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Nursing leadership is an essential feature of any successful health care administration. For many in the profession, the terms nursing administration and administration are used interchangeably because any nurse leadership role includes administrative–or managerial– and executive responsibilities.

The Path of a Nurse Administrator

The chief nursing officer (CNO) of any health care organization is considered the acme position of nursing leadership; however, there are as many nursing administrative roles as there are nurses to fill them. Every position is unique to the organization that creates it and the nurse that takes it on. The typical trajectory of a nurse leader goes in the order as follows:

  1. Bedside nurse
  2. Charge nurse
  3. Nurse manager
  4. Department director
  5. Nursing leadership, executive roles, and beyond

The Value of Nurses in Health Care Administration

As evidenced by the above, those who advance in nursing leadership gradually move further away from direct bedside care. Regardless, at every level of administration, having experience with direct patient care as a nurse is essential for constructive oversight. As such, rarely do nurses advance into administration without a foundation at the bedside, and for good reason.

Charge nurses and nurse managers directly supervise nursing within specific departments, such as the intensive care unit, or operating room. Some of them even take on patient assignments of their own, whether to fill gaps in staffing or as a fundamental part of their role. Nursing department directors act as a liaison between their unit and the larger organization or community, representing and speaking on behalf of their nurses.  

This might lead to them implementing evidence-based practice or quality initiatives based on executive feedback and financial implications. Nursing leaders, executives, and administrators direct and organize systems-wide schema to better nursing and patient care, qualitatively, fiscally, and systematically.

The Future of Nursing Administration

It seems the goal of nursing leadership and administration is a popular one for young nurses today. There are even resources for nursing students to establish themselves as nurse leaders while in nursing school, both through skill development and networking. For nurses who have the competence and resiliency to be nursing leaders, it is an opportunity to affect positively the quality of care patients receive, beyond the bedside.

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Nancy Swezey, BSN, RN, CNOR

Nancy Swezey received her BSN from Columbia University. She now practices in New York City in the operating room where she has worked as a staff nurse, and currently as a care coordinator specializing in head and neck surgery. Nancy is also pursuing her advanced practice degree at CUNY Hunter where she assists the faculty as a research assistant, focusing on nurse education and module development.
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