Nurse Executive
What is a Nurse Executive?
Nurse executives play a pivotal role in medical care as they help carry out the mission of their healthcare organization. A nurse executive often holds the most senior nursing position in their place of employment and can even have a title such as Director of Nursing. To be a practical nurse executive, RNs must clearly and effectively communicate with their nursing staff to help provide the best patient care possible. Not only do nurse executives assume social responsibility for instilling change to improve the health of patients, families, and communities as a whole, but they also practice moral and ethical principles while doing so. Nurse executives are considered to be precious members of healthcare management.
In many ways, this high-level nursing role is similar to that of a Chief Nursing Officer, but there are some differences:
| Aspect | Chief Nursing Officer (CNO) | Nurse Executive |
| Role | Oversees nursing operations in a healthcare organization | Leadership role, may span multiple departments |
| Scope | Focused on nursing and patient care | Broader organizational responsibilities |
| Hierarchy | Top nursing position | Varies, can report to CNO or senior leaders |
| Responsibilities | Patient care, staffing, budgeting, compliance | Strategic planning, policy, overall operations |
| Reporting | Reports to CEO or COO | Reporting varies by organization |
| Education | Advanced nursing degree (MSN, DNP) | Advanced degree in nursing or healthcare administration |
| Focus | Nursing practices, patient safety | Organizational strategy, financial management |
| Decision-Making | Nursing-related policies | Broader organizational decisions |
| Certifications | NEA-BC (Nurse Executive Advanced) | NE-BC (Nurse Executive) |
How Do I Become a Nurse Executive?
A successful nurse executive requires a mix of advanced nursing knowledge and savvy business skills. A high-level nursing degree and sometimes even a business degree are typically needed to enter the role, along with substantial nursing experience. To be suited for this high-level position, nurses must have a passion for leadership, excellent interpersonal and communication skills, and a knack for the business side of healthcare.
What Are the Schooling Requirements for Nurse Executives?
To become a professional nurse executive, one must complete a series of steps to be certified ultimately:
- First, obtain a 4-year Bachelor of Science in Nursing (BSN) degree from an accredited nursing school
- It is highly recommended to either double major in business or to take business classes as this position is multifaceted and managerial
- One must then pass the National Council Licensure Examination (NCLEX-RN) and become licensed as an RN
- Upon passing the boards, one must work as a registered nurse, obtaining experience in the field to help identify and find solutions to the issues encountered while working
- Next, obtain a 2-year Master of Science in Nursing (MSN) or a Master's in Healthcare or Business Administration (MHA/MBA). The program generally takes two years to complete. See our list of MSN in Executive Nurse Leadership programs.
- Before applying for certification, it is best to get experience working in an executive role in healthcare, such as a nurse manager, supervisor, director, or assistant director
- The next step is to gain certification, such as the Certified in Executive Nursing Practice (CENP) credential, through the American Organization of Nurse Executives
Are Any Certifications or Credentials Needed?
A nurse executive who manages and oversees an entire nursing staff in a healthcare environment must have advanced certification. While some degree programs may simultaneously prepare students for these certification exams, it is important to meet all accreditation standards, as there are a few exceptions. For instance, if one does not pursue a master’s degree, 30 hours of continuing education credits will be required.
As credentials make a world of difference when applying for nurse executive roles, the more credentials the RN has, the greater the employment opportunities. The American Nurses Credential Center (ANCC) offers two exams: The Nurse Executive and Nurse Executive-Advanced exams. In addition to the ANCC, the American Organization of Nurse Executives (AONE) provides certification credentials that include Certified in Executive Nursing Practice (CENP) and Certified Nurse Manager and Leader (CNML). Read more for further clarification on nurse executive certifications.
What Does a Nurse Executive Do?
Professional nurse executives must possess leadership qualities as they mentor their team. As this field is fast-paced and generally behind the scenes, one must be comfortable assuming a managerial role. Nurse executives promote creativity within a nursing team, demonstrate financial responsibility, provide continuing education courses, and encourage the staff to join national nursing organizations. The roles of nurse executives have expanded from simply focusing on nursing services to a broader overview of patient care within a healthcare system.
Where Do Nurse Executives Work?
Familiar places of employment for nurse executives include:
- Hospitals
- Healthcare organizations
- Home health agencies
- Nursing homes
- Nursing schools
- Consulting firms
What Are the Roles and Duties of a Nurse Executive?
Some of the duties tasked to nurse executives include:
- Designing and managing patient care
- Creating healthcare facility budgets
- Effectively communicating diverse needs
- Bearing the responsibility of financial accountability within healthcare organizations
- Shaping policies related to health and nursing care
- Overseeing the planning and development of policies and procedures for healthcare facilities
- Collaborating with interdisciplinary health professionals
- Advocating for patients and staff
- Developing networks of quality care and wellness
Read more in our Expert Guide to Nursing Leadership
Nurse Executive Salary & Employment
With healthcare constantly evolving, nurse executives must raise awareness and seek new ways to provide services for today and the foreseeable future. With this in mind, the duties of a professional nurse executive will only continue to expand as these nurses assume responsibility for instilling change in healthcare organizations. Nurse executives must continue to learn how to grow to succeed at their jobs by being flexible yet innovative. With advanced nursing jobs increasingly in demand, the overall employment for this type of role remains high.
Certified nurse executives can earn an annual salary of anywhere from $58,000 to over $148,500. Location, place of employment, education level, experience, and many other factors will determine the exact salary.
| Average Annual Salary | |
| Lowest 25% of Earners | $58,000 |
| Median | $93,552 |
| Top 25% or Earners | $120,500 |
| Top Earners | $148,500 |
Helpful Organizations, Societies & Agencies
- The American Nurses Credentialing Center
- American Organization of Nurse Executives
- American Nurses Association for Nurse Executives
- Journal of Healthcare Management
