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How to Become a Chief Nursing Officer

Written by: University of Tulsa   •  Jan 22, 2024
A chief nursing officer leads a meeting of nurses.

How to Become a Chief Nursing Officer

An effective health care organization relies on effective leadership. Although nurses, physicians, and other front-line medical workers are the face of a hospital or health care facility, it takes the skills, knowledge, and competent leadership of administrators like chief nursing officers (CNOs) to orchestrate a workforce capable of delivering high-quality patient care.

As health care executives, CNOs ensure that their facilities maintain a standard of excellence. However, they face considerable challenges. With a constantly evolving health care landscape, strict policies and regulations, and the difficulties of overseeing a large team of clinicians in a fast-paced environment, CNOs have demanding jobs that are integral to the success of their organizations. Their work impacts everything from staff morale to the quality of patient care, making their role one of the key leadership roles in health care. 

Health care workers interested in how to become a chief nursing officer should know that CNOs must have a specific set of hard and soft skills in nursing to be effective in their role. The required skills and knowledge base of a CNO can be developed by pursuing an advanced education, such as a Master of Science in Nursing (MSN) degree

What Does a Chief Nursing Officer Do?

The CNO has one of the most senior positions in any health care system. In addition to overseeing a team of clinicians and administrative workers, CNOs’ responsibilities include: 

  • Improving the quality of patient care
  • Performing audits to eliminate redundancies and cut costs
  • Developing strategies that improve the nursing staff’s performance
  • Ensuring compliance with local, state, and federal laws, policies, and regulations
  • Overseeing the interviewing and onboarding process for new nurses
  • Providing ongoing administrative and clinical training
  • Ensuring the health care facility’s medical equipment and nursing technology remain up to date
  • Overseeing budgets
  • Facilitating collaboration among different departments
  • Serving as the face of the health care facility for public relations efforts
  • Collaborating with physicians and other members of the leadership team
  • Providing nurse mentoring to new nurses beginning their careers
  • Ensuring that the actions of the organization reflect its mission statement, goals, and values

How to Become a Chief Nursing Officer in Four Steps

Most CNOs start as nurses who have acquired the skills, knowledge base, and experience that qualify them for a leadership position. Those researching how to become a chief nursing officer will find that the steps can be broken down as follows:

  1. Aspiring CNOs usually start by earning a Bachelor of Science in Nursing (BSN), obtaining licensure to practice as a registered nurse (RN), and then gaining nursing experience.
  2. Many nurses interested in pursuing leadership positions earn an MSN, a Master of Health Administration (MHA), or a Master of Business Administration (MBA) to develop essential nursing administration skills and knowledge. Not all health care facilities require that CNOs have an advanced degree; however, it can help candidates stand out to employers as leaders.
  3. While certification isn’t required, many nurse leaders earn a credential such as the nurse executive certification (NE-BC) from the American Nurses Credentialing Center (ANCC) to demonstrate they have the skills and competencies necessary to succeed in a health care leadership role.   
  4. To gain managerial and leadership experience, nurses must work their way up the health care hierarchy. Many nurses prove themselves in nurse manager roles or by becoming department directors before being promoted to CNO roles.

In addition, nurses should develop the right set of skills. Successful CNOs possess the following skills and competencies:

  • Interpersonal communication skills
  • Advanced clinical experience and expertise
  • Administrative skills
  • Leadership skills
  • Problem-solving abilities
  • Resilience under pressure
  • Strategic thinking skills
  • Organizational skills

CNO Salary and Job Outlook

In 2023, CNOs had a median annual salary of approximately $141,170, according to Payscale. Top earners made up to $218,000 per year, making this among the highest-paid positions in health care.

The U.S. Bureau of Labor Statistics (BLS) groups CNOs under the umbrella category of medical and health services managers. According to their most recent data, employment in those roles is expected to grow by 28% between 2022 and 2032. This is much faster than the 3% growth the BLS projects for all occupations during that time.

Begin Your Journey to Becoming a Leader in Health Care

Becoming a chief nursing officer requires developing the right skills and competencies, gaining clinical and administrative experience, and learning how to lead a team effectively. Becoming a CNO is challenging, but those who rise to the position have the opportunity to make a positive impact on their organizations through their leadership. Additionally, the CNO career path has long-term stability with a highly competitive salary.

Nurses who are interested in elevating their careers by pursuing leadership roles should explore the online MSN program offered at The University of Tulsa. The program is specifically geared toward developing the essential skills and competencies that nurse leaders need to be effective in their jobs. 

MSN students will engage with a curriculum of core nursing courses, which include:

  • Advanced Theoretical Frameworks of Nursing
  • Research and Evidence-Based Practice
  • Health Care Policy
  • Health Promotion
  • Pathophysiology
  • Pharmacology

Students in the program choose one of four specialty tracks: Leadership and Innovation, Education and Elevation, Public Health Global Vision, and Informatics and Analytics. Future chief nursing officers are encouraged to explore the Leadership and Innovation track, which provides students with the opportunity to learn about budgeting, staffing, and gauging employee performance.

Learn more about how TU can support your professional aspirations of becoming a CNO.

Recommended Readings

A Nurse Educator’s Role in the Future of Nursing

How to Become an APRN

The Most Important Leadership Skills for Nurses


American Nurses Credentialing Center, Nurse Executive Certification (NE-BC)

American Organization for Nursing Leadership, Certified in Executive Nursing Practice Certification

ANA Enterprise, Chief Nursing Officer/Chief Nurse Executive

Houston Chronicle, “Function and Responsibilities of a Chief Nurse”

Indeed, “How to Become a Nursing Officer in 5 Steps”

Indeed, “What Is a Chief Nursing Officer and How Do You Become One?”

Payscale, Average Chief Nursing Officer (CNO) Salary

U.S. Bureau of Labor Statistics, Medical and Health Services Managers

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