By Richard Hader
Is Being a
Chief Nursing Officer
in Your Future?
It is expected that nearly 55 percent of nurse leaders will
be retiring from their positions within the next decade
(Hader, Saver and Steltzer, 2006). This will leave a
tremendous void but it will also mean that outstanding
leadership opportunities will be within the profession of
nursing. You may want to consider a career in nursing
management if inspiring and leading others appeal to you.
It is never too early to begin planning for a long-term
career in nursing. If you think you might want to someday
lead your colleagues or a healthcare organization, the
time to start planning is when you are a nursing student.
NSNA IMPRINT | www.nsna.org 33
IS BEING A CHIEF NURSING OFFICER IN YOUR FUTURE?
What opportunities are is patient and family-centered will result The CNO must ensure the continued
in high patient satisfaction and increase advancement of the profession of nurs-
available in nursing the likelihood of patients returning to your ing by identifying and articulating the
management? organization for future care. Financial vision and strategic direction for the
There are several levels of nursing solvency is critical to the success of the discipline of nursing and collaborating
management positions based upon the organization. If there is not a positive on the implementation of strategies to
type of services that the health care profit margin, the institution will be achieve them. As the senior spokesperson
organization provides. Relative to your unable to fulfill the mission of delivering for nursing, the CNO must provide
experience, educational preparation, and health care to the community. leadership and direction for the devel-
leadership attributes, there are exciting opment of strategies to promote the
and challenging career opportunities at Director Level recruitment, retention, and recognition
each level. A nursing leader at this entry-level of excellence in nursing that are consis-
position into executive leadership has tent with the mission, vision and values
Entry Level responsibility for several departments of the organization.
An entry level management position or a clinical service line. This position
is usually at the supervisory or assistant requires extensive knowledge of the
What does it take to
nurse manager level. To be qualified for health care environment in order to
this position, you will typically need plan, develop, implement and evaluate be a nursing leader?
2-3 years of experience in the clinical strategic operations of the institution. There are four major components
area that you desire to manage. At this A global understanding of the operations to preparing yourself for a leadership
level of the organization, expert clinical of the healthcare organization is essential position in nursing: knowing yourself,
skills are required as the role necessi- your experience, your educational
tates managing the daily operations of preparation, and your work ethic.
a department. The front line supervisor (Hader 2007)
should display an in-depth understand- Being a nursing Know yourself: Ask yourself these
questions: Are you a take-charge individ-
ing of the clinical area learned from past
experiences; understand what to expect in leader is one of ual? Do you like to plan and implement
particular situations; and modify actions strategies to improve the way work is
and goals in response to these events.
the most fulfilling accomplished? If you answered “yes”
then you are on your way to preparing
The supervisor must also act as a
clinical resource to colleagues in the
professional roles yourself for a leadership position.
care of a particular patient population. in nursing. The best way to gain a better under-
standing of yourself is to ask a trusted
Nurse Manager friend or peer to critically evaluate your
This middle management role is the strengths and weaknesses. A friend or
leader of a particular clinical department for success. The leader is responsible colleague may enlighten you on some
and is responsible for the business unit for coordinating the development and of your own personality characteristics.
24/7. The leader assumes the role simi- implementation of recommendations Ask them how you are perceived by
lar to that of the chief executive officer and strategies to initiate new programs others. Do you have the ability to gain
of a small company who is responsible and improve current services. This results consensus when there are disagreements
for overseeing five key areas: personnel, in better outcomes and increased market between groups?
quality, service, business growth, and share and profitability. Objectively conducting a self analy-
financial solvency. The leader has the The Chief Nursing Officer (CNO) sis is paramount to success as a leader.
ability to hire staff best suited to meet is the highest ranking administrative Leadership requires innovation, the
the strategic and operational needs of nurse in the organization. The CNO is ability to take risks, good communication
the department. He/she must develop responsible for the practice of nursing skills and a passion to achieve excellence.
strong professional relationships and throughout the organization by ensuring Without these fundamental characteris-
trust among the staff. consistency in the standard of practice tics it will be very difficult to sustain
The quality of the care that is deliv- across all clinical settings. As a member the pressures and responsibility of a
ered to patients within their department of the executive team, the CNO supports leadership role.
is of paramount importance to the nurse and facilitates an interdisciplinary team Experience: It is never too early to
manager. The leader must develop and approach to the delivery of care. This gain leadership experience. As a nursing
implement a quality infrastructure that includes creating a nursing environment student, you should strongly consider
insures that patients are receiving the in which collaboration is valued and being an active member or board
highest quality of care at all times and excellence in clinical care, education, member of the local, state, or national
without exception. Ensuring that the care and research is promoted and achieved. nursing student organization. Active
34 JANUARY 2009
Choose the Role That’s Right For You
Role Experience Required Educational Preparation
Supervisor / 2-3 years in the I RN licensure
Assistant Nurse clinical area I BSN preferred
Nurse Manager 3-5 years in the I BSN required
clinical area I MSN preferred
I National certification in nursing management
Director 5-7 years of practice I MSN or master’s degree in health or
business related field
I National certification in nursing management
Vice President, 7-10 years of practice I MSN or master’s degree in health or
Chief Nursing business related field
Officer I Doctorate in nursing preferred
I National certification in nursing management
involvement in these professional that is a university affiliate or a teach- make changes that intrude on your free
organizations develops your ability to ing hospital, a doctorate in nursing is time to benefit the organization?
understand the global perspective of typically required. To enhance your
nursing. Understanding the issues in the qualifications, there are a variety of Life as a Leader
profession will stimulate you to begin to fellowships and certifications available Being a nursing leader is one of
develop strategies to improve the level through professional organizations. the most fulfilling professional roles in
of care provided to the community. Work ethic: Leading others requires nursing. The role provides you with
Networking with nurses who hold a strong commitment and long work opportunities to be creative, build rela-
leadership positions helps build a coali- days. Leaders need to be available to tionships, network with colleagues from
tion of colleagues whose guidance you their staffs. You will often have to throughout the country and, often, the
can seek as you begin your professional sacrifice time that would otherwise be world and make a significant impact
career. It is through this process that spent with family and friends, personal on the care that is delivered to patients.
you will likely find a mentor whom you obligations or interests. Days are often The position can be challenging; but the
can rely upon to help build your career extended to late evening hours to benefit of participating in the creation of
as a nurse leader. attend meetings, functions, and events an environment in which nurses can do
Education: It is essential that you to represent the organization. Clarify their best is very rewarding.
attain a graduate degree in nursing with your potential employer what the Start now to develop your career as
administration, business or health care. expectations of the position are beyond a leader. Get involved, network, choose
Undergraduate education in nursing the normal workday. Does this time a mentor and become actively engaged
does not provide the necessary informa- commitment fit into the needs of your in your professional organization!
tion or develop the skill set necessary to personal life? Are you prepared to
be successful as a nurse leader. There
are a variety of graduate programs to
choose from and many offer a dual
references Dr. Richard Hader is the
Hader, R., Saver, C. and Steltzer, T. (2006). Sr. Vice President and
degree in both nursing and business No time to lose. Nursing Management, (37), 7., Chief Nursing Officer for
administration (leading to both an p. 23-29,48. Meridian Health in Wall,
MSN and an MBA). The combination NJ. In addition, he is the
Hader, R. (2007). Are you prepared for your role as Editor-in-Chief of the
of these two credentials provides you a CNO? Nursing Management, (38), 3. p. 43-44. Nursing Management
with theoretical knowledge which can journal. He is also a past
easily be applied in the work setting. NSNA Vice President
If your intent is to lead an organization (1984-1985).
NSNA IMPRINT | www.nsna.org 35