What Does a Nurse Manager Do?

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:

• Where do nurse managers work?
• What does a nurse manager do?
• Do nurse managers treat patients?
• Who do nurse managers report to?
• What is a nurse manager’s typical day like?
• Do nurse administrators and nurse managers do the same things?
• How long do nurse managers go to school?
• Do nurse managers usually have certifications?
• How do nurse managers advance?

Where do nurse managers work?

Nurse manager positions can be found in every clinical setting where registered nurses, critical-care nurses, and nurse practitioners work. This includes:

• Doctors’ offices
• Hospitals
• Long-term care facilities
• Military medical facilities
• Nursing homes
• Outpatient surgical centers
• Psychiatric facilities
• Rehabilitation centers
• School districts
• Urgent care clinics
• VA medical centers
• Other healthcare organizations

What does a nurse manager do?

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:

• Managing staff
• Overseeing case management
• Hiring and firing nurses and other staff
• Developing and monitoring department budgets
• Creating or approving staff schedules
• Administering unit patient care practices
• Ensuring patient safety
• Meeting goals related to patient outcomes
• Developing discharge planning protocols
• Making sure that the unit is clean and well-maintained
• Handling resource planning and inventory
• Overseeing education and professional development
• Ensuring that the unit or department is complying with relevant regulations

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.

Do nurse managers treat patients?

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.

Who do nurse managers report to?

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:

• Nurse supervisors
• Head nurses
• Associate manager of nursing
• Assistant nurse manager
• Charge nurses
• Nurse practitioners and advanced practice registered nurses
• Staff nurses and bedside nurses
• Assistant nurses
• Licensed practice nurses (LPNs)
• Licensed vocational nurses (LVNs)

The nurse manager may also oversee the work of:

• Aides and assistive personnel
• Maintenance staff
• Medical technicians
• Nutritionists
• Office staff
• Social workers
• Therapists

What is a nurse manager’s typical day like?

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.”

Do nurse administrators and nurse managers do the same things?

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.

How long do nurse managers go to school?

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:

• Ball State University
• Monmouth University
• Nova Southeastern University
• University of Delaware

Nurses with BSNs can pursue a Master of Science in Nursing, a Master of Health Administration degree, or dual MSN/MBA degrees. Schools offering these options include:

• Indiana Wesleyan University – National & Global
• Jacksonville University
• Johns Hopkins University
• Kent State University at Kent
• The University of Texas at Tyler

Do nurse managers usually have certifications?

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:

• Certified in Executive Nursing Practice (CENP) designation offered by AONE
• Nurse Executive (NE-BC) designation offered by the American Nurses Credentialing Center (ANCC)
• Nurse Executive, Advanced (NEA-BC) designation offered by the ANCC
• Fellow of the American College of Healthcare Executives (FACHE) designation
• Certified Medical Practice Executive (CMPE) designation, which is granted by the American College of Medical Practice Executives (ACMPE)

How do nurse managers advance?

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.”

(Last Updated on February 26, 2024)

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