Nurses have always played a critical role in health care delivery, but in an increasingly complex health care system, they are starting to play a more critical role in health care administration as well.
Increasingly, hospitals and other health care organizations are hiring nurses for top administrative positions. According to a study by the American Organization of Nurse Executives (AONE) and the American College of Healthcare Executives, the percentage of nurses leading U.S. hospitals rose from 10 to 18 percent between 2004 and 2010.
Graduates of master's in nursing degree programs could be well positioned to lead health care organizations. Their background in nursing should enable them to understand the scientific and medical issues at stake, while their day-to-day experience in patient care helps give them a unique perspective on how to promote health and wellness.
In a very real sense, nurse administrators shape the practice of nursing. They hire nurses, schedule shift coverage and set priorities for nursing care. They also establish policies, coordinate quality improvement efforts and advocate for nurses within the larger health care organization. Nurse administrators are the voice for nursing on the health care management team, and they have the ability to strongly influence the culture of nursing within a given health care facility.
Nurse administrators frequently go by other names, including director of nursing, assistant director of nursing, vice president of nursing and nurse manager. At the broadest level, a nurse administrator is any nurse who oversees and manages other nurses. Nurse administrators, however, are typically responsible for budgeting as well. A head nurse might oversee the nurses on her shift, but is not responsible for maintaining a nursing budget. Nurse managers and administrators must plan effective nursing care and coverage that fits within the budgetary guidelines of their organization.
In the past, nurse administrators were often experienced staff nurses who had been promoted from within the organization. However, nurse administration requires a very specific set of skills. Nurse administrators must be leaders able to adapt in a changing health care environment. They need to understand how to motivate a group and how to manage people of different personalities, and they must also have a solid understanding of business, including budgeting and best labor practices.
Top-level nurse administrators typically have graduate training. Master's in nursing degree programs with a focus on leadership or nursing administration can prepare nurses to effectively manage and lead nursing teams. Alternately, a master's degree in health care administration or organizational leadership, with courses in business basics, health care policy, ethics and leadership, can provide the necessary skills.
Health care reform may also increase the demand for educated, experienced nurse managers. Nurse administrators with an advanced degree could be well positioned to help their organizations face the challenges and opportunities presented as the health care system expands to bring in previously uninsured patients and works to provide top-quality care at a lower cost.
Demand for nurse administrators is expected to remain strong. According to the Bureau of Labor Statistics (BLS.gov), employment of medical and health services managers, including nurse administrators, is expected to grow 23 percent between 2012 and 2022, which is much faster than the average for all careers. Demand for nurse administrators experienced in the latest health care technologies may increase as health care organizations gradually adopt electronic records and experiment with other ways to utilize technology to improve care.
Bureau of Labor Statistics data indicates that medical and health services managers (a category that includes nurse administrators) earned a national median annual wage of $90,940 in May 2013. Medical and nursing administrators work hard to earn that salary -- the job can require long hours and hard work. But at the end of the day, nurse administrators can feel good about the leading role in health care that they play.
Medical and Health Services Managers, Bureau of Labor Statistics, Occupational Employment and Wages, May 2013, http://www.bls.gov/OES/current/oes119111.htm
Medical and Health Services Managers, Bureau of Labor Statistics, Occupational Outlook Handbook, January 8, 2014, http://www.bls.gov/ooh/management/medical-and-health-services-managers.htm
Nurses as Executives, Advance Healthcare Network, Gail O. Guteri, February 7, 2012, http://nursing.advanceweb.com/Management-Faculty/Archives/Article-Archives/Nurses-as-Executives.aspx
"Nursing Leaders Reveal Top Trends Impacting Nurses in 2010," NurseZone, Debra Wood, RN, January 15, 2010, http://www.nursezone.com/nursing-news-events/more-news/Nursing-Leaders-Reveal-Top-Trends-Impacting-Nurses-in-2010_33230.aspx
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