A ship can’t go anywhere without a good captain. As with any complex vessel, project, or organization, a good leader can make the difference between running smoothly and crashing into epic disaster. A nursing unit is no different, and a great nurse manager can ensure their staff is happy and patients are well-cared for.
Nurse managers don’t treat patients directly, but they coordinate all the staff on their floor. They bring staff on and let them go. The unit budget falls under a nurse manager’s purview, and they make decisions on where the money goes. Nurse managers work with a higher management to address unit needs and concerns, and to apply policy changes to their units.
In a smaller facility, a nurse manager may do things like schedule staff, order toilet paper, and manage time off. In larger health systems, they may delegate some of these tasks to assistant nurse managers or nurse educators. The entire unit staff looks to their nurse manager to advocate for them, while upper management may look to them to cut costs. A good nurse manager knows how to balance the needs of the facility with the needs of their staff and patients, creating a positive environment for all.
Where Do Nurse Managers Work?
Nurse managers work on-site in any facility that houses patients and staff. Some common places that employ nurse managers include:
Hospitals
Long-term care facilities
Outpatient care centers
Skilled rehab facilities
Nurse managers typically have offices in their units. Sometimes their office sits in the middle of the action, and other times they can be more tucked away in a quiet corner of the unit. Different nurse managers have different styles: some may spend a lot of time walking the unit, jumping in to help here and there, and talking to staff. Others may spend more time at their desks, though hopefully with an open-door policy for concerns and needs.
Part of a nurse manager’s day will involve meetings. Since COVID, many meetings take place over a video call, but nurse managers may still meet in person with other managers, their director of nursing (DON), or the CEO or president of the hospital or health system. Even during COVID, most nurse managers did not work from home. If their nurses had to come in, they came in, too.
What Does a Nurse Manager Do?
A nurse manager’s day-to-day may fluctuate throughout the week, and it may look different depending on the setting. A nurse manager for a 50-bed unit in a large urban teaching hospital may have slightly different tasks than in a similar role in a 12-bed medical-surgical unit in a small community hospital. Wherever they work, nurse managers may have the following responsibilities:
Adjust unit staffing schedules and ratios
Advance policies and standard-of-care guidelines to ensure high levels of care
Coordinate unit staff schedule
Create or update nursing goals for their unit and a plan to reach them
Deescalate situations with staff, patients, and families
Develop educational plans for staff
Develop nursing staff through continuing education opportunities
Evaluate the performance of nursing staff
Hold staff meetings
Implement disciplinary action
Keep the unit up to date with state and federal regulations
Manage staff licensing requirements and compliance
Manage the unit budgets
Meet and collaborate with CEOs, CFOs, DONs, other unit managers, and nurses
Oversee day-to-day operations on the unit
Recruit, interview, and train new nursing staff
The unit itself serves as a nurse manager’s patient. They must keep a high-level view of all staff, patients, and families to serve each well. In an emergency or mass casualty event, for example, a nurse manager may come in after hours to oversee and assist.
Nurse managers may have a list of tasks and responsibilities they must perform, but they have more non-tangible duties, too. They must keep their fingers on the staff pulse, and be willing to hear complaints and concerns. Nursing staff highly values a nurse manager who truly listens and takes steps to make positive changes.
How Do I Become a Nurse Manager?
A nurse manager can be most effective if they first practice as a registered nurse (RN) for several years. The first step to becoming a nurse manager is to go to nursing school. Candidates must graduate from an accredited nursing program with their Bachelor of Science in Nursing (BSN).
After graduation, RNs need to pass the state licensing exam: the NCLEX-RN. A series of multiple-choice questions, this standardized test shows a nurse’s clinical knowledge and capability to practice in their field.
Nurse managers can get bedside experience in any type of nursing, though they will need experience in the type of unit they apply to lead. One step toward leadership is to become a charge nurse who spends their shift assigning admissions, monitoring all patients and staff, and troubleshooting any conflicts or emergencies.
In another good step toward nurse management, nurses may apply to become assistant nurse managers or nurse educators. These middle managers work closely with nurse managers. In this role, an aspiring nurse manager can learn a lot from their leader and are often the first choice when the position above them opens up.
Some nurse managers get a Master of Science in Nursing (MSN) or Master’s in Healthcare or Business Administration (MHA/MBA). This level of education is not always required, but many facilities list it as a preferred qualification. Master programs typically take two years to complete if full-time hours can be devoted to them.
The American Organization for Nursing Leadership has approved a few advanced certifications for nurse managers: the CENP and CNML. The Certified in Executive Nursing Practice (CENP) certification is designed for nurse executive positions. Applicants must have:
An active unrestricted RN license
A Master’s in Nursing with two plus years of experience in an executive nursing role OR
A Bachelor in Nursing (BSN) and four years of experience in an executive nursing role
The Certified Nurse Manager and Leader (CNML) certification is designed for nurse managers. Applicants must have:
An active unrestricted RN license
A BSN degree or higher with two plus years of experience as a nurse manager OR
A non-nursing bachelor’s degree with three years of experience as a nurse manager OR
An associate’s degree with five years of experience as a nurse manager
How Much Does a Nurse Manager Make Per Year?
Because nurse managers work in management roles, they can earn more than bedside nurses. The US Bureau of Labor Statistics (BLS) reports the average salary for nurse managers is $127,980 as of 2022. This amount can vary depending on the work setting and the cost of living in the area. The low-end average was $64,100 and the high-end was $209,990. Depending on the type of facility, an employer may be able to offer higher or lower compensation:
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
Salaries also vary depending on which state a nurse manager works in. The west coast generally pays nurses the best, but they also have a higher cost of living.
The top-paying states for nurse managers are:
New York: $171,620
District of Columbia: $156,870
New Jersey: $153,300
Massachusetts: $152,450
Delaware: $150,840
The top-paying cities for nurse managers are:
Dalton, GA: $172,490
New York-Newark-Jersey City, NY-NJ: $172,320
San Francisco-Oakland-Hayward, CA: $171,610
California-Lexington Park, MD: $171,180
San Jose-Sunnyvale-Santa Clara, CA: $165,140
Trenton, NJ: $162,390
Bloomsburg-Berwick, PA: $159,920
Boston-Cambridge-Nashua, MA-NH: $159,130
Janesville-Beloit, WI: $158,710
Rochester, NY: $157,380
Certified nurse managers can be paid more than those who aren’t certified, depending on the facility. In general, the more experience and proof of expertise, the more a nurse manager will be able to earn.
What Are the Benefits of Being a Nurse Manager?
A nurse manager has the power to make their unit the best place to work and receive care. In management, nurses have more say over big decisions. They can advocate for their staff to improve staffing ratios, introduce better equipment to the unit, and provide a listening ear.
The workday as a nurse manager can be less physical than a bedside nurse: a good option for someone who needs to take a less active role. Nurse managers usually work normal business hours and rarely have to work on holidays or weekends. They also have the opportunity for better financial compensation. Nurse managers don’t have to stop at the level of unit leader. They can continue climbing toward the goal of higher executive roles, like directors of nursing.
Are Nurse Managers in High Demand?
Nurse managers are in high demand, and the demand is set to grow. According to the BLS, there were 480,700 medical and health services manager jobs in 2021. The BLS expects this number to increase by 28% by 2031, much faster than the average position. Healthcare in the United States is a profitable industry, and new hospitals are being built all the time. With each new hospital will come new units and the need for nurse managers.
Additional Resources About Becoming a Nurse Manager
To learn more about becoming a nurse manager, these additional resources may help:
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