How to Become a Chief Nursing Officer

Chief nursing officers (CNOs), sometimes called chief nursing executives, are registered nurses (RNs) with a primary focus on high-level administration. CNOs create policies and processes to maintain compliance, improve patient outcomes, and retain nursing staff. RNs typically need a graduate degree and a few years of supervisory experience before pursuing a CNO position.

This guide explores a CNO’s role, including their daily duties, educational requirements, and salary potential. Learn more about how to become a chief nursing officer.

The chief nursing officer works under the chief executive officer or the president. This executive nursing leadership position manages all operational aspects of a healthcare facility, serving as the link between executive and medical staff. CNOs work in hospitals, outpatient clinics, outpatient surgery centers, and government agencies. They tackle human resource issues and handle fiscal responsibilities. An CNO’s responsibilities include:

Becoming an RN is the first step in pursuing a CNO career, but employers typically require additional educational and credentials. Keep in mind that specific licensing and program requirements for RNs vary by state.

As a minimum education requirement, you need a BSN degree to become a CNO. Larger hospital systems typically require an MSN degree.

An RN license serves as the basic requirement needed to become a CNO. RNs need to pass the NCLEX exam to get licensed in their state or hold a Compact license. To maintain their license, RNs need to keep documentation of their clinical hours, with requirements varying by state. For instance, Connecticut requires renewal every year, and Colorado every two years. While you do not need an APRN license, CNOs may hold an NP license.

Certification is optional for CNOs, unless required by a specific employer. CNOs who hold an RN license and a BSN degree can validate their leadership experiences with credentials from professional nursing organizations such as the American Nurses Association.

Available certifications for CNOs include the Certified Nurse Manager and Leader and Certified in Executive Nursing Practice Certification through AONL. RNs also obtain informatics and nurse executive credentials.

CNOs made an annual average salary of $138,260 as of March 2023, according to Payscale. Many factors influence what you can earn as a chief nursing officer like experience and work setting. For instance, CNOs who have more than 20 years of experience make an average of $154,000 a year, and the top 90% of CNOs earn $214,000 a year.

Hospitals, outpatient care centers, clinics, and physician offices need chief nursing officers. Nurses often find CNO positions through their employers, nursing job boards, and professional nursing organizations.

Becoming a CNO typically takes 8-10 years to meet the typical educational and experience requirements. Earning an MSN often takes 5-6 years to complete. However, graduation timelines vary by student, and if they study part or full time. Many nurses also work for years as RNs and gain management prior to taking on an executive administrative role such as a CNO.

No. CNOs need a background in executive administration and business, but a master’s in business administration (MBA) or master’s in health administration (MHA) is not a prerequisite. But, an MBA or MHA degree can make you a more competitive candidate for a CNO position at larger hospital systems.

Some nurses earn an MBA or MHA in preparation for executive leadership positions. An MBA or MHA degree teaches you about accounting, human resource management, financial management, and marketing, which may provide a competitive advantage over other candidates.

Yes. Candidates who hold a doctorate of nursing practice can pursue CNO positions as long as they meet the experience requirements. CNOs typically need several years of experience managing other nurses.

You need at least a bachelor’s degree, if not an MSN degree, to become a CNO. An MSN program helps future CNOs build nursing executive leadership and management knowledge and skills.