Nursing Administration and Healthcare Leadership Job Description

In the past, it was not uncommon for a Unit Level Clinical Director or a Nurse Executive to hold a Bachelor’s of Science in Nursing (BSN) as their highest degree. Many of these individuals earned these positions based on their clinical expertise and innate leadership skills. However, today, most employers require applicants to hold at least a master’s nursing degree.

This enhanced educational requirement results from an expanded role for nursing within healthcare systems. The Future of Nursing: Leading Change, Advancing Health report from the National Academy of Medicine (NAM) (previously known as the Institute of Medicine), stated, in part, that:

• “Nurses should achieve higher levels of education…”, and
• “Nurses should be full partners with physicians and other healthcare professionals in redesigning health care.”

The Magnet Recognition Program offered by the American Nurses Credentialing Center (ANCC) advances this position further. This program established a certification requirement for Chief Nursing Officers to hold a Master’s degree.

Unit Level Clinical Directors are responsible for the day-to-day operation of clinical departments organized by patient care specialty. The organization of departments by clinical specialty varies widely across healthcare organizations. For example, small hospitals may combine multiple related clinical practice specialties into one department, while larger hospitals often organize them into separate departments. For example, the very largest hospitals may have multiple Critical Care departments.

Some hospitals organize their clinical services into specialty departments, each led by a Unit Level Clinical Director. These departments may include:

• Critical Care – Intensive Care Units: Cardio, Medical, Neuro, Surgical,
• Emergency – Emergency, Flight, Triage, Trauma
• Intermediate Care – Step-down, Telemetry, Progressive Care
• Medical / Surgical – General patient population,
• Neurology – Stroke, Brain Disorders, and Neurosurgery,
• Oncology – Cancer, Bone Marrow Transplant (BMT),
• Orthopedics – Spinal, Hip, and Joint,
• Surgery – Perioperative, Operating Room, Recovery, Central Sterile, and
• Women’s and Children’s Health – OB/GYN, Labor-Delivery-Recovery (LDR), Labor-Delivery-Recovery-Postpartum (LDRP), Neonatal Intensive Care Unit (NICU), Pediatrics, and Pediatric Intensive Care Unit (PICU).

Unit Level Clinical Directors fill the middle tier of Nursing Administration and Healthcare Leadership teams. Directors report to the Nurse Executive. Nurse Managers, Supervisors, and other supporting specialists report to the Unit Level Clinical Directors. Unit Level Clinical Directors have individuals who report directly to them from the unit, including:

Unit Level Clinical Directors may also have ancillary staff who are direct reports. This staff may include experts who monitor and analyze aspects of department operations such as:

They align their departments with strategic goals and the newest advancements. Working with peer Clinical Directors, Nurse Executives, and hospital administration, they help develop strategic goals that ensure the success of their department.

Unit Level Clinical Directors are also responsible for their unit’s financial performance and budgets. They must maintain correct staffing levels and ensure the professional standards of their subordinates. Unit Directors build trusting relationships with their nursing staff to develop good teams with little turnover.

Unit Level Clinical Directors usually report directly to a Nurse Executive.

A Nurse Executive leads nursing Administration and Healthcare Leadership teams. Representing nursing services, the Nurse Executive usually reports to the Chief Executive Officer (CEO) or Chief Operating Officer (COO). Depending upon the management structure of the organization, the Nurse Executive may have various titles, such as:

The Vice President of Patient Care Services title reflects the expanded role of senior nursing leadership as healthcare organizations embrace the Continuum of Care concept. This concept is a fully integrated patient care service, with nursing at its center, usually includes Diagnostic Imaging, Infection Control, Laboratory, Patient Education, Risk Management, Pharmacy, Rehabilitation, and Social Services.

The Nurse Executive holds a strategic decision-making responsibility that establishes their position on senior leadership teams, including the CEO, COO, CFO, and CMO. The influence of nursing leadership continues to expand as Nurse Executives begin to fill the CEO and Board of Directors positions in hospitals and healthcare systems.

The influence of nursing leadership will continue to expand as Nurse Executives begin to take Board of Directors seats in hospitals and healthcare systems.

Nurse Executive responsibilities go beyond the usual administrative tasks to include:

• Adopting and adapting models of patient care,
• Cultivating multi-disciplinary and inter-departmental cooperation and communication,
• Monitoring and ensuring patient care standards, including outcomes for quality and safety,
• Mentoring the next generation of nurse leaders,
• Nursing research,
• Physician relations, and
• Regulatory compliance.

As senior leadership team members, Nurse Executives participate in decision-making that establishes the vision and shapes the goals of their healthcare organization. Nurse Executives act as a two-way conduit between Unit Level Clinical Directors and the senior leadership team to ensure the delivery of high-quality patient care.

Healthcare continues transitioning from a fee-for-service to a healthcare delivery model based on population management. This transition requires Nurse Executives to display emotional intelligence and be critical, transparent, creative, and visionary thinkers. They must be problem solvers to identify and organize actions in a rapidly evolving healthcare environment. These attributes bring transformational leadership to the forefront of skills these Nurse Executives need.

There are several degrees or certificate types for individuals pursuing a career in Nursing Leadership:

• Master of Science in Nursing (MSN), Master of Science, Nursing Major (MS-NM), or Master of Nursing (MN) – The master’s degree has been the most commonly offered degree type and is the minimum degree required for Nursing Leadership education. These degree programs are offered widely by public and private schools. The master’s degree in nursing focuses on advanced nursing theory and care practice. Read more...
• Doctor of Nursing Practice (DNP) – This degree prepares the student in much the same way as the master’s degree in nursing. However, the DNP emphasizes using research results to improve their nursing practice. DNP programs also emphasize the application of Evidence-Based Practice to improve the quality of patient care. DNP program graduates can take advantage of new developments in Evidence-based Practice. Read more...
• Post-Master's or Post-Doctorate Certificates – Eligibility is limited to individuals with a graduate-level or doctoral-level nursing degree. For example, someone holding an MSN as a Clinical Nurse Specialist (CNS) would be eligible to enroll in a Nursing Leadership certificate program. Read more...

Degree or certificate titles may include:

These programs generally offer the same course of instruction but may vary in emphasis.

Prospective students should verify that the Nursing Leadership program they chose is accredited. Proper accreditation ensures that graduates are eligible to sit for certification exams.

Use the Nursing Leadership Search Tool to identify programs for this and other degree combinations from our survey of more than 710 schools.

Several nursing organizations offer certifications in nursing administration or management, including:

• American College of Healthcare Executives (ACHE)
  • Nurse Executive (NE), and
  • Nurse Executive Advanced-Board Certified (NEA-BC)*.
• American Nurses Credentialing Center (ANCC)
  • Nurse Executive (NE), and
  • Nurse Executive Advanced-Board Certified (NEA-BC)*.
• American Organization for Nursing Leadership (AONL)
  • Certified in Executive Nursing Practice (CENP)*, and
  • Certified Nurse Manager and Leader (CNML).

* Master’s level degree or higher is required.

Unlike clinical roles such as the Clinical Nurse Specialist (CNS) or Nurse Practitioner (NP), nursing leadership does not require certification and licensing. However, these and other certifications provide nurse leaders with additional knowledge and skills to practice. Furthermore, individuals with certifications demonstrate competence and commitment to their profession.

This site includes a survey of more than 300 certifications in a wide range of nursing and related healthcare areas of specialization.

Nursing Administration and Healthcare Leadership positions are not required to obtain a state license from the state where they work. However, there is no waiver for Registered Nurses (RNs) to become licensed as an RN in their practice state.

States participating in the Nurse Licensure Compact have multistate RN license agreements. This Compact ease the transfer of nursing licenses and the ability to practice among participating states. Participation in this Compact varies by state. Check with your state’s Board of Nursing for more detailed information.

Nursing Administration and Healthcare Leadership positions are not Advanced Practice Registered Nurses (APRN) positions and are not subject to APRN Scope of Practice rules.

Two prominent organizations that provide resources and representation for Nursing Administration and Healthcare Leadership are:

• American Organization for Nursing Leadership (AONL) , and
• American College of Healthcare Executives (ACHE) .

Many nurse leaders belong to other professional associations that provide resources in several areas of clinical nursing and healthcare services specialization. Membership in multiple associations enables Unit Level Clinical Directors to remain current with the latest developments in technologies and clinical practices.

Additional associations at the state and local levels enable members to organize with their neighboring peers to address more localized issues. These associations may be chapters of national or international associations or organized independently.

This site includes an extensive catalog of more than 1,800 international, national, regional, state, and local nursing and related healthcare professional associations. These associations provide resources for life-long professional development and representation in many areas of nurse specialization.