does a Nurse Administrator Make Per Year?
According to the U.S. Bureau of Labor Statistics, the median annual wage for medical and health services managers was $104,280 in 2020. The median wage represents the middle; half of managers made more than this, and half made less. The lowest 10% of healthcare managers earned less than $60,000. The highest ten percent earned more than $195,000. While these wages are not nursing-specific, they can reflect the range of positions and qualifications for nurse managers with different years of experience and degree levels. Geographical location can also have a large impact on income, as reflected on the map below that shows average annual wages.
Citation Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Medical and Health Service Managers, at https://www.bls.gov/oes/current/oes119111.htm (visited January 29, 2022).
Nurse managers and administrators can be hired as hourly or as salaried employees. In positions where overtime is likely, it is important to consider the potential benefits of hourly pay and overtime pay rates.
Where and When Do Nurse Administrators Work?
Nurse administrators can work for a hospital or hospital system, either managing a care specialty or acting as the executive to whom department managers report. Directors of nursing are also commonly employed by nursing homes, long-term acute care facilities, or other institutions providing nursing care. Physicians’ offices, urgent care centers, and outpatient care facilities also employ nurse administrators to oversee nursing and support staff.
Nearly all nurse managers and administrators work full-time. While most tasks and meetings will be conducted during business hours, some work may be required at night or on weekends. Administrators working for hospitals or nursing homes, which never close, may be required to work some holidays. Some nurse managers may be required to be on-call at times, available to respond to emergencies and assist their staff members as needed.
How Do I Become A Nurse Administrator?
The path to becoming a nurse manager, administrator, or executive has several steps that are described in detail below. In list form, the typical qualifications are usually achieved in this order:
Obtain a Bachelor of Science in Nursing (BSN)
Pass the NCLEX-RN exam
Two or more years of bedside experience
Work as a charge nurse during shift
Obtain a Master of Science in Nursing (MSN)
Work as a nurse manager of a unit within an institution
Experience as a nurse executive for an entire institution
Nurse administrators are experienced RNs, with at least a bachelor’s degree in nursing. The most straightforward path to earning a Bachelor of Science in Nursing is through a four-year accredited college of nursing. Other options include part-time BSN programs and associate’s to bachelor’s bridge programs. Upon completion of a BSN, graduate nurses are eligible to take the NCLEX-RN computerized exam. Upon passing, RNs are able to apply for licensure in the state they wish to practice and begin working.
To enter nursing leadership positions, nurses must gain bedside nursing experience in a hospital. The next step is often to work as a charge nurse or the shift leader for one unit. Charge nurses are responsible for managing patient assignments, problem-solving to assist staff and patients, assisting with patient care, and communicating with other units to handle hospital-wide patient populations. These nurses have direct patient contact as well as leadership and management roles. Then, an RN may be qualified to become the nurse manager of an entire department, such as the emergency or cardiac inpatient department. At this level, most nurse managers have completed or are working toward a Master of Science in Nursing (MSN), a Master in Public Health (MPH), or a Master in Business Administration (MBA). There are also degree programs that offer a dual degree, such as MSN/MBA. Increasingly, employers in larger health systems are seeking nurses who hold a Doctor of Nursing Practice (DNP) degree. Nurse managers who successfully manage their unit and complete a graduate or doctoral level degree may consider moving into an executive-level director of nursing position.
Additional certifications available to nursing administrators include NE-BC, or nurse executive board certified, from the American Nurses Credentialing Center (ANCC). Eligibility requirements include an active RN license; a bachelor’s degree or higher; 2,000 hours in nursing leadership, management, or administrative roles; and 30 hours of continuing education in leadership or administration. The American Organization for Nursing Leadership (AONL) offers the Certified Nurse Manager and Leader (CNML) and Certified in Executive Nursing Practice (CENP) credentials. These exams have similar requirements, including at least a year of experience in a nursing leadership role.
What Are the Benefits of Being A Nurse Administrator?
Nurse managers, administrators, and executives are able to create system-wide improvements through their close work with bedside nurses as well as executive-level leaders. Managers can inspire and motivate their staff to achieve better patient outcomes and better careers through professional development. Nurse managers are also responsible for making changes that may not be popular with staff, such as decisions based on limited resources or budget, while also balancing the healthcare needs of the patients they serve. These top-paying nursing positions can be fulfilling for those who enjoy problem-solving, collaboration, and leading others in healthcare.
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