Nurses compromise one of the largest segments of America’s labor force. In total, the United States employs more than 3.1 million RNs and 695,000 LPNs. There are four times more nurses than doctors, which means they provide the bulk of direct primary and acute health services. Medical facilities need to retain highly educated and experienced nursing staff to ensure excellent patient outcomes. That responsibility is placed on the nurse administrator’s sturdy shoulders. Nurse administrators are upper-level officials who oversee the management of nurses in several departments or an entire facility. Typically, nurse administrators spend more time in meetings reporting to the Vice President and CEO than caring for patients. Nurse administrators are advanced RNs with the leadership acumen to plan, organize, and direct efficient clinical operations.


The Bureau of Labor Statistics clumps nurse administrators into medical and health services management where there’s a median yearly salary of $94,500, or $45,43 per hour. Nurse administrators can expect making around $87,970 at skilled nursing facilities and $92,330 at ambulatory care centers. However, those employed by hospitals earn significantly above-average at $114,180 yearly.

Beginning Salary

Registered nurses earn a median salary of $67,490 each year. When first promoted to nurse administrator, you’ll likely land in the bottom quarter percentile of earnings at $72,510. While this is a salary jump, income grows with experience because senior nurse administrators often bring home over $165,380 annually. According to, becoming the Head of Nursing unlocks an astounding average salary of $210,694.

Key Responsibilities

Nurse administrators are given monstrous responsibility in strategically setting the overall direction for nursing services in their organization. Administrators determine the standards used by supervisors to interview, hire, retain, evaluate, and discipline nursing staff. It’s essential for nurse administrators to ensure nursing treatments align with legal and ethical regulations. They actively establish and update policies that keep services at peak performance. Nurse administrators will collaborate with physicians and other clinicians to ensure comprehensive patient treatment. Other important duties include being a nurse role model, promoting quality improvement, encouraging innovation, providing professional development, and maintaining financial stability. Nurse administrators strongly influence the configuration of functions in nursing departments.

Necessary Skills

Stepping into the nurse administrator’s shoes will require strategic management skills to coordinate a safe, efficient clinical community. Nurse administrators need leadership ability to motivate LPNs and RNs to achieve their optimal performance. Communication skills are a must because administrators speak regularly to executives and nurses under their direction. Team-building, interpersonal, and mediation skills with a compassionate attitude is vital. Nurse administrators should be creative thinkers with the problem-solving skills to handle pressures placed on departments. Being detail-oriented and organized helps nurse administrators keep meticulous records of policy changes. Other executive-level skills like decision making, conflict resolution, mentoring, and budgeting are also important.

Degree and Education Requirements

The path to becoming a nurse administrator begins with RN licensure. Most states allow individuals to be registered nurses with a diploma, associate, or bachelor’s degree in nursing. Keep in mind that nurse administrators must have at least a Bachelor of Science in Nursing (BSN) from an accredited college before advancement. Online RN-to-BSN programs can be helpful for progressing your education. Employers are increasingly preferring master’s degrees for nursing administration titles. Attend graduate school to receive a MSN with a concentration in management. Job prospects can heat up for those pursuing dual degrees like a MBA or MHA. Earning a Doctor of Nursing Practice (DNP) may be necessary for chief leadership.

Pros and Cons of the Position

Nursing administration is a career thousands of nurses strive for, but the promotion comes with both advantages and drawbacks. Let’s begin with the positives and state the obvious – nurse administrators are among the highest paid nurses in medicine. Six-figure salary potential comes with excellent benefits and even bonuses. Jobs in healthcare are always growing, so nurse administrators enjoy a recession-proof career. Variety is available for nurse administrators to choose their workplace in virtually any state. They also receive gratification from making the necessary decisions and changes that meet patient needs. However, nurse administrators report above-average stress to avoid mistakes that could impact lives. Younger administrators are typically placed on the back burner because advanced education and experience is prized. Nurse leadership means little direct patient care, which is likely why you initially chose nursing.

Getting Started

Entering the boardroom as a nurse administrator won’t happen overnight. This upper-level position will require plenty of hard work and sweat starting in college. Nurses should capitalize on every opportunity for clinical practicum and internships. After earning an ADN or BSN, fulfill your state’s licensing requirements by passing the NCLEX-RN exam. Going the extra step to become certified in basic life support is suggested. Staff nursing jobs provide entry for gaining essential experience. Most nurse administrators spend at least five to 10 years at the bedside. While working full-time, you can attend graduate school during evenings or online for an MSN. Hospitals and other facilities often offer leadership training workshops that could prove vital. Although voluntary, consider pursuing ANCC certification as a Nurse Executive (NE-BC). The required 30 hours of continuing education could bolster your administrative career.

Future Outlook

For decades, the United States has dealt with a deficient of qualified nursing staff. Labor experts project that the critical shortage will reach dire levels by 2024 though. More than 1.2 million vacancies are expected to emerge for RNs. One major reason is there are more people above 65 years old than ever before. Aging adults are seeking medical treatment, and older nurses are reaching retirement age. Nearly 700,000 nurses will likely retire over the next decade. The BLS states that employment in nursing administration will spark by 17 percent! More than 150,000 nurses are graduating each year though. Competition will remain significant for senior-level jobs in hospitals, physician offices, surgical centers, ambulatory care, residential facilities, home health, and more.

Overall, nurse administrators are ambitious, responsible leaders who establish goals for improving performance of their healthcare organization. Administrators create the business strategies to nurture nursing staff and streamline clinical operations while driving a profitable bottom line. Nursing administration plays a significant role in guiding successful RN and LPN practice in various specialties from gerontology to pediatrics. Becoming a nurse administrator can lead to executive titles like Nursing VP, Director of Nursing, and Chief Nursing Officer.

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