Nurse managers are registered nurses who have educational qualifications and at least three to five years of clinical experience qualifying them to effectively supervise nursing units in hospitals, clinics, and other medical institutions. Generally, nurse managers are appointed to units compatible with their degree emphasis and clinical experience.
According to the Bureau of Labor Statistics, employment of medical and health services managers is expected to increase by 22 percent during the current decade ending 2020, well above average in comparison to other occupations.
Basic responsibilities associated with nurse manager positions include maintaining sufficient, qualified staff with which to operate the unit, budgeting the unit’s expenditures in accordance with available funds, ensuring patient issues are promptly and correctly addressed, and supervising all other routine operations of the unit, as well as any unforeseen occurrences that may arise.
Nurse management also encompasses features of leadership and administrative methods associated with the broad facets of the nursing profession. As a result of nurse management positions embracing outlying characteristics supplementary to nursing, a nurse manager may also hold the title of nursing supervisor. However, nurse administrator or director of nursing titles usually indicate a nurse who occupies a position of upper management in a hospital or larger clinical setting.
Considered a middle management position in larger medical facilities, nurse managers are tasked with overseeing the continued optimal functioning of the unit as well as the quality of the health care provided by nurses and other medical personnel. Within the hierarchical setting of a medical facility, nurse managers typically report to the nursing director and are considered representatives for the nursing staff and lead shift nurses that report to them. As such, nurse managers must possess the ability to develop stable and beneficial relationships based on trust and communication among all members of the unit.
Other duties expected of nurse managers include:
- Staff performance evaluations
- Creating educational programs to improve patient care
- Overseeing inventory of unit supplies
- Providing representation, mediation, mentoring and feedback services designed to improve the efficiency of the unit and its nurses
- Assisting in the development and implementation of departmental financial resources
- Consistently promote the betterment of staff and patient well-being and satisfaction
- In addition to supervising registered nurses, nurse managers may also be responsible for medical clerks and aide workers, CNAs and LPNs.
- Nurse recruitment and hiring
- Efficiently coordinating patient treatment plans by assigning individual tasks to nursing working within the department
- Implementing disciplinary actions when necessary
They must also keep up with departmental or facility-wide policy changes and ensure compliance with these policies within their department. As a predominantly supervisory position, nurse management requires a candidate to possess strong organizational skills, leadership ability as well as clinical nursing knowledge.
Although some medical institutions allow BSNs to take on mid-level management positions, a graduate degree is fast becoming the standard. Typically, a registered nurse interested in management already has a BSN, then enrolls in a graduate program that focuses on vital aspects of human resources and management concepts such as:
- Accounting techniques
- Management science and theory
- Organizational behavior
- Strategies and concepts of leadership practices
- Management practices and cultural values
- Managerial decision-making and problem-solving strategies
Graduate degrees commonly held by nurse managers include:
- MS Nursing – Management and Organizational Leadership
- Master of Science in Nursing Administration
- MS in Nursing: Leadership in Health Care Systems
Joint-degree and bridge programs are available that combine the Master of Science in Nursing with a Master of Business Administration, or Master of Health Administration. Specific blended and bridge programs include:
- MS in Nursing/MBA/Health Care Management
- MS in Nursing/Master of Health Administration
- MBA and MS in Nursing: Nursing Leadership in Health Care Systems (Bridge)
A bachelor’s degree obtained from an accredited college or university and state RN licensure is required for admission to master’s programs. Admission also typically requires letters of reference, college transcripts, and an entrance essay. An RN’s clinical experience is also taken into consideration when applying for a master’s program.
National certification ensures that those employed as nurse managers have met stringent professional standards concerning healthcare administration and nursing practice, and is a basic criterion for employment through most institutions.
The American Organization of Nurse Executives (AONE) offers two kinds of certifications: Certified Nurse Manager and Leader (CNML) and Certification in Executive Nursing Practice (CENP). The CNML is intended for those in a nurse manager position. The CENP is designed for nurses holding higher-level executive or administrative positions. Benefits of joining the AONE include access to the latest publications and news concerning the nursing profession, comprehensive guides to staff and career development and networking resources. The Certified Nurse Manager and Leader credential was designed in collaboration with the American Association of Critical-Care Nurses Certification Corporation and the American Organization of Nurse Executives. To obtain the CNML credential, potential candidates must:
- Provide proof of a valid registered nurse license
- Provide proof of a master’s degree or higher and at least two years of managerial nursing experience
- Provide proof of having a Bachelor of Science degree in nursing in addition to at least four years of experience in an executive nursing position
- Submit payment to AONE-CC
- Successfully complete the CNML examination
The American College of Healthcare Executives (ACHE) is an international organization comprised of over 40,000 hospital and healthcare executives. The ACHE offers an FACHE (Fellow of the American College of Healthcare Executives) credential that indicates a nurse manager has been board certified in healthcare management. Requirements for inclusion into the FACHE:
- Existing membership with the ACHE
- At least two years of healthcare management experience
- A master’s or doctorate degree
- Passing the Board of Governors Exam
The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association, is the world’s largest nursing credentialing organization. The ANCC offers certifications for nursing leadership professionals that include the Nurse Executive (NE-BC) accreditation, appropriate for nurse managers, and the Nurse Executive, Advanced (NEA-BC) accreditation, designed for those holding upper-level administrative positions.
Requirements for the NE-BC credential include:
- An active RN license
- Bachelor’s degree at minimum
- Two years of mid-level management or management consultation experience in the five years prior to applying
- Thirty hours of nursing administration continuing education in the three years prior to applying (waived for candidates who hold master’s degrees)
According to the Bureau of Labor Statistics, the average annual salary for health and medical service managers as of May 2010, was $84,270, with the top ten percent earning more than $144,000 on average.
The Bureau points out that health and medical service management salaries differ according to size and type of medical facility, and cites an example from the Medical Group Management Association, which states that administrators working in facilities employing six or fewer physicians earned around $86,000. Medical service establishments with more than seven, but fewer than 25 physicians, paid managers $115,000 on average. Hospitals and clinics employing 26 or more doctors paid nurse managers and other individuals in similar roles a yearly salary of approximately $150,000.