How to Become a Chief Nursing Officer?: A 2024 Guide

Warm greetings to everyone and welcome to this guide on how to become a Chief Nursing Officer!

In this new guide, we will detail and explain what you need to do if you are aspiring to dive into this exciting healthcare career path.

By the time you’re done reading through, you are guaranteed a full knowledge of what steps to take to attain Nursing leadership as a CNO.

You will also learn what implementing the steps involves.

Here are some of the points we will cover in this guide:

• The Nursing educational requirements and other necessary steps
• Available Nursing programs and certifications for aspiring CNOs
• Interview questions for aspiring CNOs

Without wasting any more time, let’s start!

Educational Requirements for Becoming a CNO

To become a Chief Nursing Officer, you must have a Bachelor’s degree in Nursing (Bachelor’s of Science in Nursing), which must be obtained from an accredited school of Nursing.

The program is usually 4 years in duration.

If you are currently a Registered Nurse, you can enroll in an RN to MSN bridge program without having to go through the BSN Program.

But the easiest and best way to move advance to any Nursing leadership position or the business of healthcare is through a Master of Science in Nursing (MSN) degree with a focus on healthcare systems or leadership.

You could also opt for a Master of Health Administration (MHA) – or a Master of Business Administration (MBA).

Some larger organizations require candidates to go a little step further by obtaining a Doctor of Nursing Practice (DNP) in executive healthcare administration.

The Doctor of Nursing Practice curriculum will give aspiring Nurse Leaders the best environment to develop their administrative skills in the following areas:

• Teamwork with other healthcare professionals

• Evaluating results from the analysis of health trends and patient care

• Coming up with economical treatment plans that meet the needs of the average citizen

Years of experience in direct patient care is very important for any Nurse Leader, other skills are needed.

For example, they must learn to collaborate with Nurses and Physicians under their jurisdiction, they will also report to or answer to the facility’s board of directors or Chief Executive Officer (CEO).

They need critical thinking, and good communication skills and must be adept at delegating tasks and finding solutions to day-to-day day administrative challenges.

Necessary Certifications

Certifications complement a Chief Nursing Officer’s education and years of experience.

For this reason, there are lots of credentialing centers that offer such.

However, each of these certifications may be ̣articularly suitable for some specific job descriptions while some are not job-specific.

The American Nurses Credentialing Center (ANCC) and the American Organization for Nursing Leadership (AONL) offer most of these certifications for CNOs.

Although there is no CNO Certification, there are several other certifications that are related to Nursing leadership, healthcare administration, and business management.

Here are some of them in no specific order of importance:

1. Executive Nursing Practice Certification (CENP)
2. Nurse Manager and Leader Certification (CNML)
3. Clinical Nurse Leader (CNL)
4. Nurse Executive, Advanced Certification (NEA-BC)

Let’s discuss more on them:

Executive Nursing Practice Certification (CENP)

Nurse leaders who are diving into Executive Nursing practice should consider the Certification in Executive Nursing Practice (CENP).

Here’s how to qualify for this certification:

Eligibility criteria

• You must have an active registered nursing license
• You must have obtained a Bachelor’s Degree in Nursing and must have also gathered at least four years of experience in any Nursing executive position
• You must have also earned your Master’s degree and gathered  a minimum of 2 years of experience with it

Nurse Manager and Leader Certification (CNML)

Only Nurse Leaders who are currently in a Nurse Manager’s position can apply for the Certified Nurse Manager and Leader (CNML) credential.

Eligibility criteria

• You must have an active and unrestricted Registered Nursing license
• You must have a Baccalaureate in Nursing degree or any other higher degree, you must have  also gathered at least 2080 hours in a Nurse Manager position
• Alternatively, with a Diploma or Associate Degree in Nursing (ADN), you must have  also gathered at least 5200 hours in a Nurse Manager position

Clinical Nurse Leader (CNL)

Eligibility criteria

• To qualify for this certification, you must either be a graduate of a CNL Master’s/other post-graduate degree or must be in the final year of the program – The program must be accredited by the U.S. Secretary of Education
• You must have an active and unrestricted Registered Nursing license
• The candidate’s education documentation form must also be submitted by the Director of Nursing

Nurse Executive, Advanced Certification (NEA-BC)

Eligibility criteria

• You must have an active RN license in any State within the U.S.A, or an equivalent legally accepted license in another country
• You must hold a Bachelor’s degree and a Master’s degree in Nursing or the BSN should be in Nursing while the MSN may be in another related field
• You must have held a Nursing administrative position for at least two years – Alternatively, you could also have occupied the role of a facility manager, teaching Nursing graduate students for at last 2 months
• Finally, you must have completed at least 30 hours of continued education in Nurse management in the last 3 years – If you have a Master’s degree, this requirement can be waived

Step-by-Step Procedure for Becoming a Health Services Manager or CNO

Before we go into the details of how to become a CNO or a Health Service Manager, you should know that working your way up to the management position in Nursing can take time.

It is not just about meeting the education requirements and earning the certifications highlighted above.

It is a combination of education, skills, and years of experience.

Here is a step-by-step breakdown of the entire procedure:

Earn a Bachelor’s degree

This is the start of a CNO’s career path.

Search for an approved Nursing program, which could be any of the following:

1. Bachelor of Science in Nursing (BSN),
2. Associate degree in nursing (ADN), or
3. Diploma in Nursing

A BSN program, which is usually a 4-year program, is often the best because students will gain more knowledge and more clinical experience.

Students will be drilled in the following sections:

• Human anatomy and physiology
• Basic pharmacology
• Microbiology and chemistry
• Disease prevention and health promotion
• Behavioral and life sciences
• Data management and healthcare technology
• Fundamentals of nursing theory and practice

As you dive deeper and deeper into the program, you will gather more experience as well as other learning opportunities.

Getting these opportunities is vital if you will proceed in your journey to become a CNO.

Become a Registered Nurse

Whichever Nursing school or degree you later settle for (BSN, ADN, or Diploma), the goal is to become a Registered Nurse after your complete the program.

That means immediately after you graduate, you must sit for and pass the National Council Licensure Examination (NCLEX-RN) Examination.

This licensure exam is administered by the National Council of State Boards of Nursing (NCSBN), and it gives the Nursing graduate the license to practice their profession.

Eligibility requirements for this exam are the same although some states may have slight variations in their list of requirements.

So, make sure you confirm what the requirements are in the state where you reside.

Generally, the NCLEX-RN Exam is at least 75 multiple choice questions and a maximum of 265 MCQs.

According to the NCLEX Brochure, here are the four main areas where applicants will be tested:

“Physiological Integrity: Basic care, dosage calculations, therapeutic procedures, medical emergencies, illness management.

Safe and Effective Care Environment: Interdisciplinary collaboration, case management, incident prevention, safe use of equipment, ethical practice.

Health Promotion and Maintenance: Health screening, physical assessment, health promotion, disease prevention, lifestyle choices.

Psychosocial Integrity: Mental health concepts, stress management, support systems, family dynamics, grief, and loss.”

Enroll in a Master’s degree program

If you are serious about becoming a CNO, don’t just stop at being a Registered Nurse; pursue your Master’s degree certification immediately.

This is a crucial requirement.

Most master’s degree programs accept applicants with any of the following:

• BSN degree
• ADN degree
• Diploma in Nursing

For other Universities, any other degree in a relevant field other than Nursing is acceptable.

However, not that the duration of the program will be affected by the mode of entry.

A typical MSN Program will take 2 to 3 years.

If you are enrolling as an ADN Certificate holder or a diploma holder, except that the program will be a little longer than normal.

This extra time will get you the required clinical training and head knowledge that you missed as a result of not going through the BSN route.

Here are some of the core subjects you will study in an MSN Program:

• Principles of Advanced Nursing Practice
• Leadership in health care systems and delivery
• Nurse advocacy and health care policy
• Evidence-based practice
• Statistical procedures and health informatics
• Health care organizational management and finance

To earn an MSN degree, you are expected to complete both the coursework and hundreds of clinical hours.

You will also complete seminars, clinical practicals, internships, and minor research.

The MSN program also allows you to specialize.

For aspiring CNO, it is recommended that you focus on administration while pursuing your CNO.

Some healthcare facilities may accept candidates with MBA instead of MSN for CNO positions.

Get Necessary Certifications

On completing your MSN Program, the next hurdle to surmount is to get certified by the relevant certification body.

You can choose either one or all of the certifications discussed in the section above.

Credentialing is the best way to tell Chief Executive Officers of medical facilities that you have received specialized training in Nursing administration and management.

You should also consider joining professional Nursing organizations like the American Organization of Nursing Leadership (AONL) and the American Nurses Credentialing Center (ANCC).

Double-check the eligibility requirements of each certification before applying.

This will prevent any potential issues with the certification board.

Pursue a DNP

This final step involves earning a Doctor of Nursing Practice degree.

Although some may argue that the Doctor of Philosophy (Ph.D.) is wholly focused on research.

However, the degree is also meant for Nurses who are seeking some sort of terminal degree in Nursing practice.

So, if you are looking at a career as a Nursing executive, you should not hesitate to pursue a DNP.

As you continue this advanced education, you will gain more experience, you will sharpen your skills, you will gain exposure, and more importantly, you will gather significant clinical expertise.

According to the website of AACN, each DNP Program will focus on the following eight learning objectives:

1. Scientific underpinnings for practice: Focuses on the ethical, psychological, analytical, and organizational knowledge of Nursing science.
2. Organizational and systems leadership and systems thinking: Assess patient care and operational cost, then create a cost-effective initiative to replace existing strategies.
3. Clinical scholarship and analytical methods for evidence-based practice: Utilizing IT to improve patient care and caregiving – Digitally tracking, analyzing, interpreting, and leveraging data using available human resources.
4. Information systems/technology and patient care technology for the improvement and transformation of health care: Creating and supervising systems that evaluate outcomes of patient care and patient response.
5. Health care policy for advocacy in health care: Advocating and promoting Nurse leadership across all levels of healthcare – Understanding and helping to implement relevant policies.
6. Interprofessional collaboration and population health outcomes: Promoting healthy communication and collaboration between several departments.
7. Clinical prevention and population health: Analyzing cultural diversity and epidemiological, environmental, and biostatistical records as a function of managing population health.
8. Advanced Nursing Practice: Demonstrating advanced knowledge of clinical judgment, accountability, evaluation, and improving patient outcomes.

Are You a Good Fit?

Well, don’t be so quick to conclude that you are ready.

Here is a small checklist that can help you determine if you are a good fit or not:

• Are you passionate about leadership roles and administration?
• Are you interested in managing a team of Nurses and monitoring their improvement over time?
• Are you in any way interested in the business and financial aspects of healthcare?
• Are you an advocate of solving common healthcare industry problems using various available IT models and even yearning for newer models?

If your answer to all these questions is yes, then you are mentally ready to pursue a career as a CNO.

Chief Nursing Officer Interview Questions

Assuming you have crossed all the hurdles and completed all the steps mentioned above, no doubt you will still need to apply for a job as a CNO.

The process isn’t that rigorous, although you can expect several interview sessions with the hospital’s executive board or CEO.

To perform well in these interviews, you need to anticipate the questions so that you can give appropriate answers to them.

The goal of the interviewer is to ascertain if your skillset and experience meet the current need of the medical facility.

For instance, if the medical facility is planning a major staff overhaul, you may be asked what your experience with staffing and dismissing Nurses is.

In addition to questions about educational background, personal information, and work history, we present to you the most common interview questions and what each means.

Why do you want to work here?

Keep in mind that each hospital has its peculiar challenges and policies.

The interviewer is interested in why you feel the current challenges they are facing are not going to stop you from managing the Nursing staff.

To give the best answer, do your research about the medical facility.

Touch on the size of the facility, the reputation it has in the city, and how you can improve its clinical focus.

How will you approach and manage workplace conflict?

No matter how professional the team is, once in a while, working together in a team is still challenging.

The interviewer is interested in how you plan to manage the different personalities and maintain a peaceful working atmosphere.

Here is where your experience with managing Nursing staff comes to play.

The ability to manage different personalities is crucial for a CNO.

How will you create an optimal work environment for our Nursing team?

If you are preparing for life as a CNO, you should be ready to discuss specific ways that you plan to create a positive work environment for everyone working in the medical facility.

Once your interviewer asks this question, be sure to highlight anything you have done in the past along that line.

Examples include employee surveys and daily scheduling and budgeting.

What’s your experience in working with Physicians?

The importance of teamwork in this career path cannot be overemphasized.

It can be a challenge to work as a team when dealing with Physicians who are professionals and have more clinical skills.

You should have a plan in place to handle and manage their egos.

Your interviewer is also interested in knowing how well you did it in your past jobs and even how you diffused tense situations with Physicians.

If you have one or two success stories in the past, don’t hesitate to share them.

What are the most important qualities for a Nurse to possess?

This is a tricky question because there is no right or wrong answer.

The interviewer is just interested in how you speak about Nursing and your passion for it.

Be confident and talk about key values that each Nursing staff must cultivate.

Conclusion

The highest rank a Nurse Practitioner can achieve is the post of Chief Nursing Officer.

Although it requires hard work and lots of dedication, you too can become a CNO.

This guide has outlined all you need to do and in what order.

We encourage you to read the article again to be familiar with what your next step should be.

This position is more of administrative and supervisory roles and less of real-time clinical tasks.

However, as sweet as the prospects seem, there are challenges too.

Remember that we love to see you succeed!

FAQs

References

Nurse.org

Registered Nursing.org

Bradley University

Career Karma