Before discussing the necessary skills of nursing leaders, let’s pause to better understand the services they provide and the functions they perform.
According to the American Nurses Association (ANA), nurse executives (also known as chief nursing officers) are senior administrators in the field of nursing. Often the highest-ranking nurses in a particular organization, they manage teams and facilities with a dual focus on operational efficiency and quality patient care.
Nurse executives have become a crucial piece of any healthcare system. Common responsibilities of these professionals include:
As of April 2025, Payscale reports that board-certified nurse executives earn an average base salary of $150,000 per year, and ZipRecruiter notes a similar average of about $156,000 for chief nursing officers.
According to the United States Bureau of Labor Statistics (BLS), medical and health services managers (a category that includes nurse executives) earned a median annual wage of $117,960 in May 2024. This is a notable increase from May 2021, when the BLS listed a median salary of $101,340 per year. Additionally, the employment outlook for healthcare managers is distinctly positive — with a 29% projected growth rate from 2023 to 2033 (significantly faster than the national average for all jobs).
Nurse executives are leaders who must be able to guide organizations and motivate teams. Below are just a few core skill sets for nurses with leadership aspirations:
From tailoring messages to fit specific audiences to choosing the right methods for delivering those messages, nurse executives must master a broad range of communications skills. They ideally will also develop high emotional intelligence to better understand others and interact with them in a positive, productive way.
When you make decisions based on the sound analysis and evaluation of available information, you are in a far better position to address professional issues and capitalize on opportunities. This means that effective decision-making and problem-solving are essential for a successful administrative career in nursing.
Even if they possess excellent communication, interpersonal, decision-making, and problem-solving skills, nurse executives may flounder if they don’t focus their efforts on a set of clear, measurable, and attainable goals. Take the time to hone an aspirational vision and create a strategic plan to get you there.
Nurses who become administrators do not leave their clinical knowledge behind. Read on to examine how nurse executives continue to use that knowledge to lead daily operations and manage regulatory compliance.
Many nurse executives rise to prominence within a particular area of specialized practice. Their clinical expertise in this practice area will inevitably serve them well as administrators.
As the healthcare industry news and analysis provider Fierce Healthcare puts it, “A clinician’s training is grounded in leveraging data and science to manage patients.” When a nurse executive uses sound clinical insights to make administrative decisions, healthcare organizations and their patients tend to benefit.
The paths from clinical practice to executive leadership are as varied as the professionals who take them. However, a good shift nurse will often make a good nursing administrator. From handling numerous tasks at once to thinking clearly in times of crisis, many of the general skills of the practicing nurse can prove equally beneficial in the executive boardroom.
Nursing clinical expertise and general healthcare knowledge are also invaluable when it comes to managing government regulations and establishing clear ethical standards.
Healthcare is heavily regulated, and healthcare providers face significant penalties for breaking the law. Aside from overseeing regulatory compliance, nurse executives are uniquely poised to further the best interests of patients.
As the peer-reviewed article “The Evolving Role of Nurse Leadership in the Fight for Health Equity,” states, “Nurse leaders play a crucial role in the nation’s goal of achieving health equity for all.” The ANA echoes this sentiment, contending that “strong leaders in nursing are vital to help navigate the constant evolution of healthcare” and that nursing executives “serve as role models and influence health care organizations at all levels.”
Healthcare is a serious industry that can make the difference between life and death. Failing to meet official regulations can land professionals in legal trouble. Furthermore, certification through a respected industry authority can open doors career-wise for a nurse executive, so it is important to note the accreditation requirements of those authorities.
Professional financial oversight is one area of business administration that doesn’t always come naturally to the average shift nurse. If your work history doesn’t include skills such as budgeting, billing, risk management, and asset allocation, you will want to hone these competencies as you advance your career as a nurse executive.
Effective budgeting and resource management are key to success in nearly every area of nursing administration.
Organizations of all kinds have limited resources (money, supplies, and the like) to devote to their range of activities. In the healthcare arena, effective resource allocation can make a tremendous difference in critical patient outcomes. According to research in the Applied System Innovation journal, nurse executives must commonly contend with “various challenges associated with limited resources regarding staff shortage; staff and patient time slots and scheduling; and equipment.”
To effectively allocate resources as a nurse executive, you must first be able to plan for that allocation with a sound financial budget. This may involve prioritizing certain facilities and/or services.
In addition to planning a budget that supports effective asset allocation, nurse executives must be able to work within the larger world of healthcare finance, which typically involves interaction with insurance providers.
While all organizations must generate income to survive, healthcare organizations need to pay equal attention to patient outcomes and well-being. This has led to the dual notions of cost-effectiveness and return on investment (ROI) in the healthcare industry. Both cost-effectiveness and ROI center on saving money on healthcare operations and procedures. When taking cost-effective measures, nurse executives measure patient health outcomes against the expenses associated with various treatment interventions. In contrast, return on investment focuses exclusively on profitability and can often prioritize financial returns over patient benefits.
In terms of finances, the healthcare industry is fueled by payments from the insurance industry. This has led to billing and reimbursement processes that are highly complex. Nurse executives must learn to navigate these processes and understand the underlying financial risk that goes along with them.
As the highest-ranking nurse in a healthcare organization, a nurse executive can oversee large numbers of nurses and nursing managers. A large part of the profession revolves around capitalizing on the talents of these nursing teams and effectively delegating tasks to their individual members.
Before you can manage the team of your dreams, you must build it. A good nurse executive must be able to recruit the best professionals for each staff position. It is also vital to provide appropriate compensation and promote a workplace culture that allows you to retain the talent you recruit.
Beyond offering the right salary and benefits to attract top talent, nurse executives will want to actively recruit through educational institutions and digital outreach. A great way to partner with a college or university is to establish an internship or clinical partnership. By reaching out through social media and other online channels, you can promote your organization to potential employees and establish it as a trusted healthcare source.
After building your healthcare team, you must ensure that they work well together. Here are some general tips for promoting effective collaboration in the healthcare industry:
We have previously identified task delegation as an essential skill for nurse executives. Drawing upon their clinical experience and their team management experience, they must be able to facilitate constructive work among professionals from different disciplines.
From compromise and competition to accommodation and avoidance, there are numerous different ways to address the conflicts that inevitably arise within teams. A good nurse executive will strategically choose the right conflict resolution approach for the situation at hand. Even when teams are working well, leaders can manage dynamics to make them work even better.
High-performing healthcare teams flourish when cultural competence and community representation are prioritized. Nurse executives must help ensure that their teams reflect the diverse populations they serve. Fostering an inclusive environment through intentional recruitment and training, healthcare organizations can better meet the varied cultural needs and expectations of both patients and caregivers. Investing in initiatives such as cultural competence training, multilingual resources, and community outreach programs not only improves patient care outcomes but also strengthens team cohesion and morale — empowering staff (and patients) from all backgrounds to feel valued and supported.
The healthcare field is always poised on the cutting edge of scientific advancement. Therefore, nurse executives should be ready to adapt to ongoing healthcare trends.
Nurse executives are uniquely positioned to embrace change and drive innovation in healthcare.
To best serve patients and support operations, healthcare organizations must stay abreast of the latest clinical and administrative developments. This can require commitment due to the rapid evolution of the healthcare industry.
Although you don’t want to rely on new diagnostic and treatment technologies before they are thoroughly tested, you can’t risk falling behind when it comes to providing the most advanced care possible. From workflow management to patient record-keeping, nurse executives should also embrace the right office and operational tech.
By welcoming change and innovation, nurse executives can continually optimize service delivery while reducing workload for team members.
Big data analysis is driving healthcare improvement in countless ways. Patients benefit from data analysis in areas that range from the predictive evaluation of treatment options to the automated scheduling of office visits. Nurse executives can also use information from healthcare organizations and the industry as a whole to enhance general operational efficiency.
Below are a few final thoughts to keep in mind on the road to the administrative nursing job of your dreams.
Let your professional strengths and interests show you the best path forward as a nurse executive. Your unique combination of skills can be tailored to fit any number of leadership roles in a range of clinical sectors.
In addition to choosing the right academic degrees, successful nurse executives seek professional growth throughout their careers via continuing education and certification.
Through our degree and certificate programs, Nebraska Methodist College (NMC) offers numerous paths to becoming a nurse executive. Get started today: Apply to your ideal program online!