Chief Nursing Officer: How to Climb to the Top of the Nursing Leadership Ladder

The nursing field is constantly evolving along with the entire healthcare industry. Nursing leadership positions are becoming increasingly predominant to ensure that nurses are always offering their highest quality of care. Some of those impactful roles are: Nurse Manager, Director of Nursing, or Chief Nursing Officer.

If you are interested in leadership and want to get to the top level of nursing practice, this article is for you. This comprehensive guide on the Chief Nursing Officer role will answer all your questions about becoming a CNO, salary prospects, employment opportunities, and much more. 

Let’s get started. 

What is a Chief Nursing Officer?

A Chief Nursing Officer (CNO), sometimes called Chief Nursing Executive, is at the top of the nursing hierarchy. It is a non-clinical, administrative position where the jobholder no longer provides direct care to patients but supervises those who do. CNOs are responsible for the level of care patients receive and work toward a crucial goal: to achieve quality patient outcomes. By overseeing RNs, Nurse Managers, Directors of Nursing, and all other nursing staff members, the Chief Nursing Officers actively keep a finger on the pulse of the organization’s smooth-running operations. 

Additionally, they have a birds-eye view over the hospital’s business perspective, planning and coordinating budgets and ensuring that local, state, and federal regulations are followed. Ensuring that the nursing staff’s needs are met and that the organization’s mission, values, and vision are upheld also fall under the CNO’s job description. 

In all, the Chief Nursing Officer has the complex task of creating an environment that fosters nursing excellence.

What Qualities Are Essential for a Chief Nursing Officer?

The fact that Chief Nursing Officers need extensive nursing knowledge and clinical experience goes without saying. But there are more qualities that a CNO needs to possess to be successful at their job. 

Strong leadership skills are at the heart of this practice. While there are many leadership styles, it’s important for CNOs to choose one that involves working with others as full partners in an environment based on mutual respect and collaboration. This type of leadership is scientifically proven to generate improved patient outcomes, fewer medical errors, and less staff turnover. 

 A CNO cannot do without sharp communication skills. They are the primary spokesperson for the nursing staff, so they need to communicate clearly and efficiently with everyone from the bedside to the boardroom. In a healthcare setting, effective communication is the way to identify and achieve common goals and guarantee the quality of care.  

Problem-solving skills are particularly valuable for aspiring Chief Nursing Officers. In hospitals and other medical environments, problems arise daily that do not have easy or singular solutions. CNOs need to display critical thinking and composure under pressure to tackle and solve any problem easily. 

Business skills are another vital addition to the Chief Nursing Officer’s toolbox. The administrative aspects of the job require a business-minded person who can combine their passion for patient wellbeing with organizational management. 

How to Become a Chief Nursing Officer?

The path to becoming Chief Nursing Officer demands hard work, commitment, and determination. All of these need to build upon a solid educational foundation. But before we get ahead of ourselves, let’s take it step-by-step and trace the entire process of securing a CNO career. 

Step 1. Enroll in a Nursing Program

The journey of a thousand miles begins with a single step, and for Chief Nursing Officers, that first step is enrolling in an accredited nursing program. You can opt for an Associate Degree in Nursing (ADN) or a Bachelor’s Degree in Nursing (BSN). Either of these degrees results in licensure as Registered Nurse. Nightingale College’s BSN program, which you can complete in as few as 32 months, will equip you with the evidence-based skills and knowledge required to pass the NCLEX-RN and succeed in nursing practice. 

Step 2. Pass the NCLEX-RN

Completing a nursing program is only the first step. To be fully licensed as a Registered Nurse, you need to pass the NCLEX-RN exam. This comprehensive test puts your nursing knowledge under the microscope and determines your preparedness to become an RN. Once you pass this exam, you’ll officially be a Registered Nurse. Add this important accomplishment to your nursing resume, start preparing for nursing interviews, and move to the third step: acquiring on-ground experience.

Step 3. Get work experience

Some aspiring CNOs may go into an MSN degree immediately after completing their BSN. However, the far more common option is to gain several years of hands-on work experience in an RN role before going back to school. The importance of bedside clinical nursing experience cannot be overstated. It allows RNs to apply academic knowledge to real-world practice. It helps them gain perspective on different aspects of nursing practice. It encourages them to grow a professional network from which they can learn and develop their skills further. These benefits of work experience will prove valuable when you decide to go after a Chief Nursing Officer career. 

Step 4. Consider Certification

Getting certified in management, leadership and/or administration will give you a substantial competitive advantage while also shaping you into a better professional. Some potential certification options for aspiring Chief Nursing Officers include: 

• Nurse Executive Certification (NE-BC) offered by The American Nurses Credentialing Center (ANCC)
• Nurse Executive Advanced Certification (NEA-BC) is also available through the ANCC. 
• You can also become Certified in Executive Nursing Practice. The CENP credential is offered by the American Organization for Nursing Leadership (AONL)
• Nurse Manager and Leader Certification (CNML) is another certification that can be obtained from the American Organization for Nursing Leadership (AONL). 
• Clinical Nurse Leader (CNL) managed by the American Association of Colleges of Nursing (AACN).  

Bear in mind that each certification has its own eligibility requirements that you need to comply with in order to get it. Generally, certifications need to be renewed every three to five years. To renew your credential, you will need to fulfill specific continuing education requirements, which, once again, may vary from one certifying body to another. 

Step 5. Advance your education 

The minimum education requirement for Chief Nursing Officers is a Master’s Degree in Nursing. Generally, prospective CNOs pursue a Master’s program that is focused on Nursing Administration or Leadership, Master of Health Administration, or Master of Business Administration. 

If you are an ADN-educated RN, you can enroll in a bridge RN-to-BSN program to get your Bachelor’s degree. Because it is designed with working professionals in mind, Nightingale College’s fully online RN-to-BSN can be completed within 12 months and will elevate your nursing skills and knowledge while allowing you to continue working. Once you have your Bachelor’s degree, you can pursue an MSN. Some nurses may choose to bypass the BSN step and enroll in an RN-to-MSN degree program. 

Although not yet ubiquitous, some healthcare organizations will require their Chief Nursing Officer to have a doctorate. So, depending on the employer, as well as personal ambitions, it may be worth considering getting your Doctor of Nursing Practice (DNP) degree with a focus on executive administration. 

Step 6. Here you are! 

All in all, it can take up to ten years to become a Chief Nursing Officer. After years of hard work and intense studying, you are finally here, in a top nursing position, ready to elevate your career and the future of healthcare alongside it. It’s time to celebrate your accomplishments, embrace the responsibilities, and start reaping the many benefits that this career offers. 

What Does a Chief Nursing Officer Do?

Chief Nursing Officers have an extensive list of responsibilities covering many aspects of nursing practice. In this section, we’ll break down the duties and tasks a CNO may have to undertake on a daily basis. The job description of a Chief Nursing Officer may slightly differ from one organization to another. Still, for the most part, it will include: 

• Developing strategic plans for the institution by collaborating with senior management, nursing staff, and medical staff
• Advising and establishing alongside senior management compensation wages, retention programs, implementation of best nursing practices
• Ensuring nursing standards of practice are upheld and, subsequently, patient outcomes are improved
• Leading nursing staff and establishing achievable goals for improving the nursing department
• Acting as a spokesperson for the entire nursing department and representing nurses at board meetings
• Overseeing the implementation of recruitment, hiring, and retention processes
• Facilitating opportunities for training and development and professional advancement for members of the nursing team
• Implementing new technologies and practices that can modernize operations and improve the effectiveness of nursing procedures
• Managing budgets and financial assets
• Establishing guidelines and monitoring evaluatory practices
• Creating and updating nursing policy
• Ensuring the organization’s mission, vision, and values are reflected in the day-to-day practices of the nursing staff. 

Where Do CNOs Work?

Chief Nursing Officers can find employment in a variety of healthcare settings. Typically, they work full-time office jobs that adhere to a traditional nine-to-five Monday to Friday schedule. Some exceptions may exist depending on the employer and situation. Some of the most popular places for CNOs to work include:

• Hospitals
• Trauma centers
• Outpatient care centers
• Outpatient surgery centers
• Clinics
• Group physician practices
• Insurance companies’ corporate offices
• Rehabilitation facilities
• Government agencies
• Healthcare system corporate offices

How Much Does a Chief Nursing Officer Make?

The salary benefits are a big selling point for this career path. Due to their extensive training and experience and the fundamental role they play in healthcare organizations, Chief Nursing Officers are some of the best-compensated nurses. 

According to data from ZipRecruiter, as of May 2022, the average salary for Chief Nursing Officers was around $136,250 annually. The size of the paycheck will, of course, vary depending on geographic location, years of experience, certifications, employer, and other factors. In Massachusetts, CNOs can earn up to $147,120. Hawaii and Connecticut are close behind, offering mean annual salaries of $145,704 and $144,880, respectively.

In addition to high salaries, Chief Nursing Officers enjoy excellent job security and outlook. While there is no specific data for CNOs, the Bureau of Labor Statistics indicates that top executives’ overall employment is projected to grow 8 percent from 2020 to 2030. However, the growth in employment for Chief Nursing Executives may be higher considering that the demand for healthcare services is increasing at unprecedented rates. As the large baby-boom population ages and people remain active later in life, the need for healthcare skyrockets. Consequently, more nursing professionals are needed, including competent leaders such as CNOs.  

Are You Ready to Get a Top-Level Nursing Position?

If you want to make a difference in healthcare, no nursing role puts you in a better position to make it happen than that of a Chief Nursing Officer. The job is challenging but equally rewarding –  in more ways than one: professionally, personally, financially. 

So, if you are already envisioning it in your future: leaving the nitty gritty of hands-on patient care and pursuing the highest administrative non-clinical role available for Registered Nurses, you should start working toward it now!

Enroll in Nightingale College’s BSN degree or advance your nursing education with our online RN-to-BSN program. Whichever one you choose, we’ll help you build a strong foundation. And that foundation will serve you well when you’re finally ready to go after that coveted Chief of Nursing Officer job!