How to Become a Chief Nursing Officer

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Top view of medical professionals reviewing paperwork at a table with coffee and a tablet.Chief nursing officers (CNOs) work in executive leadership positions and are responsible for the overall operations of patient care services and nursing staff. While they don’t directly work with patients, the work associated with this multifaceted role impacts the level of care patients receive. 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. This is handled through a wide range of fundamental tasks, including developing budgets, providing aid with various administrative issues and maintaining compliance with local, state and federal regulations.

Because of what they do, CNOs play an important role in a wide range of healthcare-related environments, from individual hospitals to large-scale healthcare systems with associated acute-care facilities, surgery centers, home care and rehabilitative services.

The road to becoming a chief nursing officer requires hard work, dedication and a solid foundation as a registered nurse (RN). The foundational work can include earning a Doctor of Nursing Practice (DNP) degree from an accredited nursing school. A DNP education allows RNs to become experts in clinical care and the business of nursing and can ultimately help them make a significant impact on a healthcare facility’s ability to deliver optimal care for their patients.

Chief Nursing Officer Requirements

Because the role is integral to healthcare facilities’ functioning, there are several chief nursing officer requirements and steps to prepare for them. These steps are designed to build an individual’s knowledge and skills to prepare them to oversee a healthcare facility consistently as its needs and government compliance requirements evolve.

  • Become an RN: Students should first pursue an undergraduate degree in nursing –—normally a bachelor’s or associate degree. They must then pass the NCLEX-RN examination to become licensed as a registered nurse.
  • Advanced Education: A master’s degree is the typical minimum requirement to pursue a CNO position. However, earning a terminal degree like a DNP can optimize students’ knowledge level and skill set. This could potentially open up more job opportunities, as some employers may prefer to hire someone with a doctorate degree.
  • Work Experience: CNOs often first gain several years of hands-on experience in other nursing roles, such as RN roles. This experience is crucial for learning how to apply academic knowledge to real-world practice. It can also help RNs establish a professional network, which can be important as their careers grow.
  • Certification: Aspiring CNOs may choose to gain certification. This can be achieved by passing an exam such as the nurse executive certification (NE-BC) exam offered by the American Nurses Credentialing Center. The certification lasts for a finite period of time and must be renewed at the end of the appointed timeline.

Chief Nursing Officer Skills

A large part of becoming a chief nursing officer is cultivating the required skill set to be successful in the role. Those considering this career path should have the following chief officer nursing skills:


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 policies of healthcare.


CNO leadership does not just entail 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.

Interpersonal Skills

CNOs need interpersonal skills that allow them to quietly and reflectively listen and act. This quality can enable those in the role to interact in a way that meets others at their level rather than the other way around. This could be especially valuable when delivering a challenging message.

Chief Nursing Officer Salary

With such extensive job duties, CNOs work long hours and have a lot of responsibility. According to PayScale, CNO compensation can correlate with years of experience, and ranges from around $95,000 to around $202,000. PayScale reports the median annual chief nursing officer salary is around $135,800 as of 2021.

The Importance of a DNP Degree

Nurses have long held influential positions in providing patient care. However, the evolution of the healthcare industry has provided a wealth of unique opportunities for nurses to step up and be leaders at an unprecedented scale. For instance, the COVID-19 pandemic has highlighted the dire consequences stemming from the ongoing physician shortage, and exposed healthcare vulnerabilities and access disparities across the country, particularly in rural areas. These issues can be mitigated by skilled advanced nursing professionals who not only can administer patient care but can oversee its effectiveness as well.

Earning a DNP can help students become chief nursing officers who deliver a high level of patient care even in difficult times. By applying their DNP-honed skills toward a facility’s operational and administrative processes, they ensure greater efficiency and effectiveness within the facility. This can potentially spell the difference between exemplary and suboptimal patient care.

Preparing Executive Nurses for Leadership Through the DNP Program

DNP nurses are moving beyond traditional leadership roles and into more senior executive-level positions that carry the responsibility of overseeing the development, implementation and execution of legally compliant health policies and practices. Nurses with a DNP degree are expected to analyze current healthcare policies and develop new policies that shape healthcare financing, regulation and delivery.

DNP nurses have the opportunity to develop their expertise through DNP programs that provide extensive study in:

  • Working with vulnerable populations
  • Fiscal and human resource management
  • Emerging technologies
  • Developing educational policies

DNP students also can explore other factors that affect leadership, including:

  • Leadership Style: Comparing leadership models, such as authoritarian leadership and Magnet certification leadership
  • Evidence-Based Management Practices: Embracing evidence-based practice and strategizing about its use in management practices
  • Collaboration: Working with teams to achieve the goals of an organization

With their specialized expertise, graduates of a DNP program should be prepared to:

  • Effect change through the implementation of policies within a healthcare system composed of varying constituents
  • Assume leadership roles as an educator, administrator or advanced clinician
  • Demonstrate accountability in nursing standards for patient care
  • Use advanced skills in healthcare facility management
  • Analyze critical indicators in a healthcare system or provide multidisciplinary leadership
  • Understand research findings and translate them into practice

Be a Force in the Future of Healthcare

A CNO is a steadying presence amid the ever-changing world of healthcare. By leaning on the knowledge and skills honed through a DNP program, CNOs can provide guidance and deliver efficiency in a wide array of healthcare environments. Ultimately, they can be instrumental in influencing a healthcare facility’s ability to provide care that can improve patient outcomes.

For individuals interested in how to become chief nursing officer, Duquesne University’s online DNP program can be an important step. The curriculum is designed to equip you with the skills and knowledge necessary to be a fearless leader in healthcare, ready to tackle whatever challenge is around the corner. Learn how Duquesne University can help you achieve your professional goals.

Recommended Readings

Finding a Work-Life Balance as a Nurse Leader

The Future of the DNP Degree

Top Concerns for Nurse Leaders


American Association of Colleges of Nursing, DNP Essentials

American Nurses Credentialing Center, Nurse Executive Certification

Association of American Medical Colleges, AAMC Report Reinforces Mounting Physician Shortage

Houston Chronicle, Function & Responsibilities of a Chief Nurse

Incredible Health, “A Beginner’s Guide to Nursing Ranks”

Incredible Health, “What Is a Chief Nursing Officer?

Indeed, How to Become a Nursing Officer in 5 Steps

Indeed, “What Is a Chief Nursing Officer and What Do They Do?”

The National Academies of Sciences Engineering Medicine, Infographic: The Future of Nursing

PayScale, Average Chief Nursing Officer (CNO) Salary

Rural Health Information Hub, Healthcare Access in Rural Communities