How Do I Become a Nurse Administrator?

According to the Bureau of Labor Statistics (BLS May 2022), there were 3,072,700 registered nurses (RNs) and 632,020 licensed practical/licensed vocational nurses (LPNs/LVNs) in the American workforce. According to the American Association of Colleges of Nursing (AACN), nursing is the nation’s largest healthcare profession and an indelible part of how American healthcare operates.

While most RNs and LPNs are on the front lines of healthcare taking vitals, creating and implementing plans of care, and assisting MDs, some nurses actually take a step back from patient care in order to complete the necessary administrative tasks that support nurses and keep vital healthcare services available, affordable, and effective.

Nursing administrators are nurses who step up into management in order to complete tasks like employee supervision and training, employee representation, finances and budgeting, policymaking, quality control, communication with executives, development activities, data-driven decision-making, and more.

Nurse administrators may take on jobs with titles like head nurse, charge nurse, chief executive of nursing, director of nursing, director of patient services, or nurse manager. To be effective in their roles, nurse administrators must demonstrate a blend of competencies in their interpersonal, analytical, and organizational skills. While many nurse administrators will find work in hospitals, options are available in clinics, private practices, governmental agencies, and academia as well.

While the BLS does not track the nurse administrator profession specifically, the demand for this position will likely grow over the years. Between 2021 and 2031, the BLS predicts that demand for medical and health services managers will grow by 28 percent—this is almost six times faster than the 5 percent growth rate predicted for all occupations. With 136,200 new positions becoming available over the next decade, those considering pursuing a career in nurse administration will most likely find themselves with serious options.

Before entering into nursing administration, an administrator is expected to have experience as a practicing nurse. As a result, the very first step to becoming a nurse administrator is deciding how one wants to enter nursing practice.

This guide will cover possible journeys to nursing administration with the following nursing beginnings.

• Pathway 1: Start as RN with an associate degree
• Pathway 2: Start as LVN/LPN
• Pathway 3: Start as an RN with a bachelor’s degree

Step 1: Graduate from High School or Earn a GED (Four Years)

High school students can prepare themselves by taking anatomy and physiology, chemistry, statistics, nutrition, psychology, and business courses. It is also possible for those who earn a GED to be accepted into nursing programs, so long as they have completed the required prerequisite coursework.

Step 2: Graduate from an Accredited Associate Degree Program (Two Years)

One way to become an RN is to earn an Accreditation Commission for Education in Nursing (ACEN) accredited associate degree in nursing (ADN). Over two years, graduates complete general and nursing-specialized coursework to earn the following types of degrees.

• Associate degree in nursing (ADN)
• Associate of science in nursing (ASN)
• Associate of applied science in nursing (AASN)

Note: If graduate school is an eventual goal, GPA at this stage does matter. GPAs of 2.0 or higher are required, and a GPA of 3.0 or higher opens up more options.

Step 3: Become a Practicing RN Through Licensure and Examination (Timeline Varies)

Upon earning an ADN, graduates should pursue licensure by registering with their nursing regulatory body in the state where they wish to practice (e.g., Indiana State Board of Nursing). This action will create eligibility for the ADN graduate to sit for The National Council Licensure Examination for Registered Nurses (NCLEX-RN), the exam required to practice as an RN.

Upon passing the NCLEX, completing all licensure application requirements, and paying all licensure and exam fees, the ADN graduate will be awarded with RN license and can begin nursing practice.

Step 4: Acquire Practical Experience as an RN (One Year or More)

RNs who aspire to transition to nurse administration should attempt to gain administrative experience as they work as RNs. It is useful to volunteer to assist administrators in their work, step up into administrative tasks when possible, and find ways to begin practicing leadership and supervision tasks throughout one’s employment.

How long an RN works before applying to graduate school or to nurse administration positions depends wholly on the judgment of the RN. In some circumstances, an RN may feel it’s appropriate to look for positions as a nurse administrator or acquire more training earlier in their career.

In other circumstances, an RN with nursing administrator ambitions may decide to work for a longer period to deepen their practical knowledge of healthcare systems before returning to school, to work toward promotions within their current organization, or to acquire a level of practical experience needed to acquire nursing administrator positions in the job market successfully.

Step 5: Pursue Accredited Higher Education for Nursing Administration (One to Three Years)

From a semantic perspective, this step could be skipped by earning enough practical experience in the field of nursing administration to make formalized education unnecessary. However, many employers seeking nurse administrators require a bachelor’s degree or higher as a prerequisite to employment. This step will cover the different ways an ADN-RN can level up their formal training.

Don’t want to go back to school? Skip to Step 6.

Here are three ways that ADN-RNs can pursue formal nursing education:

• RN-to-MSN programs
• RN-to-BSN-to-MSN
• RN-to-BSN

Those seeking to go straight to an MSN can find bridge programs culminating in a master’s of science in nursing administration. Those doing a bridge to a BSN may be able to take coursework in nursing administration, but most BSNs are generalized degrees.

The Commission on Collegiate Nursing Education (CCNE) becomes the most widely recognized standard for nursing education accreditation at the bachelor’s level or higher. ACEN and otherwise accredited degrees can also be a stepping stone but may require those who have earned these degrees to provide the additional burden of proof of training when applying for graduate school or licensure later on.

• RN-to-MSN Bridge Programs (Two to Three Years) – RN-to-MSN programs are designed for ADN-RNs who are not required to hold a BSN, and who are ready for master’s level training in nursing administration (e.g., the University of Texas at Arlington).
• RN-to-BSN-to-MSN Bridge Programs (Two to Three Years) – Master’s level training is often desired, and bachelor’s level training is required. RN-to-BSN-to-MSN programs condense the learning timeline and confer both a bachelor’s and a master’s degree (e.g., Herzing University).
• RN to BSN Bridge Programs (One to Two Years) – RN-to-BSN programs are for ADN-RNs whose employers require a bachelor’s, who wish to open up their options in the job market, or who wish to broaden and deepen their formal training in nursing (e.g., Capella University).

Step 6: Transition To Nursing Administration (Timeline Varies)

• Transition to a nursing administration position within one’s current organization – One way to become an NA is to gain the skills, knowledge, and competence necessary to shift into a nursing administrator position where one currently works. Some organizations allow for advancement based solely on on-the-job performance, while others may desire or require formalized education. In the latter circumstance, some employers do subsidize or pay for the desired or required educational attainment.
• Enter the nursing administration job market – RNs whose highest educational attainment is an ADN do have options in the job market. Assistantships and nursing administrator support roles provide a wider range of options for ADN-RNs than directorships, although directorship jobs with an ADN as the minimum requirement exist.

RNs with a BSN’s highest educational attainment have a much broader range of options than ADN-RNs, as these BSNs are often the minimum degree required to be hired as a nursing administrator. Although MSNs are often desired, it is possible that a BSN-RN with enough supervisory and leadership experience could be hired instead.

Although MSNs are not always required to find employment as nurse administrators, they are often desired. Those with MSN degrees or higher and years of experience in supervisory roles will be quite competitive in the nursing administration job marketplace.

Step 7: Pursue Professional Certification (Optional, Timeline Varies)

Professional certification is a voluntary process under which nursing professionals demonstrate professional capability in their chosen field through minimum experiential requirements and by passing examinations in their specialty field. Although certification is not required to work as a nurse administrator, having a certification can lead to raises in pay, distinction in the job market, and promotions within one’s current healthcare organization.

Nursing administrators have the following options for certification:

• American Organization for Nurse Leadership (AONL) – Certified Nurse Manager and Leader Certification (CNML)
• American Nurses Credentialing Center (ANCC) – Nurse Executive Certification (NE-BC)

The LPN-to-nurse administrator pathway is very similar to the ADN-RN to Nurse Administrator pathway, with a few key differences. Full details for how to complete these steps can be found in Pathway 1, with the key differences between the two pathways listed below.

Step 1: Graduate from High School (Four Years).

See Pathway 1, Step 1.

Step 2: Graduate from an Accredited LPN/LVN Program (Six to 18 Months)

LPN/LVN programs are the cheapest, easiest, and most affordable programs to turn prospective nurses into practicing nurses. As the “practical” implies, LPN programs train future nursing professionals in the practical skills that enable LVN/LPNs to carry out care plans as created by RNs, NPs, and MDs. Upon graduation, LPN/LVNs earn certificates (e.g., Northland Community & Technical College).

Step 3: Become a Practicing LPN/LVN Through Licensure and Examination Timeline Varies)

Same as Pathway 1, Step 3 above, except graduates will be pursuing Practical Nurse/Vocational Nurse licensure, and will be taking the National Council Licensure Examination for Practical Nurses (NCLEX-PN).

Step 4: Gain Practical Experience (One Year or More)

See Pathway 1, Step 4.

Step 5: Become an RN (One to Three years)

With an MSN as the often-desired level of formal education for nurse administrators, it is important for LPNs to know that there are no direct LPN-to-MSN bridge programs currently. LPNs will have to become RNs before they can take the next step toward becoming a nurse administrator.

• LPN-to-ADN-RN (12 to 18 Months) – LPN-to-RN programs train an LPN to become an RN in a faster timeline than an ADN-RN program designed for those new to nursing. Programs like these acknowledge the practical skills that an LPN/LVN has already acquired through training and work and add training in the critical thinking skills that nurses need to provide care at their level of responsibility. Upon completion of an LPN-to-ADN-RN bridge, graduates will earn an ADN, ASN, or AASN (e.g., Fairmont State University).

To understand what comes next, return to Pathway 1, Step 3 above.

• LPN-to-BSN-RN (Three Years or More) – BSNs are required for many nurse administration positions. LPN/LVNs who wish to become NAs can transition their formalized training to the desired levels through an LPN-to-BSN bridge program. Like LPN-to-ADN-RN programs, these programs are designed for the unique circumstances of LPNs and accelerate BSN attainment in comparison to BSN programs for nursing-inexperienced. (Example: Kent State University)

To understand what comes next, go to Pathway 3, Step 3 below.

The BSN-RN to nurse administrator path also overlaps with the ADN-RN pathway above. Find the key differences between the two pathways below.

Step 1: Graduate from High School (Four Years)

See Pathway 1, Step 1 above.

Step 2: Graduate from an Accredited BSN Program (Four Years)

While leadership skills can be acquired informally by any motivated nurse, the benefit of beginning one’s nurse administration pathway with a BSN is the addition of leadership, management, and research into one’s formal training from the very beginning. Because a BSN program takes longer than an ADN or LPN program, BSN training has the space to help students go deeper into critical- and big-picture thinking.

At this level of education or higher, the Commission on Collegiate Nursing Education (CCNE) becomes the gold standard for accreditation. As mentioned above, ACEN or otherwise accredited programs may require a higher burden of proof for the acquisition of knowledge at later steps in this process.

Step 3: Becoming a Practicing RN Through Licensure and Examination (Timeline Varies)

See Pathway 1, Step 3 above.

Step 4: Gain Practical Experience (One Year or More)

See Pathway 1, Step 4 above.

Step 5: Graduate from Master of Science in Nursing Administration Program (12 to 24 Months)

As mentioned in the ADN-RN pathway, this step could be skipped by those who have acquired enough practical experience in the field of nursing administration to forego formalized training. However, with the MSN a requirement for many nursing administrator positions, earning an MSN may make a candidate more competitive, qualify a nurse administrator for more pay, and provide indelible insight into best practices for nursing administration.

MSN programs are available on campus and online and may require students to complete clinical hours. Common application requirements for non-bridge MSN programs are:

• A minimum GPA threshold
• A current, unencumbered RN license
• Official transcripts
• A minimum number of years of practical experience as a working RN
• Proven experience in supervision or leadership roles
• MAT or GRE Scores

To understand what comes next, return to Pathway 1, Step 6 above.

As an RN or LVN pursues nursing administration, the following professional organizations and associations can connect professionals to the issues, information, professional networks, and continued education needed to be successful and effective in leadership, management, and administration:

• American Association for Nursing Leadership (AONL)
• National Association of Directors of Nursing Administration in Long-Term Care (NADONA)
• American Hospital Association (AHA)
• American Nurses Association (ANA)
• American Association of Post-Acute Care Nursing (AAPACN)
• Association for Nursing Professional Development (ANPD)
• The National Forum of State Nursing Workforce Centers (NFSWC)
• Nursing Ethics Network (NEN)
• Organization for Associate Degree Nursing (OADN)