How to Become a Chief Nursing Officer

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Written by Diana Campion, MSN, APRN, ANP-C Education Development Nurse, Content Writer, IntelyCare
A CNO explains how to become a chief nursing officer.

Have you ever wondered how far your nursing career can take you? Do you possess a predisposition for leadership or aspire to hold the highest nursing position in a healthcare organization? If so, then you’ll want to learn more about how to become a chief nursing officer (CNO).

We’re here to provide you with the information you need to know about the CNO role. We’ll cover the responsibilities, the salary, and other pertinent information about this exciting career path.

What Is a Chief Nursing Officer?

A chief nurse officer is an executive leader — usually the highest-ranking nurse — within a healthcare organization, often holding the position of a vice president. While the CNO has a clinical nursing background, they normally don’t provide direct patient care. Their focus is on nursing leadership, operations, and administration.

What Does a Chief Nursing Officer Do?

As the most senior nurse within an organization, the CNO has many responsibilities in managing nursing operations and patient care delivery throughout their organization. Common job responsibilities of chief nursing officers include:

  • Leading and directing nursing staff to ensure efficient workflow with optimal patient outcomes
  • Creating and implementing evidence-based initiatives to enhance the quality and safety of patient care
  • Developing and managing nursing budgets and resources
  • Establishing and enforcing nursing policies and procedures to ensure compliance with government regulations
  • Conducting nursing management reviews to identify areas of success and where there’s need for improvement
  • Collaborating with multidisciplinary leaders to collectively meet the organization’s goals, mission, and vision

Whom Does the Chief Nursing Officer Report To?

As a senior leader within a healthcare organization, the CNO reports to the Chief Executive Officer (CEO) or Chief Operations Officer (COO). In cases where the CNO’s organization is part of an extensive healthcare system, they will likely report to a Chief Nurse Executive (CNE).

What Is a Chief Nursing Officer vs. Director of Nursing?

As you research how to become a chief nursing officer, it’s good to understand the difference between the two top nurse leadership positions. The chief nursing officer holds a higher rank than a director of nursing (DON). However, in cases where a post-acute care facility does not have a CNO position, the DON is the most senior nursing leader for the organization.

The CNO is an executive responsible for the overall nursing operations and management of nursing services. They focus on developing and implementing nursing policies, maintaining compliance, and promoting high-quality nursing care.

In contrast, the DON is a mid-level to senior management position that supervises the day-to-day operations of nursing departments, including staffing and budgeting. The DON reports to and collaborates with the CNO to achieve the organization’s nursing objectives.

Chief Nursing Officer Education Requirements

By now, you are likely wondering, What degree should a CNO have? This is an excellent question. Take a look at the steps involved in pursuing this career path.

Earn a BSN Degree

At minimum, you should have a bachelor of science in nursing (BSN) from an accredited nursing program to become a chief nurse officer. There are different education paths you can take depending on your needs and preferences.

Pass the NCLEX

Once you have your degree, you will take and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Then, you will be ready to apply for and obtain your RN license through your state’s board of nursing.

Optional: Get an Advanced Degree

To remain relevant in a competitive job market, consider obtaining an advanced degree. While currently not mandatory, more employers are requiring a master’s or doctorate to apply for their top nursing position. Degree options include:

  • Master’s in healthcare administration
  • Master’s in business administration
  • Master’s in nursing management or nursing leadership
  • Doctorate of nursing practice in executive leadership

Consider Chief Nurse Officer Certification

Professional certification is not required to become a CNO. However, once you gain experience as a CNO, pursuing a certification in nurse leadership can help you develop in your role. Organizations that offer certifications include:

What Are Some Good Chief Nursing Officer Skills to Develop?

There are a vast array of essential skills a good CNO must possess as an executive nursing leader. Here are some skill sets that you can begin to cultivate during your journey to becoming a CNO:

  • Clinical expertise
  • Cultural competency
  • Emotional intelligence
  • Soft skills (communication, collaboration, etc.)
  • Decision making
  • Compliance and regulations
  • Business management

How Long Does It Take to Become a Chief Nursing Officer?

While exceptions exist, it’s reasonable to expect your journey from nursing school to chief nursing officer to take a minimum of 9 to 12 years. The timeline varies for each person and their unique circumstances.

It’s a good idea to work in a clinical setting for two to three years. Then, you’ll be ready to transition into a nursing leadership role for at least five years before applying for your first CNO position.

Where Can a Chief Nursing Officer Work?

As an executive nursing leader, CNOs can work in various settings within healthcare. Locations include, but are not limited to:

  • Medical centers
  • Healthcare systems
  • Hospitals
  • Hospices
  • Government agencies
  • Health insurance companies
  • Long-term care facilities

How Much Do Chief Nursing Officers Make?

The years of education and hard work are well worth the investment, as this position commands a high salary. The average chief nursing officer salary in the US is $253,300. However, this can range between $216,520 and $294,560 based on the CNO’s level of education, years of experience, job setting, and geographic location.

Ready to Take the Next Step in Becoming Nursing’s Top Leader?

Now that you know how to become a chief nursing officer, you may be looking for more nursing experience to start building the amazing career you want. Get alerts for jobs that can help you climb the ladder from IntelyCare.