A career in nursing doesn't always involve patient care. While nearly all nurses start their careers in clinical work, some eventually choose to move into administrative roles.
One such role is nurse manager. Nurse managers oversee the quality of care, deal with regulatory compliance, handle staffing issues, manage budgets, participate in policy setting, create schedules, and more. In short, they take on just about everything related to successfully running a nursing unit.
It's not an easy job. When you become a nurse manager, you're accountable for everything from the quality of patient care delivery to staff satisfaction and professional development.
Nurses most likely to thrive in this role are well-organized, enjoy doing fast-paced, multi-dimensional work, and feel comfortable taking on the mantle of leadership. Having a strong personality is a must because nurse managers oversee their peers. When you step into this role—particularly when you've been promoted from within—you'll need to maintain firm professional boundaries to make objective (and sometimes tough) decisions for your unit.
In this guide to how to become a nurse manager, we lay out everything you'll need to know to advance into this challenging role. We'll cover:
When you become a nurse manager in a hospital, doctor's office, school system, urgent care clinic, or psychiatric institution, you quickly discover that this role involves more than just managing staff. You'll have your daily defined duties, but you'll also be expected to handle anything and everything that comes your way.
Nursing managers are like mobile command centers. When there's a crisis, the nurses in your unit will come to you. When a nurse goes above and beyond or shows potential for advancement, it will be your job to give recognition or find suitable professional development opportunities. You'll be called upon to advocate for both patients and staff—two groups that can at times be at odds—and you'll answer to administrators at your facility. Staff issues are yours to handle. You'll have budgetary responsibilities and organizational goals to meet.
You have a hand in everything, including:
You'll also work with (and may manage) a diverse list of personnel that includes not only nurses but also:
The most important work you'll do as a nurse manager is to serve as a communications bridge between patients' families, unit staff, and administrators. Everyone will bring their professional and personal needs and concerns to you. You'll have to look at each of those needs and concerns in the context of providing the best possible care. According to the Agency for Healthcare Research and Quality, a branch of the US Department of Health and Human Services, "Nurse managers lead their unit staff in preventing patient harm in their unit, empowering nurses to be the first line of defense against patient harm." That's a lot to take on, and may be why not every nurse aspires to join the ranks of management.
The skills and traits a successful nurse manager needs exceed those required to perform competent clinical care. To become a nurse manager, you'll need:
The first step on your journey to becoming a nurse manager will be to earn a bachelor's degree in nursing (BSN). While you can become an RN with nothing more than an associate's degree in nursing, most employers will require at least a bachelor's degree for management positions.
If you're just starting out and your goal is to become a nurse manager, it makes the most sense to earn your BSN from a school accredited by the American Association of Colleges of Nursing (AACN) or National League for Nursing (NLN).
Once you have your BSN, you can take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam administered by the National Council of State Boards of Nursing (NCSBN) to get your RN license. This is an important step, because before you can advance into the role of nurse manager, you'll need to spend a few years—typically five or more—working in direct patient care.
On the other hand, if you're already working as an RN with your associate's degree, you should look into RN-to-BSN and RN-to-MSN programs. There are on-campus and online RN-to-BSN programs that take just one or two years to complete and can put you on a faster track to management. An RN-to-MSN program might be the better choice, however, if you have ambitions beyond the nurse manager role. This degree pathway takes longer—about three years—but you'll have the nursing education and qualifications necessary to move into higher administrative positions.
BSN holders who aspire to become nurse managers can choose between a Master of Science in Nursing or a Master of Health Administration degree. Some nurses choose dual MSN/MBA or MHA/MBA degrees instead, though you should always consider the cost and workload of any degree program before applying. Dual degree programs typically represent a much bigger commitment of both time and money.
You can become a nurse manager with any of these degrees. It's essential, though, to choose a program that offers a concentration in nursing administration or nursing leadership and allows you to study topics such as:
The main certification for nurse managers—Certified Nurse Manager and Leader (CNML)—is granted by the American Organization for Nurse Executives (AONE). As you advance in your career, you may decide you want to pursue other certifications related to nurse leadership. These include:
Nurse managers occupy many roles, including:
At some point in your career, you may decide you want to advance further. Nurse managers can advance to nurse executive and nurse leader roles, and from there into the position of chief nursing officer (the terminal executive nursing role).
If that's your ultimate goal, you can start working toward it right now by joining the American Organization of Nursing Executives. As a member, you can take advantage of continuing education for aspiring nurse leaders and networking opportunities that will put you in touch with executives currently working in the field.
That depends. If you love providing clinical care and interfacing with patients, it probably makes more sense to look into becoming a nurse practitioner. If your motivation for becoming a nurse manager is money, be aware that the average nursing manager salary is about $85,000— that's less than an NP earns. On the other hand, if you like the idea of exercising more control over your work environment, this career might be a good fit. When you become a nurse manager, you get to be in charge, which can be tremendously refreshing after working in clinical care for years under doctors, nurse managers, and administrators.
The job comes with a warning: front-line management in healthcare can be hugely stressful. As one nurse manager told healthcare leadership coach Renate Ilse: "Everything's my fault. A patient's family complains—I must have screwed up. A doctor yells at a nurse—why didn't I prevent it? Something is stolen—my problem. Power failure—deal with it. Stock out—find supplies! Nurse meltdown? Get her back to work. Then they turn around and tell me all the new metrics we have to meet."
On the positive side, the pay is substantial, and so is the job outlook, and the rewards you'll enjoy in this career add up to more than a steady paycheck. As a nurse administrator, you'll have the ability to potentially improve quality of care for not just a handful of patients, but thousands of patients over time. If you got into nursing to help people, joining the ranks of management is one of the best ways to make a more significant impact.
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