Nursing MSN & DNP

| 9 January 2024

The data in this blog is for general informational purposes only and information presented was accurate as of the publication date.

Nursing Leadership: What It Is and Why It’s Important

A faculty practitioner at USAHS works with nursing students in a simulation lab.

Healthcare is constantly evolving, whether it’s new treatments, legal guidelines or technology. Nurses are on the front lines of this change, and nursing leadership is critical to guiding colleagues and healthcare organizations through it. With an average of 193,100 annual openings for nurses each year through 2032, experienced nurses must step up as leaders to maintain high-quality standards of care.1

Learn more about nursing leadership and how it can take your nursing career to the next level.

Table of Contents:

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What Is Nursing Leadership?

A nurse leader is a nurse with a clear understanding of nursing, business and leadership that allows them to2:

  • Deliver high levels of patient care
  • Inspire their colleagues
  • Manage a team of nurses
  • Communicate goals to their team
  • Motivate their team to accomplish their goals
  • Take an overarching view of daily tasks

Definition of nursing leadership.

Most nurse leaders may have a specific leadership role, but some may prefer to act as leaders while still working as a registered nurse.2 These nurses may:

  • Mentor a new nurse
  • Volunteer for committee roles
  • Get involved in the community, such as at a vaccination drive
  • Take continuing education courses to further their knowledge
  • Stay up-to-date on healthcare trends
  • Engage with public policy at the local, state or national level

Nurse leaders are essential to healthcare organizations for various reasons, including2:

  • Shaping workplace culture, including job satisfaction and retention rates
  • Influencing healthcare legislation in their community
  • Impacting the development and training of future nurses

Nursing Leadership Roles

Job titles and responsibilities may vary based on the size and structure of the healthcare organization. We’ll cover a few of the most common nurse leadership roles below:

“Navigating the intricate landscape of healthcare demands visionary leaders who bring innovation and dynamism to the forefront. Effective nursing leaders inspire a collective vision, foster collaboration, and ensure the highest quality patient care. These leaders are the bedrock of healthcare organizations and represent the voice of the patients, families, and nurses. Through their advocacy, they instigate positive transformations paving the way for excellence in healthcare.”

Ashlee Loewen, DNP, APRN, FNP-C: Assistant Program Director, Nursing at USAHS

Charge Nurse

A charge nurse is a registered nurse who manages a shift of nurses while providing clinical care with the rest of the team.3,4 This is often a registered nurse’s first formal experience as a nurse leader.5 They report to a nurse manager or supervisor.3

Nurse Manager

A nurse manager has both a clinical and executive role within the healthcare organization.6 They oversee patient care and daily operations in their units, like a charge nurse, but they also often have managerial duties such as setting staff schedules and monitoring their team’s performance and growth.6,7 They are still involved in some patient care but may also handle disputes between patients and nursing staff.6,8 In some healthcare organizations, they may also collaborate on policy development, setting budgets and creating unit policies.6,5

Nurse Administrator

Often called the Director of Nursing (DON), a nurse administrator is a leadership position overseeing an entire department.6 These nurses focus on the business aspect of nursing: making budgets and handling HR matters such as hiring and firing staff. They often monitor nursing staff to ensure they comply with laws and regulations and develop policies and procedures.9

Hierarchy of nursing leaders.

Nurse Executives

These are the most senior nurses who work at a corporate level.6 They oversee the operations of a nursing staff, create and manage budgets and develop organizational policies. They work primarily with other executives in a healthcare organization.5 Titles at this level include Chief Nursing Officer (CNO) and Chief Nurse Executive (CNO).3

Nurse Educator

A nurse educator primarily teaches nursing students, whether it’s in a formal classroom or a clinical setting.10 Some nurse educators may also conduct research.

Essential Qualities for Nurse Leaders

Regardless of their role, nurse leaders must have all the qualities and skills of a good nurse, including empathy, communication and time management. In addition, they also need the following attributes:

“To be a great nurse leader you need the following traits: a willingness to listen, a willingness to grow beyond your comfort zone, and, most importantly, a willingness to try. Great nursing leaders keep the people who they lead at the forefront, are willing to be agile in the face of change and elevate the profession no matter their practice specialty. All nurses are leaders.”

Sarah Cartwright, DNP, RN, NI-BC, CAPA, FASPAN, Interim Executive Director, Associate Professor, Nursing Program at USAHS

  • Experience: To meet the educational requirements and credentialing prerequisites for most nursing leadership positions, you will need some nursing experience.6 See Educational Requirements below.
  • Advanced Education: Most nursing leadership roles require advanced nursing knowledge, business and leadership skills. Enrolling in continued professional development courses and advanced degree paths such as a Master of Science in Nursing (MSN) program will help you attain the required level of education.2 See Educational Requirements below for more information.
  • Critical Thinking Skills: As a nurse leader at any level, you’ll need to troubleshoot problems, develop policies and analyze decisions that impact your team and the healthcare organization.2
  • Business and Operational Skills: Many nursing leadership positions, especially those at the nurse administrator and executive levels, require business and operations skills such as budgeting and human resources.6
  • Passion for Nursing11: As a nurse leader, part of your job is to encourage and inspire your team.2 You’ll also engage in activities that shape the future of nursing, whether it’s creating policy or mentoring a new nurse. A passion for the profession will inspire those around you.
  • Ability to Inspire and Motivate12: Nursing can be stressful, and good nurse leaders know how to inspire their teams to overcome difficult situations and continue providing high-quality care.
  • Conflict Resolution12: Depending on your role, you may need to step in to resolve conflicts, whether they are between nurses on your staff or a patient and a nurse. Strong conflict resolution skills establish a healthy work environment, linked to increased job satisfaction and nurse retention rates.
  • Technology Proficiency12: Medical care incorporates a great deal of technology, and as a nurse leader, you’ll have to understand the technology and train others on how to use it safely and effectively.

Leadership Styles in Nursing

Nurse leaders influence everything from job satisfaction of the nurses on their teams to patient outcomes.2 To be successful, you’ll need a specific nurse leadership model that fits your personality and ideal team dynamic.

Seven leadership styles for nurses.

A few of the most common nursing leadership styles include the following.

Autocratic/Authoritarian Leadership

Autocratic leaders don’t consult others and prefer to make quick decisions.2 These leaders maintain a clear division of power between themselves and their team members and like to control situations by delegating responsibilities.14,2 While this style can negatively impact team morale, it is highly effective in emergencies.

Democratic Leadership

This leadership style is highly collaborative and fosters open communication between the leader and team members.2,14 However, it can lead to delays in decision-making while the leader consults everyone on the team, so it may not be a good fit for emergencies.14

Laissez-faire Leadership

French for “leave it be,” laissez-faire leadership relies on a hands-off approach to leadership.14 This type of leader trusts their team to make decisions and solve problems and supports them by providing resources and tools. This leadership style works when you are leading an experienced team, but it can hurt patient outcomes and team morale if the team does not feel like anyone is holding them accountable.2,14

Servant Leadership

Nurse leaders who utilize this style prioritize the team over themselves and choose to focus on meeting the needs of everyone on the team.14,2 They are encouraging and supportive, which makes this leadership style effective for any nurse leader working with nursing students. However, this leadership style requires a strong relationship between the leader and the team member, which can take time to build.14

Situational Leadership

Situational leadership involves using multiple leadership approaches and selecting the best style for the situation.2 This flexible leadership style is a good fit for working with student nurses.13,2

Transactional Leadership

Nurse leaders who utilize transactional leadership are task-oriented and focused on the performance of each team member.2 The leadership style is based on a system of rewards and punishments, which may not be effective for team members who aren’t motivated by rewards.14

Transformational Leadership

This leadership style focuses on inspiring the nurses on your team through mentorship.2 These leaders build strong relationships on their team and seek to improve their workplace.14 This leadership style is highly successful for both the nurses on your team and the patients in their care, positively impacting job satisfaction, morale and patient outcomes.

How to Become a Nurse Leader

Educational requirements for nurse leaders vary by role, but you can generally expect your employer to require a blend of real-world experience and a formal education.5 Many nurse leaders start as a charge nurse and then pursue a master’s degree in nursing or business, but more advanced roles may require you to earn a Doctor of Nursing Practice (DNP).5

A breakdown of nurse leader qualifications by nursing role.

Nurses typically follow the steps below to become a nurse leader.

Step One: Become a Registered Nurse (RN)

Becoming an RN may involve completing an accredited registered nursing program or earning either an Associate Degree in Nursing or a Bachelor of Science in Nursing (BSN).19 You’ll then need to pass the NCLEX-RN exam and obtain the registered nurse license in your state (requirements vary by state).

Step Two: Gain Nursing Experience

The amount of necessary nursing experience varies depending on the role. For example, nurse executives need an average of five years of progressive leadership experience.6 To determine how much experience you need for a specific role, ask human resources at your organization.

Step Three: Earn an Advanced Degree

While nurse managers need at least a BSN, most other nurse leadership positions require a Master of Science in Nursing (MSN) degree.6 Some positions may also accept a degree in healthcare administration instead of an MSN.6

At the University of St. Augustine for Health Sciences (USAHS), you can enter the MSN program as an RN or with a BSN, allowing you a flexible entry pathway. If you enroll in the BSN to MSN program, you can also focus your studies on role specialties to prepare for a specific nursing leadership role:

  • Nurse Executive (for nurses looking to pursue an organizational leadership role)
  • Nurse Educator (for nurses looking to pursue teaching—note that this program is not currently accepting students)

Depending on your healthcare organization’s requirements, you may want to pursue a Doctor of Nursing Practice (DNP). While you can become a nurse executive in most healthcare organizations with an MSN, earning a DNP may help increase your salary as it is a terminal degree. Like the MSN, you can also focus your DNP on one of several role specialties, including the Nurse Executive Role Specialty.

If you wish to pursue the nurse educator role and want to teach at the college level, consider earning a PhD in nursing—a terminal nursing degree that prepares you for a career in nursing education.

Step Four: Get Certified in Nursing Leadership

Many employers do not require certification, but becoming certified shows you have the expertise to handle the role.6

There are several nursing leadership certifications you can pursue:

Certified in Executive Nursing Practice (CENP)

  • Current active RN license22
  • One of the following: MSN or higher and at least 4,160 hours of experience in an executive or senior nursing role OR BSN and at least 8,320 hours of experience in an executive or senior nursing role
  • Passing score on the credentialing exam
Certification Requirements
Nurse Executive (NE-BC)
  • Current active RN license20
  • Bachelor’s or higher
  • At least 2,000 hours of experience in a leadership, management or administrative role overseeing daily operations and outcomes of at least one unit within the last three years
  • Completed 30+ hours of continuing education in leadership, management or administration within the last three years
  • Passing score on the credentialing exam
Nurse Executive Advanced (NE-BC)
  • Current active RN license21
  • Earn a graduate degree (either the bachelor’s or master’s must be in nursing)
  • At least 2,000 hours of experience in a leadership, management, or administrative role overseeing organization-wide or system-wide operations and outcomes within the last three years
  • Completed 30 hours of continuing education in leadership, management or administration within the last three years
  • Passing score on the credentialing exam
Certified Nurse Manager and Leader (CNML)
  • Current active RN license23
  • One of the following: Bachelor’s or higher (one of which must be in nursing) and at least 2,080 hours of experience as a nurse manager/primary unit leader OR BSN or higher (one of which must be in nursing) and at least 4,160 hours of experience in a comprehensive nursing leadership support role
  • Passing score on the credentialing exam
Clinical Nurse Leader (CNL)
  • Current active RN license24
  • For current students and alumni
    • Currently enrolled in your last semester of a CNL-accredited program
    • Graduated from a CNL-accredited program
  • For faculty
    • Hold a current active RN license
    • Hold a graduate degree in nursing or related healthcare discipline
    • Teach in an existing CNL-accredited program
    • Demonstrate relevant work experience
    • Provide a letter from your program’s dean (or equivalent role) explaining your qualifications and current teaching
  • Passing score on the credentialing exam

Become a Nurse Leader with USAHS

Take the next step in your nursing career with USAHS.

“Getting my DNP has been one of my far-off goals. It’s been challenging—but the skills I learned during this program will look good on my resume and prepare me for the future. During my practicum, I’ve been able to sit in on division-wide leadership meetings and see the inner workings at that level. It’s eye-opening.”

Brian L., DNP

As a leader in health sciences education, USAHS connects you with faculty and nursing students focused on excellent patient care and the pursuit of nurse leadership opportunities. Our programs emphasize interprofessional education, preparing you for the collaborative nature of modern nursing roles. Our innovative learning model incorporates online courses and on-campus intensives for some role specialties.

If you’re still exploring your options for nurse leadership, request more information about which USAHS nursing program might be right for you. Then, apply to our MSN or DNP programs to secure your future as a nurse leader.

Sources:

  1. Bureau of Labor Statistics, “Registered Nurses,” Occupational Outlook Handbook, last updated November 2023, https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-6.
  2. American Nurses Association, “Leadership in Nursing: Qualities & Why It Matters,” Nursing World, https://www.nursingworld.org/practice-policy/nursing-excellence/leadership-in-nursing/.
  3. AllHeart, “Types of Nurses: All Nursing Titles and Rankings You Need to Know,” AllHeart, https://www.allheart.com/blog/types-of-nurses.html.
  4. American Nurses Association, “Charge Nurse vs. Nurse Manager: What’s the Difference?” Nursing World, https://www.nursingworld.org/resources/individual/charge-nurse-vs-nurse-manager/.
  5. American Nurses Association Enterprise, “Nurse Leadership,” Nurse Focus, https://nursefocus.org/nursing-leadership/.
  6. Shrilekha Deshaies, “Nurse Leadership Roles: The Differences Among Nurse Executives, Administrators and Managers,” NurseJournal, last modified March 2023, https://nursejournal.org/resources/nurse-exec-vs-admin-vs-manager/.
  7. Eileen Williamson, “Nurse Managers and Leaders: Differences and Qualities They Share,” Nurse.com, last modified February 2023, https://www.nurse.com/blog/nurse-manager-vs-nurse-leader-whats-the-difference/.
  8. Indeed Editorial Team, “Nurse Leader vs. Nurse Manager (With Roles and Differences),” Indeed, last modified June 2023, https://sg.indeed.com/career-advice/career-development/nurse-leader-vs-nurse-manager.
  9. Maura Deering, “Nurse Administrator Career Overview,” NurseJournal, last modified December 2022, https://nursejournal.org/careers/nurse-administrator/.
  10. Genevieve Carlton, “Nursing Leadership: 8 Jobs to Consider,” Best Colleges, last modified March 2023, https://www.bestcolleges.com/nursing/nursing-leadership-jobs/.
  11. Kathleen Gaines, “Top Nursing Leadership Roles & How to Become a Nurse Leader,” Nurse.org, last modified August 2023, https://nurse.org/education/nursing-leadership/.
  12. Darby Faubion, “22 Leadership Qualities in Nursing Every Nurse Leader Must-Have in 2023,” NursingProcess.org, https://www.nursingprocess.org/leadership-qualities-in-nursing.html.
  13. Top Nursing, “Leadership Styles in Nursing for Improved Quality of Care,” Top Nursing, https://www.topnursing..
  14. Darby Faubion, “8 Types of Leadership Styles in Nursing — Which One Is Right for You?” NursingProcess.org, https://www.nursingprocess.org/leadership-styles-in-nursing.html.
  15. Terri Heimann Oppenheimer, “Nurse Manager,” Nurse.org, last modified September 2023, https://nurse.org/resources/nurse-manager/.
  16. American Nurses Association Enterprise, “How To Become a Nurse Administrator,” Nursing World, https://www.nursingworld.org/resources/individual/how-to-become-a-nurse-administrator/.
  17. NurseJournal Staff, “Nurse Executive Career Overview,” NurseJournal, last modified October 2023, https://nursejournal.org/executive-nurse/.
  18. NurseJournal Staff, “How To Become a Nurse Educator,” NurseJournal, last modified May 2022, https://nursejournal.org/careers/nurse-educator/how-to-become/.
  19. Nursing License Map, “How to Become a Registered Nurse (RN),” Nursing License Map, last modified November 2022, https://nursinglicensemap.com/nursing-specialties/registered-nurse/.
  20. American Nurses Credentialing Center, “Nurse Executive Certification (NE-BC®)” American Nurses Credentialing Center, https://www.nursingworld.org/our-certifications/nurse-executive/./li>
  21. American Nurses Credentialing Center, “Nurse Executive, Advanced Certification (NEA-BC®)” American Nurses Credentialing Center, https://www.nursingworld.org/our-certifications/nurse-executive-advanced/.
  22. American Organization for Nursing Leadership, “CENP Frequently Asked Questions,” American Organization for Nursing Leadership, https://www.aonl.org/initiatives/cenp-faq .
  23. American Organization for Nursing Leadership, “CNML Frequently Asked Questions,” American Organization for Nursing Leadership, https://www.aonl.org/initiatives/cnml-faq .
  24. American Association of Colleges of Nursing, “CNL Certification Exam,” American Association of College of Nursing, https://www.aacnnursing.org/our-initiatives/education-practice/clinical-nurse-leader/cnl-certification/exam.

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