Nurse Administrator: A Day in the Life

There are over three million registered nurses in the US, and, according to the Bureau of Labor Statistics, many more are on their way. Even so, the retirement of the Baby Boomers requires an unprecedented number of care providers and nurses are taking on more and more responsibilities in their roles. To coordinate all of a care facility’s nursing staff requires a dedicated manager who can blend expert technical knowledge with robust organizational leadership; in short, it requires a nurse administrator.

Simply put, a nurse administrator manages a care facility’s nursing staff. They coordinate the schedules, implement policy, and draw up the budget. But this is no ordinary management position. Nurse administrators come from robust nursing backgrounds themselves, holding advanced degrees, work experience, and official licensure. It’s only through that background that they’re able to come into management with an understanding of the intricacies and quirks that go with the nursing profession and the healthcare industry at large.

Nurse administrators need to be masters of two worlds: organizational management and nursing practice. While they do step away from the bedside to perform this role, they never forget what it means to be a nurse. And, at the same time, they implement the sort of managerial skill seen in Fortune 500 companies: adhering to a budget, managing staff, and implementing departmental policy.

With an increasing number of nurses comes an increased need for nurse administrators. If you’re curious what it takes to lead in this profession, read on to get a look at a day in the life of a nurse administrator.

Nurse administrators can work wherever other nurses do. That often means hospitals, urgent care clinics, doctor’s offices, outpatient treatment centers, and long-term care facilities. Generally, the higher the nursing staff, the more urgent the need is for a nurse administrator.

While a nurse administrator may spend a significant chunk of time on their feet during the day, shuttling between different areas of a care facility, they will usually call an office away from the clinical unit their home base.

If nursing is a team sport, then nurse administrators hold the roles of coach and general manager. They’ll need to manage the nursing staff, but, especially in larger care facilities, there are other key players they’ll need to coordinate with as well. Key partners include physicians, executive leadership, and other non-medical staff.

A nurse administrator’s daily responsibilities will be shaped by the particular care facility which employs them. Broadly speaking, their tasks can be divided into three categories: managing staff, managing finances, and managing policy. But in many cases these areas overlap, and require a delicate juggling act on behalf of the nurse administrator.

Typical daily responsibilities for a nurse administrator may include:

• Recruiting, training, counseling, and evaluating nursing staff
• Verifying licensure, certification, and credentials of nursing staff
• Creating and implementing a nursing department budget
• Evaluating purchasing decisions
• Designing nursing schedules and personnel procedures
• Developing and implementing nursing policy
• Liaising between medical and administrative staff
• Determining what services the nursing staff can offer to patients

In addition to their daily work, nurse administrators are tasked with some less measurable responsibilities. They need to ensure their staff is not just working effectively, but also growing personally and professionally. And, as a leader, they need to serve as a mentor and role model for the nursing staff under their supervision.

Nurse administrators are nurses themselves, and must adhere to the strict education and licensing requirements of registered nurses (RNs). Due to their leadership role, many nursing administrators hold advanced nursing degrees, such as a master of science in nursing (MSN) or a doctor of nursing practice (DNP). While those degrees do develop expert-level nursing skills, they may not dive deeply into all the skills necessary for nursing leadership. Other advanced degrees, such as a master of business administration (MBA) or a master of healthcare administration (MHA), will eschew practitioner-level education in favor of management-level skills.

Nurse administrators need to be masters of several skills at once, and their body of knowledge has to reach across different disciplines. Financial acumen must be paired with leadership skills, technical know-how must be matched with empathetic listening. This requires both passion and pragmatism. With a mix of clinical expertise, business analysis, and organizational understanding, a nurse administrator can get the best out of their staff, and thus provide their patients with the highest level of care.

Nurse administrators looking to distinguish themselves in the profession have multiple options for certification. While not a requirement to practice, peer-reviewed certification does demonstrate a nurse administrator’s commitment to continuing education, industry best practices, and general standards of excellence.

The primary certification track for nurse administrators is to become board-certified as a nurse executive (NE-BC) through the American Nurses Credentialing Center (ANCC). In order to be deemed eligible, applicants must hold a current and active RN license; a bachelor’s degree or higher in nursing; two years of recent work experience in nursing administration or nursing management; and either 30 hours of continuing education in nursing administration or a master’s degree in nursing administration.

Once eligible, applicants must pass a competency-based board exam. Exam fees are $295 for members of the American Nurses Association (ANA), and $395 for non-members. Those with the NE-BC designation must recertify every five years by completing 75 hours of continuing education, in addition to meeting one of several categorical fulfillments. Recertification details are available on the ANCC website.

The American Organization for Nursing Leadership (AONL) offers two additional certifications of interest to nurse administrators: the Certified in Executive Nursing Practice (CENP) and Certified Nurse Manager and Leader (CNML) designations.

In order to be eligible for the CENP, applicants must hold a valid and unrestricted license as an RN, and have either a master’s degree and two years of experience in an executive nursing role, or a bachelor’s degree and four years of experience in an executive nursing role.

Once deemed eligible, applicants will then need to pass an exam covering four core principles: communication and relationship building; knowledge of the healthcare environment; professionalism; and business skills and leadership. Exam fees are $325 for AONL members and $450 for non-members. CENP-holders must recertify every three years by completing 45 hours of continuing education, or by successfully retaking the CENP exam.

In order to be eligible for the CNML, applicants must hold a valid and unrestricted license as an RN. Additionally, they’ll need a bachelor’s degree or higher in nursing, as well as over 2,080 hours of experience in a nurse manager role. Applicants who have a bachelor’s degree or higher in a field other than nursing may also apply, but the work experience requirements are higher (3,120 hours).

Once deemed eligible, applicants will need to pass a 115-question exam on four core knowledge areas: financial management; human resource management; performance improvement; and strategic management and technology. Exam fees are $300 for AONL members and $425 for non-members. CNML-holders must recertify every three years by completing 45 hours of continuing education or by successfully retaking the CNML exam.