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Nurse Executive Career Overview

Keith Carlson, BSN, RN, NC-BC
Updated March 28, 2024
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Nurse executives fulfill important roles as nursing leaders within healthcare organizations of all sizes. Learn what nurse executives do and how you can become one.
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median annual salary

median annual salary$101,340SOURCE: U.S. Bureau of Labor Statistics

Nurse executives are nursing leaders who use their knowledge and experience to guide various healthcare-related organizations toward success. For a nurse seeking a position of responsibility, increased earning power, and the ability to inspire and make decisions, this can be an exciting and fulfilling career path with countless possibilities.

Nurse Executive Career in Brief

Nurse Executive Certification
Nurse Executive Advanced Certification
Executive Nursing Practice Certification

A nurse executive can differ from managers. They use skills in leadership, operations, finance, human resources, communication, collaboration, and big-picture thinking to guide healthcare-related organizations to success.

Roles may include chief nursing officer, director of nursing (DON), or chief executive officer. Such a leader may supervise a number of individuals and interact with other executives, department heads, and boards of directors if serving in the nonprofit sector.

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Where Do Nurse Executives Work?

Common workplace settings for nurse executives include hospitals, clinics, home health agencies, nursing schools, community health, and many other settings.

  1. 1


    In the hospital setting, the nurse executive may serve as chief nursing officer, nursing director, or nurse administrator. Skills include an understanding of patient care in the hospital setting, collaboration with other disciplines, and compliance with regulatory bodies, such as The Joint Commission.

  2. 2

    Assisted/Independent Living

    In these settings, the nurse executive may serve as chief nursing officer, nursing director, or nurse administrator. Skills involve having familiarity with the needs of patient (especially the elderly and those with living disabilities), managing multidisciplinary collaboration, and an understanding of the financial aspects of running an organization.

  3. 3

    Home Health

    Nurse executives may serve as chief nursing officer, nursing director, or nurse administrator. Skills include knowledge of the field of home health, compliance with regulatory bodies, and the management of a multidisciplinary workforce.

Why Become a Nurse Executive

Serving as a nurse executive can be an interesting, intellectually stimulating, and a satisfying career path. This role can also demand a great deal, with high-level responsibility for many aspects of an organization’s 24/7 operation, such as the management and oversight of a large community of employees.

Advantages to Becoming a Nurse Administrator

  • check-circlePositive patient outcomes
  • check-circleA guide to helping a healthcare organization to success
  • check-circleof $101,340Median salary
  • check-circleProfessional satisfaction

Disadvantages to Becoming a Nurse Administrator

  • x-circleHigh levels of responsibility (for example, budgets, human resources, strategic growth, regulatory compliance, etc.)
  • x-circleWork-related stress
  • x-circleDifficult not to bring work home
  • x-circleAlways feeling like you must have all the answers
  • x-circleFeeling distanced from direct patient care
  • x-circleAround-the-clock responsibilities

Step 1: Earn a bachelor of science (BSN) degree.

Earning a BSN degree from an accredited nursing university provides the grounding in clinical skills, leadership, research, and critical thinking that every nurse needs as an entry to the profession.

Step 2: Pass the NCLEX exam to receive a registered nurse (RN) license.

Passing the National Council Licensure Examination (NCLEX) is the initial gateway to becoming a licensed nurse and embarking on your nursing career.

Step 3: Earn a master of science in nursing (MSN) or doctoral degree.

Licensed RNs can begin logging clinical nursing hours. Graduate nursing programs and certification organizations may require specific hours or years of work experience.

A doctorate (also known as a terminal degree) confers upon the recipient the highest level of nursing education. A doctorate in nursing can be helpful in terms of marketability and credibility in a competitive field.

Step 4: Pass a certification exam.

Certifications that a nurse executive can choose to pursue are nurse executive certification, nurse executive advanced certification, and executive nursing practice certification. Certification can increase marketability, knowledge, and expertise.

Step 5: Get board certification (optional).

Earning the designation of board-certified nurse executive and becoming a respected nurse leader identifies that you are an ambitious individual dedicated to achieving advanced knowledge and expertise.

How Much Do Nurse Executives Make?

Although the BLS does not differentiate among various types of nurse leaders in its data beyond “Medical and Health Services Managers,” in general, there is a projected 32% job growth between 2020 and 2030, which is considerably faster than other industries.

Indeed.com reports that the average salary for a director of nursing in the U.S. is $91,640 as of April 2022, whereas the BLS states that $101,340 is the median salary for medical and health services managers. At the same time, Salary.com reports the median salary for a chief nursing executive as of April 2022 to be $243,400.

This disparity may reflect how each website chooses to classify and categorize various nurse leadership positions.

Frequently Asked Questions About Nurse Executives

question-mark-circleWhat does a nurse executive do?

A nurse executive uses skills in leadership, operations, finance, human resources, communication, collaboration, and big-picture thinking to guide healthcare-related organizations to success.

question-mark-circleHow much do nurse executives make?

Salaries range from $91,640 for a director of nursing, according to Indeed in April 2022, to $243,400 for a chief nursing executive, according to Salary.com in April 2022.

question-mark-circleHow long does it take to become a nurse executive?

If an individual chooses to pursue both a BSN and an MSN degree, the length of the educational journey could be at least five years. This includes general education and prerequisite undergraduate courses.

The certification process typically does not take more than a few months if the applicant has completed the required continuing education hours and other requirements.

question-mark-circleIs a DON (director of nursing) a nurse executive?

Yes, the DON is considered a nurse executive.

Resources for Nurse Executives

  • American Organization for Nursing Leadership

    Formerly known as the American Association for Nurse Executives, AONL focuses on “the professional development of nurse leaders through innovative and competency-based learning experiences.” It offers online and in-person services for nurse leaders of all kinds, including but not limited to, executives, nursing directors, nurse managers, and clinical leaders.
  • American Nurses Association

    As the flagship national nursing organization, the ANA seeks to champion nurses through advocacy, education, outreach, certification pathways, and a large network of affiliated state-based nursing associations.
  • American College of Healthcare Executives

    Membership in ACHE is highly regarded within the healthcare community. It currently has 48,000 members from all types of executive healthcare leadership roles. Nurse leaders can stand out by getting the ACHE certification called Fellow of the American Colleges of Healthcare Executives.
  • Organization of Nurse Leaders

    ONL’s mission is “to advance a culture of health through excellence in nursing.” The organization “works in full collaboration with local and national professional healthcare organizations to promote excellence in nursing leadership, and by extension, high-quality and high-value patient care.”

Related Careers

Page last reviewed April 24, 2022

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