As medicine has grown increasingly complex, so too has nurse management, leaving nurse managers with greater responsibilities than ever. As supervisor of the nursing team, a nurse manager presides over nursing staff, oversees resource management, and handles a growing number of administrative tasks. They also field concerns and complaints from patients and families. And on top of that, they still provide direct patient care when the unit is short-staffed.
The certified nurse manager role is an evolving one, so the nurse manager of tomorrow may be asked to handle even more—or a totally different set of—responsibilities. What that means is that you should keep an open mind after reading this article. Different hospitals and health networks ask different things from their nursing managers and other nurse administrators.
What most nurse manager positions have in common, however, is that they pay quite well. Various sources put the average nurse manager salary somewhere between $65,000 and $85,000. The best-paid nurse managers can earn $116,000, which is a lot more than the average registered clinical nurse earns.
That sounds like a lot, but it may not feel like enough considering the extent of your responsibilities when you become a nurse manager. You should also be aware that less-experienced nurse managers with master’s degrees sometimes earn less than senior RNs with associate’s degrees, even though they’re doing a lot more.
Only you can decide whether the work is worth the wage. In this article that answers the question ‘What does a nurse manager do?‘, we cover:
Nurse manager positions can be found in every clinical setting where registered nurses, critical-care nurses, and nurse practitioners work. This includes:
Health administration undergraduates sometimes start out in admissions, marketing, risk management, managed-care analysis, or other non-clinical staff positions and work their way into higher-level administrative roles. While it’s possible to work in healthcare administration without an MHA, it can take a lot longer to climb the managerial ladder without a master’s degree. (
According to the most recent data from the Bureau of Labor Statistics, as of May 2018, the median wage for health service managers was $99,730 per year, with the highest 10 percent in the field earning over $182,600 in base pay. Employment opportunities for health services managers is expected to grow by 20 percent by 2026. This growth is much faster than growth for other occupations. ( )
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Being a nurse manager involves more than just overseeing staff nurses and making sure that nursing practices, procedures, and policies conform to facility rules. When you become a nurse manager, you’ll have a hand in everything that happens in your department or unit. If there’s a dispute between two nurses, it will be your job to mediate it. If there’s a crisis, the nurses you manage will look to you for guidance. If facility administrators or the chief nursing officer have concerns about patient safety, they will ask you to explain what nurses are doing to mitigate risks.
Nurse managers are responsible for:
Doing all this and more isn’t easy. The hardest part of a nurse manager’s job may be balancing the different needs of patients, unit staff, and facility administration. Each of these groups will bring their concerns to you, and those concerns can be very different. You’ll have to balance budgetary limitations with your desire to give patients every possible comfort, and then there are your staff’s needs as well. Studies clearly show that some nurse managers thrive on the complex nature of this role while others actually end up getting sick because the role is so stressful.
Some nurse managers care for patients when an extra pair of hands is needed, but most nurses who work in administration don’t see patients every day. If you became a nurse because you love providing clinical care and interfacing with patients, this probably isn’t the role for you. And if you were considering becoming a nurse manager because you were hoping for more autonomy, this also might not be the right role. Nurse managers are leaders, but they are leaders who answer to everyone from hospital executives to doctors to nursing staff to patients and their families.
Most hospitals and other healthcare settings have a clearly defined organizational structure in the nursing department. Nurse managers are close to the top of the nursing hierarchy, but there are other, higher-up leadership roles in nursing. A nurse manager might report to the director of nursing in some workplaces or directly to the chief nursing officer at other facilities.
In turn, many nursing professionals report to the nurse manager, including:
The nurse manager may also oversee the work of:
A nurse manager’s day is often longer than a staff nurse’s day, and their to-do list is usually longer, too. On any given day, a nurse manager might face a calendar packed with scheduled meetings. Before they attend any of those meetings, however, they’ll review everything that happened during the previous shifts and then review messages from nurse executives, doctors and specialists, and other employees in the unit. There are always problems to be addressed, questions to answer, and administrative tasks to complete (e.g., scheduling), so if there’s time before the first meeting of the day, the nurse manager might try to address some of them.
The meetings the nurse manager attends each day will be different. They might involve advocating for better staff conditions or discussing a hard-to-treat patient. A nurse manager may also have to meet with a patient’s family to talk about concerns they have about their loved one’s care or mediate a dispute between two RNs in the unit.
In between meetings, a nurse manager might answer emails, keep working on the staff schedule, brainstorm ideas for policy or process changes, or chat with an LPN about professional development prospects.
Nurse manager Antonio Vazquez Barrero describes his role and his typical day like this: “I often feel like the director of an orchestra, responsible and accountable for the individual sound of every instrument and every nuance. I know that by looking after the individual, collectively, a beautiful sound will emerge…” While “the rewards may not always be immediately evident… patient care is always at the forefront of my mind. This makes me wake up and return each day and try to do my best.”
Hospitals and other facilities that employ nurse leaders may or may not treat nursing management and nursing administration as separate disciplines. Some medical offices have a nurse administrator on staff who does everything listed above—or performs tasks more similar to those handled by health services managers. When facilities treat nurse manager and nurse administrator as two separate roles, the nurse manager is usually responsible for overseeing RNs a single unit, while the nurse administrator is responsible for running a group of units, an entire hospital, or even nursing operations at multiple facilities.
To do all they do, nurse managers have to know nursing inside and out. The highest level of education required to become a nurse manager is technically a bachelor’s degree in nursing (BSN). You can still join the nursing profession with nothing more than an associate’s degree in nursing. Still, most employers want candidates who apply for management positions to have at least a BSN, if not a master’s in nursing (MSN).
If you think you’d like to explore careers in nurse leadership, make sure you’re looking at Bachelor of Science in Nursing programs that are accredited by the American Association of Colleges of Nursing (AACN) or National League for Nursing(NLN). After you take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam administered by the National Council of State Boards of Nursing (NCSBN) and have your degree, you can start working as a licensed nurse.
Most nurses spend five or more years working in direct patient care before making the transition to management. During this time, RNs with associate’s degrees may complete RN-to-MSN nursing programs like those at:
Continuing education is part of all careers in nursing, and most nurse managers pursue certifications. The number one certification for nurse managers—the Certified Nurse Manager and Leader (CNML) credential—is offered by the American Organization for Nurse Executives(AONE). There are also other certifications for nurse managers, including:
Nurse manager isn’t a terminal position in nursing administration; there are many opportunities for advancement. The most obvious positions awaiting an ambitious nurse manager are nursing director and chief nursing officer (the terminal executive nursing role). Be aware that these roles can involve even more stress and frustration. The top brass in the nursing department is often responsible for overseeing multiple units, sometimes at multiple facilities.
If doing that (along with everything else we’ve outlined above) sounds energizing instead of exhausting, however, chances are good that you’ll thrive in this multifaceted role. Nurse Renate Ilse did, and later wrote about her experiences—both the good and the bad—summing up her time in the role this way: “My years as a front-line nurse manager were some of the most interesting and rewarding I’ve experienced in my career. I developed skills and content knowledge that still serve me well today. [Working as a nurse manager] made me a better person and leader.”
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