Nursing administration may be best defined as the strategic management of nursing personnel, patient care, and facility resources through the support of regulating policies.
Nurse administrators are responsible for ensuring that hospitals or other healthcare facilities operate in a safe and cost-effective manner. They achieve this through the management of financial and human resources, and through the supervision of nurses and other allied healthcare team members.
In addition to overseeing the nursing staff, nurse administrators are called upon to address and direct any number of projects related to regulatory, quality/safety, community, and financial issues. It is up to nurse administrators to ensure that all activities are efficiently and safely coordinated.
In other words, the job of nurse administrators involves the supervision of both the operations and functions of the nursing staff, as well as overseeing the administrative branch, where they focus on everything from financial aspects to human resources and protocol compliance.
In general, charge nurses are responsible for facilitating the delivery of quality nursing care through the coordination and management of the nursing staff, while nurse managers are responsible for overseeing personnel resources and patient care within a specific nursing unit or division.
Nursing directors oversee several nursing units or a specific area or function, while chief nurse executives establish and control the budget and oversee the implementation of standards of nursing practice and guidelines of care.
Job Duties and Responsibilities of Nurse Administrators
Due to the rapidly changing state and complexity of our nation’s healthcare system, the expertise of nurse administrators serving at the forefront of the nurse leadership team is crucial. They are responsible for addressing any number of issues that affect the function and performance of a nursing team.
As such, their job duties and responsibilities may include:
- Overseeing the hiring, firing, and retention of the nursing staff
- Creating and overseeing budgets and approving spending
- Ensuring compliance with regulatory requirements
- Motivating and mentoring the nursing staff
- Ensuring facility service, budget, and resource records are accurate and current
- Overseeing and reviewing the work activities of the nursing staff
- Ensuring efficiency, cost savings, safety, and patient satisfaction goals are met
- Overseeing staff and administration meetings
- Preparing and presenting reports and data
- Addressing operational issues in a timely manner
- Attending committee and board meetings
- Collaborating with medical and academic partnerships in the community
- Overseeing fund-raising efforts, such as evidence-based research projects
- Overseeing the professional development of the nursing staff
To be successful at their jobs and to display a commitment to the nursing profession, nurse administrators must possess a number of characteristics. In addition to being self-motivated, creative thinkers, nurse administrators must be excellent mediators, they must effectively handle pressure, and they must be able to resolve conflict among team members.
Nurse administrators must have strong leadership skills. They must be innovative and possess excellent interpersonal skills so as to provide leadership to a team of nurses and to fulfill the mission of advancing patient care.
Nursing Administration Scope and Standards of Practice
The ANA’s Nurse Administration: Scope and Standards of Practice (2009) outlines the Standards of Nurse Administration Practice as:
- Assessment: Nurse administrators are able to collect data pertinent to issues, situations, and trends.
- Identifies issues, problems, and trends: Nurse administrators are able to analyze assessment data as to realize trends, issues, and problems.
- Outcomes identification: Nurse administrators are able to identify expected outcomes of a situational plan.
- Planning: Nurse administrators are able to develop a plan that takes planned strategies and alternatives into consideration as to affect specific outcomes.
- Implementation: Nurse administrators are able to implement an identified plan through:
- The coordination of care
- Health promotion, health teaching, and education
- Consultation
- Evaluation
The Standards of Professional Performance takes into consideration that nurse administrators recognize the following:
- Quality of practice: Systemically enhances the quality and effectiveness of nursing practice and nursing services administration
- Education: Attains knowledge and competency that is reflective of current nursing practice
- Professional practice evaluation: Evaluates their own nursing practice in relation to professional practice standards and guidelines and rules and regulations
- Collegiality: Interacts with peers and colleagues as to contribute to professional development
- Collaboration: Collaborates with all levels of the nursing staff, as well as with interdisciplinary teams and executive leaders
- Ethics: Integrates ethical provisions into all areas of practice
- Research: Integrates research findings as to guide practice decisions
- Resource utilization: Considers safety, cost, effectiveness, and the impact on practice in the planning and delivery of nursing services
- Leadership: Provides leadership in the practice of nursing administration
- Advocacy: Advocates for the protection and rights of individuals, communities, families, populations, and healthcare providers related to health and safety
How to Become a Nurse Administrator
Although there is no one path to become a nurse administrator, those who serve in this nursing role generally first earn their RN license, earn a number of years of valuable clinical experience, and then go on to earn a higher nursing degree, such as a Master of Science in Nursing (MSN) with a focus on administration.
Nurses aspiring to enter nursing administration may choose to focus their studies on any number of specific tracks, such as:
- Charge nurse
- Chief nurse executive
- Director of nursing
- Director of patient services
- Nurse manager
While Bachelor of Science in Nursing (BSN) programs provide advanced study in the nursing practice, MSN programs allow students to focus their nursing career specifically on nursing administration. Therefore, the MSN has become the widely accepted educational route to a career in nursing administration.
Many MSN programs for today’s nursing students are designed as RN to MSN programs, which allow RNs with a pre-licensure nursing diploma or Associate Degree in Nursing (ADN) to earn both their BSN and MSN. These bridge programs take into account a nurse’s previous education and experience, thus allowing them to transfer many of the general education and nursing prerequisite requirements. An RN to MSN program may therefore take just 2 to 3 years to complete.
RN to MSN programs also offer flexible schedule options and online study. In fact, a large majority of RN to MSN programs are now offered online. Online courses allow nursing professionals to earn their BSN and MSN at their own pace and on their own time.
Admission and Curriculum Requirements
A typical RN to MSN program requires students to possess a current and unencumbered RN license and a minimum GPA. Other requirements may include a resumé, professional references, and the completion of an interview or essay. Most programs also require minimum GPA requirements for any transferred credits.
The curriculum of an MSN in Nursing Administration draws from both nursing and management/business, thereby preparing students to become staff leaders and leaders within the broader organization. It is common for MSN in Nursing Administration students to complement their studies with business or public services courses.
An MSN in Nursing Administration includes study in leadership, finance, quality/safety, research, and technology, thus ensuring success at any level of nursing leadership and administration.
Graduate requirements for students interested in focusing their MSN study on nursing administration often include courses such as:
- Budgeting for health professionals
- Nursing informatics
- Nursing administration theory
- Nursing administration practicum
Professional Certification Options for Nurse Administrators
Professional certification is the ideal way for nursing administrators to demonstrate that they have acquired a specific level of professional education and experience and are committed to advancing their career.
The American Nurses Credentialing Center (ANCC) offers professional certification designations for nurse administrators as either a Nurse Executive or Nurse Executive, Advanced.
To be eligible to take the Nurse Executive examination and earn the NE-BC credential, candidates must:
- Currently hold an active RN license
- Possess a bachelor’s degree or higher in nursing
- Possess at least 24 months of experience in the last 5 years as a mid-level administrative (nurse manager, director, supervisor, assistant director) or higher position or a faculty position teaching graduate students
- Have completed at least 30 hours of continuing education in nursing administration within the last 3 years OR possess a master’s degree in nursing administration
To be eligible to take the Nurse Executive, Advanced examination and earn the NEA-BC credential, candidates must:
- Possess a current and active RN license
- Possess a master’s degree or higher in nursing OR a bachelor’s degree in nursing and a master’s degree in another field
- Possess at least 24 months of experience in the last 5 years in an administrative position at the nurse executive level or a faculty position, teaching graduate students
- Have completed at least 30 hours of continuing education in nursing administration within the last 3 years OR possess a master’s degree in nursing administration
Both certifications are valid for a period of 5 years.
Nurse administrators working in critical care settings may also choose to become certified as a Certified Nurse Manager and Leader or as a Certified in Executive Nursing Practice, both of which are a collaborative effort between the American Association of Critical Care Nurses (AACN) and the American Organization of Nurse Executives Credentialing Center (AONE).
To be eligible to take the examination and achieve the Certified in Executive Nursing Practice (CENP) designation, candidates must:
- Possess a valid and unencumbered RN license; AND
- A master’s degree or higher, plus at least two years of experience in an executive nursing role; OR
- A BSN, plus at least 4 years of experience in an executive nursing role
To be eligible to take the examination and achieve the Certified Nurse Manager and Leader (CNML) certification, candidates must:
- A valid and unencumbered RN license; AND
- A BSN degree, plus at least two years of experience in a nurse manager role; OR
- A non-nursing bachelor’s degree, plus at least three years of experience in a nurse manager role
Involvement in professional organizations is also a highly regarded activity among nurse administrators:
- American Nurses Association
- American Organization of Nurse Executives
- National Association of Directors of Nursing Administration in Long Term Care
- American Association of Colleges of Nursing
Salaries for Nurse Administrators
The American Organization of Nurse Executives (AONE), in their 2013 AONE Salary and Compensation Study, revealed that about half of all nurse leaders and executives reported a salary of between $80,000 and $130,000, with just 14 percent earning less than $80,000. About 34 percent of respondents in the study reported a salary of more than $130,000, with 13 percent of them reporting between $150,000 and $200,000. Nine percent reported an annual salary of more than $200,000.
The AONE survey also found that nurse leaders with senior titles earned higher salaries than other nurse leaders. For example, directors and managers were most likely (about 84 percent) to earn between $80,000 and $160,000 annually. Just 6 percent of directors and 17 percent of managers earned salaries of less than $80,000.