Career Profile: Working as a Chief Nursing Officer

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Chief Nursing Officers are responsible for the overall operations of patient care services and nursing staff.

Chief nursing officers (CNOs) work in executive leadership positions and are responsible for the overall operations of patient care services and nursing staff. In this multifaceted role, CNOs develop budgets, assist with administrative issues and maintain compliance with local, state and federal regulations.

As the chief nursing executive, CNOs quickly learn what being an effective nurse manager means and how to meet ever-changing needs in the healthcare system. Today, nurse executives are heading up a range of medical institutions, from individual hospitals to large-scale healthcare systems with associated acute-care facilities, surgery centers, home care and rehabilitative services.

MedScape, in an article titled, “So You Want to Be a Chief Nursing Officer?,” said CNOs prompt change within facilities because of their knowledge and expertise of nursing and the entire healthcare system.

“Nurse executives are able to influence the work environment of nurses and other disciplines as well as the retention of employees in the facility or system,” author Laura A. Stokowski, RN, wrote in the article. “They can empower frontline and junior management level nurses and other healthcare professionals to construct the solutions to barriers that may stand in the way of the twin goals of a satisfied and healthy workforce and quality patient outcomes.”

Indeed, becoming a CNO takes hard work, dedication and a solid foundation as an RN. The foundational work includes earning a Doctor of Nursing Practice (DNP) degree from an accredited nursing school, including an online DNP program. Unlike the research-based Ph.D. in nursing, a DNP education allows RNs to become experts in clinical care and the business of nursing. The recently introduced Executive Nurse Leadership and Health Care Management track offers a greater focus on the executive aspects of nurse leadership.

Skills Needed to Work as a CNO

Peggy Gordin, CNO and vice president of patient care services at St. Louis Children’s Hospital, said the path to becoming a nurse leader is the same for many RNs.

“Typically, the nurse will become the CNO for a large healthcare facility or organization first and be recognized as someone who is a strategic asset to the organization and who sets standards for quality in patient care,” Gordin told MedScape. “The CNO who moves from organization to systems will be someone who has the financial skills to understand budgets and appreciate the challenges inherent in today’s economic environment.”

At the same time, the American Organization of Nurse Executives (AONE) said RNs who hope to work as CNOs should possess these competencies:


CNOs should be able to communicate to staff, patients and outside entities. Communication includes understanding the diverse needs of staff and patients and building positive relationships that effectuate conflict resolution.

Knowledge of the healthcare environment

In addition to possessing an in-depth understanding of clinical practice, CNOs are expected to understand the economics, governance and policy of healthcare.


CNO leadership does not just include managing staff and demonstrating authority. Leadership includes implementing systems thinking and succession planning for the future of an institution and its workforce.


CNOs exhibit professionalism by developing personal and professional accountability, helping staff and patients thrive and upholding ethical principles. CNOs act as advocates for staff and patients.

Business skills

From budgeting to human resources, CNOs should understand the inner workings of healthcare systems. Other business skills include understanding information technology and strategic management.

In addition, CNOs need interpersonal skills that allow them to quietly and reflectively listen and act. Gordin said a successful chief nurse executive “has the ability to ask questions or deliver a challenging message in a way that people can hear it.”

CNO Salary Outlook and Education

With such extensive job duties, CNOs work long hours with a lot of responsibility. According to, CNO compensation can be commensurate to years of experience, with the range between $91,000 and $210,000. The average salary is $127,964. An entry-level CNO with less than a year of experience can expect to earn $111,255, while a CNO with 10 to 19 years of experience can expect to receive $129,518, PayScale said.

Gordin said healthcare organizations are increasingly looking for CNOs who have a foundational leadership education.

“If you are young and think leadership is in your future, you should think about the doctor of nursing practice (DNP) in healthcare administration or healthcare systems leadership. Doctoral-level education is already a requirement for CNO positions in some organizations and will be mandatory in the future,” Gordin said.

Through Duquesne University’s online DNP program, RNs can advance their careers to work as CNOs. The program provides faculty mentors and is 100% online so that busy professionals can advance their careers with minimal interruption to their personal lives.

Earning an Online Doctor of Nursing Practice at Duquesne University

Duquesne University’s online DNP program prepares RNs to work at the highest level of clinical leadership and to improve care and medical practice.  The program offers concentrations in three areas of study: Transcultural Nursing, Forensic Nursing or Nursing Education.

The program offers two tracks to meet the needs of aspiring nurse leaders: Clinical Leadership and the recently introduced Executive Nurse Leadership and Health Care Management option. A Post Master’s Executive Nurse Leadership and Health Care Management track is also available.

The online DNP program is tailored for students who seek rigorous academic training and professional development from the nation’s leading medical experts.  For more information, contact Duquesne University now.




So You Want to Be a Chief Nursing Officer?: Medscape

Nurse Executive Competencies: AONE

Average Chief Nursing Officer (CNO) Salary: PayScale