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Registered nurses who possess master’s degrees along with several years experience in nurse management positions may be qualified to hold the Chief Nursing Officer (CNO) position in hospitals, clinics, nursing homes, and other large medical facilities. Although in some institutions the hierarchy within nursing leadership may include additional higher-level administrative positions, the Chief Nursing Officer title is very often synonymous with other executive leadership titles such as Chief Nurse Executive or Vice-President of Nursing. As the highest ranking nurse administrative position, CNOs work under the direct supervision of the Chief Operating Officer and the general supervision of the Chief Executive Officer of a healthcare organization, while managers and directors report to the CNO.
A proactive mindset and the highest level of competency in all aspects of nursing are among the characteristics a CNO is expected to exhibit, as the ability to respond swiftly, rationally, and decisively to emergencies or other complex situations that might arise within a medical facility is vital to the job. A committment to exceeding the expectations of patients, their families, and facility administrators, as well as a highly developed sense of compassion and dependability are also fundamental to competently filling the role of Chief Nursing Officer. Naturally, CNOs need to possess an aptitude for business and accounting concepts in order to report on and maintain budgetary compliance. With operational costs rising, many hospitals require the expertise of a CNO compentent in the area of cost reduction.
In an effort to ensure that patients consistently receive high-quality healthcare while the institution operates efficiently and remains profitable, the Chief Nursing Officer is responsible for the following:
- Informing all nurses of any new procedure or policy implementations introduced by the healthcare facility’s administration
- Interviewing, hiring, and training nurses and other non-licensed personnel
- Ensuring that work standards, legal procedures and ethical praxis regarding nursing practices are adhered to at all times
- Making recommendations to the CEO concerning procedure or policy modifications when necessary
- Maintaining open channels of communication among nurses and nursing managers in order to enhance operational methods and provide optimal patient care within a medical facility
- Creation and submission of a variety of reports to higher administration recapitulating problems, goals and any pertinent developments influencing the operation of the facility
- Remaining up-to-date with the latest information about products, equipment, and services relevant to the field of nursing and healthcare
- Monitoring job performance of shift nurses, nursing managers, and directors in order to regularly evaluate each nurse and suggest bonuses, promotions, or terminations
- Creating schedules, implementing staff rotations, and enacting rescheduling needs that address the current demands of the medical facility
- Supervising regular education-oriented meetings in which state and federal guideline changes are discussed with nursing staff in addition to any recent developments in the medical field that relates to nursing
- Assisting facility administration with annual budget reports by communicating the necessity for new equipment, additional personnel, or other items that directly improve the operation of the facility
- Maintaining effective infection control procedural protocol that ensures patients and staff are not being exposed to disease-causing organisms
- Overseeing the utilization of in-service educational programs so that the nursing staff remains cognizant of the latest techniques and medical information
- Implementing disciplinary procedures when necessary
- Possessing a deep awareness of the health care needs and difficulties encountered when treating a diversity of individuals possessing different ethnic, social, and cultural backgrounds
Educational Requirements
In addition to a BSN, CNOs most often possess graduate degrees, as this is typically a qualification necessary for obtaining employment in higher-level leadership positions. Employers searching for qualified nurses to fill CNO positions seek candidates who have had at least five years experience in a nurse leadership role. While working in a management position, some nurses may choose to pursue degrees that enhance their knowledge of administrative practices, management, accounting, budgetary analysis, information technology, employee motivational techniques, and successful conflict resolution procedures. The graduate degrees that are commonly held by Chief Nursing Officers include:
- MS Nursing – Management and Organizational Leadership
- MS in Nursing: Leadership in Health Care Systems
- Master of Science in Nursing Administration
Joint programs that combine the Master of Science in Nursing with a Master of Business Administration, or Master of Health Administration are also available:
- MS in Nursing/MBA/Health Care Management
- MBA and MS in Nursing: Nursing Leadership in Health Care Systems (Bridge)
- MS in Nursing/Master of Health Administration
Holding a bachelor’s degree from an accredited institution, as well as an active RN license, is the standard requirement for admission to MSN and MBA programs. Admission may also require letters of reference and an entrance essay. An RN’s clinical experience is also weighed heavily when applying to a master’s program.
Certification
Certification through the American Nurses Credentialing Center (ANCC), the American Organization of Nurse Executives (AONE), or the American College of Healthcare Executives provides Chief Nursing Officers with a number of options for professional designation:
The American Nurses Credentialing Center (ANCC)
- Nurse Executive (NE-BC)
- Nurse Executive, Advanced (NEA-BC)
The American Organization of Nurse Executives (AONE)
- Certified in Executive Nursing Practice (CENP)
- Certified Nurse Manager and Leader (CNML)
The American College of Healthcare Executives (ACHE)
- Fellow of the American College of Healthcare Executives (FACHE)
Job Outlook and Salary Information
The U.S. Bureau of Labor Statistics reports that the job outlook for healthcare leadership positions, including Chief Nursing Officer positions, is expected to increase by 22 percent in the current decade ending 2018.
The Bureau of Labor Statistics (BLS), Occupational Outlook Handbook 2010, showed the median salary among all healthcare executives and administrators to be $84,270, while the median among the 90th percentile was $144,880. The average salary among healthcare executives was $96,030, while top earners in the 90th percentile earned $147,890 on average.
The Bureau’s 2010 report went on to show the average salary for the industry classifications that employed the most healthcare executives:
- General Medical and Surgical Hospitals – $102,040
- Offices of Physicians – $93,770
- Outpatient Care Centers – $92,860
- Home Health Care Services – $85,860
- Nursing Care Facilities – $80,750