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How to Become a Chief Nursing Officer

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If you dream of being in the highest level of nursing and transforming healthcare through nurse leadership, then aim for a Chief Nursing Officer (CNO) position. A few words describe a CNO: visionary, empowering, influencer, self-learner, flexible, leader, integrator. A CNO influences nursing care decisions within an organization that lead to the best possible patient outcomes. Not only are CNOs a spokesperson, operational coordinator and leader for nursing within their organization, but they also have a national platform to transform care everywhere by modeling best practices and supporting nursing initiatives and legislation.

What Is a CNO?

The CNO is one of the highest nursing positions, and these professionals serve on an executive team. Like other C-suite positions, such as Chief Executive Officer (CEO), Chief Operating Officer (COO), Chief Financial Officer (CFO) and Chief Information Officer (CIO), the position of Chief Nursing Officer (CNO) is a leadership role. CNOs work closely with organizational leaders to develop and implement programs in alignment with their mission.

A CNO’s role can expand across all areas in one facility or multiple facilities within a system. Some CNOs cover a single hospital or clinic, others a small geographical region within a state or several states. A few CNOs oversee an entire system across a significant section of the United States. Often, the only higher position than CNO is a nursing executive vice president (EVP). Nurses in these roles oversee several facilities or a large organization with hundreds of hospitals in their network. Examples include Ascension Health (the largest non-profit) or Healthcare Corporation of America (HCA) (the largest for-profit) networks.

What Does a CNO Do?

CNOs represent the voice of nurses. Their primary role is to lead nurses and coordinate all patient care. In addition to planning, organizing and directing the overall operations of nursing (medical/surgical floors, intensive care, operating room, education), many CNOs also cover other departments such as social services/discharge planning, respiratory services, laboratory services, utilization review/risk management, employee health or education.

The position of CNO has many duties but mainly focuses on nursing direction, fiscal responsibility, collaboration and partnerships.

  • Nursing Direction. The CNO is responsible for the direction and oversight of nursing care and actively provides executive leadership to nursing teams. They develop an overall strategic nursing plan, establish standards for nursing practices and maintain authority, accountability and responsibility for nursing services. They determine how nursing care is assessed, delivered and evaluated within the scope of nursing practice. In addition, they are in charge of compliance and quality accreditations.
  • Fiscal Responsibility. The CNO develops and manages the nursing services budget and ensures staffing meets patient needs. They work closely with the senior leadership team to control costs and eliminate waste. In collaboration with the CFO, they plan the budget for personnel, supplies and equipment. They make recommendations for new facilities and equipment to provide the highest quality patient care. Overall, they drive various process improvements, often focused on innovative models of care to improve care delivery and maintain costs.
  • Collaboration and Partnerships. A CNO collaborates with other disciplines to implement programs, policies and procedures to improve services, outcomes and patient safety. They develop vital multidisciplinary relationships within their organization and relationships among their community to improve local health. In addition, a CNO may work closely with nursing colleges and schools to continue recruiting the next generation of nurses and provide educational and leadership opportunities for clinicians.

How to Become a CNO?

A CNO role might be a good fit for you if you are a nurse interested in administrative, leadership or executive work. Most CNOs have a decade or more of leadership experience, with many rising through the ranks of staff nurses, charge nurses, nurse managers, house supervisors, service line managers, multi-unit or multi-service line managers to more senior-level leadership.

Finding the right fit for a CNO role is essential, so many organizations hire executive healthcare recruiters. They help find the best possible talent to meet their needs. Recruiter fees are typically free to the candidate as they are paid to the recruiting firm by the organization.

CNO positions typically require a Master of Science in Nursing (MSN) degree, with a Doctorate in Nursing Practice (DNP) or Ph.D. preferred for more significant roles that cover larger populations. The MSN online program at The University of Alabama in Huntsville can help you better understand the role of CNO and how you might advocate for nurses to improve their day-to-day work, ultimately improving patient care.

Learn more about The University of Alabama in Huntsville’s Master of Science in Nursing – Nursing Administration online program.

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