Nursing is a hierarchical profession, like the military. The privates of nursing—to extend the military metaphor—are licensed practical nurses (LPNs), who handle the grunt work such as bathing patients and cleaning bedpans. Next come registered nurses (RNs), then advanced practice registered nurses (APRNs) and nurse practitioners (NPs). That's when you reach the supervisory level: charge nurses nurse managers, nursing directors, and finally—if an operation is large enough to require one—a chief nursing officer (CNO).
The road to becoming a chief nursing officer is a long and arduous one that passes through many, if not all, of these lower-level roles. This is not a job one gets upon receiving a Master of Science in Nursing or a Doctor of Nursing Practice (DNP) degree. Rather, it is the culmination of an accomplished career. It comes with tons of responsibility and an income appropriate to that level of responsibility. You may even get your own parking space, which—admit it—is pretty cool.
How much does a chief nursing officer earn? In this article on chief nursing officer salaries, we will cover:
The average salary for chief nursing officers is $125,087, according to Indeed. PayScale concurs, more or less, listing the average salary for CNOs at $127,762 per year. In contrast, a nursing manager earns an average salary of $85,503, according to PayScale.
How much you can earn as a chief nursing officer will likely be impacted by where you live. The five highest-paying states for CNOs, according to ZipRecruiter, are:
The bottom five are:
Note that even though CNOs in North Carolina make nearly $45,000 less than the ones in New York, they are still earning roughly double the national average household income. Plus, the cost of living in a state where you can guzzle BBQ sauce for just pennies an ounce is much less than if you live in New York City, where you might need to dip into your pension plan for an egg sandwich. All of these factors should influence your decision on where to practice.
A study by the American Organization for Nursing Leadership lays out some of the benefits that nurse executives receive, as well as the percentage of senior-level management that receives them. The best and most common perks include:
CNOs make great money, albeit not as much as other high-level healthcare executives. According to the New York Times, the average salary for an insurance chief executive officer is $584,000. For the hospital CEO, it is $386,000; a hospital administrator earns $237,000 a year. These numbers don't even tell the whole story since other forms of compensation (such as stock options) can send top executive incomes into the millions.
Chief nursing officer is a managerial position; a CNO oversees the daily operations of a nursing department, working with other healthcare executives to create systems and policies for the nursing team to follow. Some of these professionals include:
Melanie Patterson, chief nursing officer at the CHOC Children's Hospital, uses an evidence-based process to improve patient-centered care. "We encourage a culture of inquiry among our nurses," explains Patterson. "Our Nursing Research and Innovation Council promotes the integration of research and innovation into practice, and facilitates nurse involvement in related activities across the organization."
A chief nursing officer's duties primarily involve creating an environment that allows nurses to excel. Their specific responsibilities include:
Every CNO starts out as a registered nurse (RN), regardless of the type of graduate degree they earn. The traditional route to becoming an RN is to earn a Bachelor of Science in Nursing (BSN) and then pass the NCLEX-RN exam, which qualifies you for an RN license. You may also need to complete additional state certification requirements (e.g., passing a background check).
It is possible to become an RN with just an Associate's Degree in Nursing (ADN), but we don't recommend it if you're just starting out. According to a position paper released by the National Academy of Sciences, "To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates." Translation: most new RN jobs go to BSNs, not to ADNs.
If you already have an ADN, don't fret. There are a number of transition programs that allow RNs to earn their BSN (though, at that point it might be more effective to just attend an RN to Master of Science in Nursing (MSN) program).
If you haven't already realized, a graduate degree in nursing (either an MSN or doctorate) is a crucial step in becoming a head nurse. You will most likely earn one of the following:
There are a few key differences among these programs. Completion time is one of the biggest. Completing a master's degree typically takes two years for a full-time student, longer for a part-timer. A DNP program will take a little longer (three or four years), and a PhD program can take anywhere from three to six years.
An MHA provides more training on the business side of nursing (excellent training for aspiring CNOs), while a PhD is primarily a research or teaching degree, though it does have practical applications.
Certifications can also be valuable to aspiring CNOs, particularly when their background is in applied nursing rather than healthcare business and administration. These include:
If you want to make some money and help individual patients, become a nurse. If you want to improve the working conditions for a nursing staff, have a direct impact on the health of your patients, and make a lot of money, become a chief nursing officer. It's a job that will put you at the pinnacle of your profession. If you have what it takes to oversee nursing operations for a large healthcare concern, it may be a good fit for you.
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