Are You a Leader? Become a Nurse Administrator

woman healthcare administrator meets with team of nurses and leaders

Nurse Administrator Career Overview

What you’ll do: Serve as a leader to create policy, oversee nursing staff, and make high-level decisions

Where you’ll work: Hospitals, skilled nursing facilities, doctors’ offices

Degree you’ll need: Master of Science in Nursing (MSN)

Median salary: $104,830

Nursing administration is a fast-growing healthcare field with opportunities for nurses with strong leadership and communication skills and a desire to shape the direction of patient care. Instead of seeing patients, nurse administrators oversee other nurses and make decisions about staffing, budgets, policies, and more.

Nurse administrator is one of a number of nurse specialties, and the term can refer to several roles, including charge nurses, nurse managers, and directors of nursing.  In each of these roles, you’ll combine nursing expertise with business and administrative skills.

“Nurse administrators are in a position where they face complex challenges daily and thrive on driving change and education, leading by example, and showing compassion to the community,” says Amanda Savage, MEd, BSN, RN, a house manager registered nurse at Eastern Maine Medical Center, where she oversees hospital operations and patient care. “The relationships nurse administrators build in this role provide them with lifelong learning, values, and relationships.”

Instead of seeing patients, nurse administrators oversee other nurses and make decisions about staffing, budgets, policies, and more.

Learn more about what you’ll do, what education you’ll need, how much you could earn, and more.

What Does a Nurse Administrator Do?

No matter the job title, nurse administrators lead—creating policy, overseeing nursing staff, and making high-level decisions. Savage says your duties will depend on the needs of your unit or facility and can change quickly.

“The day-to-day responsibilities are vast and ever-evolving,” she says. “Being able to multitask and communicate are essential if one is to be an empowering and successful nursing leader on a daily basis.”

“In one day, you might be expected to drive patient safety, quality improvement measures, and evidence-based practices,” says Savage. “A nurse administrator/nurse leader also needs to balance budgets, hire, train, and engage staff, do performance evaluations, create policy, and ensure compliance.”

Typical Day-to-Day Job Duties

With so many possible duties, you’ll need to be comfortable thinking quickly and addressing unexpected situations as they arise. Here are just some of the tasks you may take on during a typical workday:

  • Interviewing and hiring staff
  • Planning and leading staff training
  • Scheduling staff
  • Supervising staff
  • Giving performance evaluations
  • Managing staff concerns and conflict
  • Handling budgeting and recordkeeping
  • Ordering new equipment for your unit
  • Creating policies to improve patient care
  • Meeting with other administrators and department leaders in your facility
  • Ensuring your facility is meeting safety standards

What’s the Difference Between a Clinical Nurse Leader and a Nurse Administrator?

One of the primary differences between nurse administrators and clinical nurse leaders (CNLs) is the education required for each role.

Education: Requirements for nurse administrators can vary depending on the facility and the position. Most have a Master of Science in Nursing (MSN). At the very least, you’ll need to have earned or be working toward a BSN, Savage says. This scenario would apply to a nurse who has an Associate Degree in Nursing (ADN) and nurse management experience.

“Nurse administrators need to have an RN license and either be actively enrolled or have completed a Bachelor of Science in Nursing (BSN) degree from an accredited institution,” Savage says. “This will help aspiring nursing administrators gain a conceptual understanding of the foundation of the professional nursing practices, policies, and standards that are needed to be successful in this role.”

In contrast, there’s no educational leeway for CNLs. All CNLs must have a master’s degree and Clinical Nurse Leader (CNL) Certification from the American Association of Colleges of Nursing (AACN).

Duties: Beyond education, another major difference is daily job duties. Unlike nurse administrators, CNLs sometimes provide direct care for patients. CNLs also may oversee complex procedures, mentor other nurses, and work to implement best practices by making changes to patient care models and measuring their outcomes.

CNLs and nurse administrators might work together on some of these tasks, but unlike nurse administrators, CNLs aren’t normally involved in executive tasks such as scheduling, budgeting, and hiring.

Types of Nurse Administrators

You can take on several roles under the umbrella of nursing administration, each with different tasks and varying levels of responsibility. For example, while charge nurses manage a shift in their unit, a director of nursing manages the operations of all nursing units and staff in a facility.

Charge Nurse, Nurse Shift Leader, and Nurse Shift Supervisor

Charge nurse, nurse shift leader, and nurse shift supervisor are all titles given to nurses who act as direct supervisors or managers of other nursing staff in a unit. Their responsibilities include:

  • Making schedules
  • Handling staffing matters, including call-offs (when nurses are sent home due to low patient load)
  • Ensuring policies are followed
  • Overseeing patient admissions and discharges
  • Training new staff
  • Reviewing treatment plans

Charge nurses generally don’t provide direct patient care. However, they might step in during an emergency. You’ll find charge nurses at hospitals, nursing facilities, and a variety of other healthcare settings where there are nursing units or teams.

Nurse Manager

A nurse manager has many of the same duties as a charge nurse but also additional responsibilities. On top of supervision and staffing, nurse managers are often in charge of hiring, staff evaluations, and other personnel matters. Plus, nurse managers aren’t just in charge during their shift. They’re responsible for their units at all times. Their duties often include:

  • Improving the quality of patient care
  • Training staff
  • Handling patient complaints and concerns
  • Budgeting and ordering supplies
  • Scheduling, including managing leave requests
  • Responding to crisis situations
  • Working as part of team on complex patient cases

Nurse managers don’t provide direct patient care. However, they might interact with patients to handle concerns or complaints. You’ll find nurse managers across many healthcare settings.

Director of Nursing

Director of nursing is a leadership position that often includes overseeing multiple nursing units. In this role, you’ll be accountable for the care provided by the nursing staff you oversee. You’ll take on numerous responsibilities, such as:

  • Assessing staffing needs
  • Creating job descriptions
  • Planning department budgets
  • Handling staffing issues, including terminations
  • Implementing quality-control and assurance programs
  • Developing department policies
  • Meeting with other facility leaders

A director of nursing plans and implements changes, such as improving patient care and safety. A director can also serve as the face of the nursing department, communicating with other facility leaders, patients, families, and the public.

Chief Nursing Officer

Chief nursing officers work at the executive level in healthcare organizations, using their nursing knowledge to ensure operations are efficient and to balance quality patient care with budgetary and other concerns. They might meet with other leaders to give a nursing perspective on proposed changes and make sure that all changes are in line with nursing best practices. Nurses at the executive level also:

  • Manage new patient programs
  • Improve profit margins for the organization
  • Work with other healthcare executives on new policies
  • Conduct quality assessments
  • Serve as a liaison between other leaders and departments in the organization

There is no direct patient care in this role. In fact, chief nursing officers may spend most of their time in an office setting instead of inpatient care units. However, they still need to be aware of what’s happening in all of the units in their organization. You’ll find chief nursing officers at large healthcare organizations, such as hospital systems. 

Where Do Nurse Administrators Work?

From physicians’ offices to the boardrooms of multi-hospital healthcare systems, you can find nurse administrators in just about any healthcare setting, including:

  • Hospitals
  • Rehabilitation centers
  • Skilled nursing and other long-term care facilities
  • Physicians’ and specialists’ offices
  • Outpatient clinics
  • Mental health facilities
  • Community health organizations
  • Healthcare systems
  • Government facilities

How Do I Choose a Specialization?

You can choose to specialize in nursing administration during your master’s-level coursework. If you’re not going for your MSN right away, you can sometimes take nursing administration coursework as part of your BSN degree.

In addition to administration coursework, it can be helpful to take courses geared toward the kind of unit or specialty you’re interested in. For example, if you want to work as a pediatric nurse manager, it’s a good idea to take classes in both nursing administration and pediatrics during your bachelor’s program.

Helpful Personality Traits and Skills

man shaking hands in meeting

You can probably already guess that it takes leadership skills to be a nurse administrator, but other traits also will help you succeed in this role. High levels of emotional intelligence and critical thinking skills are a must for leaders in a nursing administrator role, Savage says.

“Individuals who hold these positions have good working interprofessional relationships, strong communication skills, and a bedside understanding of how to deliver excellent patient-centered care,” she says.

What Education Is Required?

Your education will depend on the role you want but, in general, it’s best to aim for an advanced degree. While you might be able to find nurse administrator roles with a Bachelor of Science in Nursing (BSN), most employers are looking for nurses with MSNs. Additionally, many employers will want nurses who also have completed postgraduate coursework in nursing administration.

While you might be able to find nurse administrator roles with a BSN, most employers look for nurses with MSNs.

Check out some of the paths you could take toward a nursing administration career below.

RN-to-MSN in Nursing Administration

You can fast track from an Associate Degree in Nursing (ADN) to an MSN in nursing administration in two to three years. This can be a great way to advance your career if you’re currently working as a registered nurse, since many RN-to-MSN programs are designed with working nurses in mind.

You can find these programs both on campus and online, and many schools have full-time and part-time options. Financial aid is often available. Your current employer might even reimburse you for earning your degree.

Nurse Administration Coursework
for an MSN

Much of your learning will focus on business and advanced healthcare. Some common classes include: 

  • Business management
  • Healthcare economics
  • Public health
  • Nursing leadership
  • Healthcare budgeting
  • Nursing administration theory
  • Organizational behavior
  • Quality control
  • Healthcare law
  • Data analysis

MSN in Nursing Administration

You can apply to an MSN program if you already have your BSN. Expect to dedicate anywhere from one to three years earning your degree. Programs are offered both online and on campus. Most programs will involve clinical hours that you’ll need to get in a healthcare setting. This will allow you to get the hands-on experience you’ll need to succeed in nursing leadership.

Dual Master’s Programs

If you’re really ambitious, you might consider earning dual master’s degrees. Combining two advanced degrees can give you an even deeper knowledge of nursing administration and possibly more career options.

Master of Science in Nursing/Master of Health Administration (MSN/MHA)

For nurses interested in gaining a deeper knowledge of nursing along with expertise in administration, an MSN/MHA could be the right choice. This degree can be a strong asset if you’re looking at an administrative role like chief nurse officer or director of nursing.

You’ll need a BSN before you start an MSN/MHA program. Each program will have its own admissions requirements, but both will generally include an unrestricted RN license. You can expect to spend between 18 and 24 months earning this dual degree.

Master of Science in Nursing/Master of Business Administration (MSN/MBA)

An MSN/MBA is a good option for nurses who are interested in the business side of nursing administration and want to work at the executive level, making budgetary and other financial decisions.

Admission requirements are generally similar to MSN/MHA programs. To apply, you’ll need a BSN, an active RN license, and other requirements that can vary from school to school. You can expect to spend between 24 and 36 months earning this dual degree.

Graduate Certificate in Nursing Administration

If you already have a BSN or MSN without a concentration in nursing administration, a certificate can help you achieve your career goals. A postgraduate certificate program can allow you to get the education you need to transition into an administrative role, often starting on a part-time basis. Some programs are designed for nurses with BSNs, while others require at least an MSN. In either case, you’ll need an RN license in good standing before you enroll.

Nurse Administrator Certifications

It’s a good idea to consider earning a credential to demonstrate your education and experience. Certifications can help you stand out to future employers and show you’re dedicated to your career. You’ll need to take an exam and meet some additional requirements to earn a certification. Certifications for nurse administrators include:

  • Nurse Executive-Board Certification (NE-BC) from the American Nurses Credentialing Center (ANCC). You’ll need an active RN license, at least a BSN, and at least 2,000 hours of nursing leadership experience to qualify for this certification.
  • Nurse Executive, Advanced Certification (NEA-BC) from the ANCC. This certification is for nurse administrators who have advanced education and make high-level decisions about finance, strategy, and other matters. It requires at least a master’s degree.
  • Certified Nurse Manager and Leader (CNML) Certification from the American Organization for Nurse Leadership (AONL). Unlike the certifications from the ANCC, the CNML is open to nurses who have an ADN and at least 5,200 hours of nurse management experience. You can also earn certification at the BSN and MSN levels.
  • Certified Executive Nursing Practice (CENP) from the AONL. You’ll need at least a BSN and experience as an executive nurse leader to qualify for this certification.

Nurse Administrator Salary & Job Outlook

Nursing administration is a fast-growing field. In fact, the U.S. Bureau of Labor Statistics (BLS) projects an 28.4% growth in jobs for medical and health service manager roles through 2032. This includes nurse administrators—good news for the many nurses interested in the field.

According to a study by AMN Healthcare, a healthcare staffing company, and the Center for the Advancement of Healthcare Professionals, more than a third of millennial nurses expressed interest in moving into leadership. “For Gen X nurses, the numbers were smaller, with one-fourth interested in leadership roles, while for baby boomer nurses, only 10% expressed interest,” the study found. “However, baby boomer nurses had a much higher percentage of RNs already in leadership positions, compared to Gen X and Millennial nurses.”

The U.S. Bureau of Labor Statistics (BLS) projects 28.4% growth in jobs for medical and health service manager roles through 2032.

That means that now could be a great time to get started if you’re interested in the field. Earning a degree or credential now could put you ahead of the pack for nursing leadership roles down the road.

What’s the Salary Range for Nursing Adminstration?

The BLS doesn’t track salary data for nurse administrators specifically. However, it does track annual salaries for medical and health services managers in general. Take a look at median annual salaries by state:

Medical and Health Services Managers

National data

Median Salary: $104,830

Projected job growth: 28.4%

10th Percentile: $64,100

25th Percentile: $81,430

75th Percentile: $143,200

90th Percentile: $209,990

Projected job growth: 28.4%

State data

State Median Salary Bottom 10% Top 10%
Alabama $82,160 $58,690 $138,770
Alaska $116,920 $71,490 $213,290
Arizona $102,940 $61,980 $203,360
Arkansas $80,330 $53,250 $136,180
California $131,880 $67,250 $219,000
Colorado $120,820 $75,210 $220,570
Connecticut $109,990 $76,870 N/A
Delaware $127,950 $80,270 N/A
District of Columbia $133,050 $82,830 N/A
Florida $101,700 $58,580 $205,330
Georgia $113,060 $63,140 $214,900
Hawaii $117,330 $61,930 $178,230
Idaho $102,560 $59,630 $176,730
Illinois $105,940 $70,620 $213,830
Indiana $96,460 $56,680 $160,810
Iowa $95,380 $65,820 $157,580
Kansas $96,280 $57,930 $164,340
Kentucky $94,180 $57,530 $168,390
Louisiana $98,760 $60,310 $167,140
Maine $99,680 $67,800 $160,430
Maryland $127,390 $78,120 $217,620
Massachusetts $127,020 $76,820 N/A
Michigan $100,090 $58,520 $186,850
Minnesota $102,560 $74,080 $165,280
Mississippi $80,950 $53,800 $134,200
Missouri $100,100 $61,750 $165,970
Montana $96,700 $61,370 $147,730
Nebraska $99,220 $63,940 $171,840
Nevada $101,880 $54,760 $170,450
New Hampshire $132,970 $78,700 $203,770
New Jersey $127,760 $88,790 $226,420
New Mexico $108,050 $72,140 $205,240
New York $138,010 $79,730 N/A
North Carolina $102,910 $67,910 $208,900
North Dakota $106,210 $74,490 $216,530
Ohio $99,890 $61,860 $172,300
Oklahoma $95,580 $60,700 $156,860
Oregon $124,730 $78,020 $222,160
Pennsylvania $103,790 $67,060 $176,280
Rhode Island $128,670 $80,770 $209,510
South Carolina $98,690 $61,670 $187,270
South Dakota $104,940 $77,000 $173,590
Tennessee $98,860 $61,450 $173,510
Texas $102,940 $64,950 $174,270
Utah $99,660 $51,500 $205,450
Vermont $103,790 $67,790 $199,300
Virginia $107,020 $66,980 $182,020
Washington $129,870 $77,220 $215,100
West Virginia $101,770 $56,330 $165,780
Wisconsin $110,010 $79,070 $194,420
Wyoming $100,230 $57,480 $150,800

Source: U.S. Bureau of Labor Statistics (BLS) 2022 median salary; projected job growth through 2032. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.

Your salary will depend on multiple factors, including your education and experience. Where you work also can be a major factor, as this BLS average salary list shows:

  • Nursing care facilities (skilled nursing facilities)—$103,800
  • Home healthcare services—$104,220
  • Physicians’ offices—$126,210
  • Outpatient care centers—$122,870
  • General medical and surgical hospitals—$139,490

How Do Nursing Administrator Salaries Compare to Similar Jobs?

Based on BLS data for health services managers, nurse administrators can make around 49% more than registered nurses, who make a median annual salary of $81,220. With the exception of nurse anesthetists, nurse administrators generally make more than nurses in other advanced positions:

Career Median Annual Salary
Medical and Health Services Managers $104,830
Nurse Practitioners $121,610
Nurse Midwives $120,880
Nurse Anesthetists $203,090
Nursing Instructors and Teachers, Postsecondary $78,580

How to Stay Informed in this Field

You can stay current on emerging trends and issues in your field by joining organizations, subscribing to journals and following social media accounts for nurse administrators. A great place to start is the AONL. This group advocates for nurse administrators, offers continuing education, and provides networking opportunities. Here are some more useful resources:

The Journal of Healthcare Leadership, which publishes peer-reviewed research dedicated exclusively to leadership in healthcare.

The Organization of Nurse Leaders on Twitter, a social media account that provides news about the profession and information about conferences.

The Nursing Management podcast, which interviews nurse administrators about the latest in the profession.

Emerging RN Leader, a blog dedicated to nurses who are pursuing leadership roles.

You can check out our resource page for even more ways to stay informed.

If you’re a motivated leader with great communication skills, a career as a nurse administrator could be a great fit for you. Nurse administrators have the opportunity to help shape policy and create standards for exceptional patient care.

“Nursing leaders are passionate about their patients and staff,” Savage says. “There’s lots of growth opportunities, no matter what educational level you start at. Through utilizing continuing education, certifications, advanced degrees, and professional organizations, nurse administrators are given the opportunity to mentor, lead, and cultivate a culture of caring.”

Written and reported by:

Stephanie Srakocic

Contributing writer

amanda savage

With professional insight from:

Amanda Savage, MEd, BSN, RN

Assistant Professor at Husson University and House Manager at Eastern Maine Medical Center