Top Nursing Leadership Roles & How to Become a Nurse Leader

The American Nurses Association (ANA) Leadership Institute describes a nurse leader as “a nurse who is interested in excelling in a career path, a leader within a healthcare organization who represents the interests of the nursing profession, a seasoned nurse or healthcare administrator interested in refining skills to differentiate them from the competition or to advance to the next level of leadership.”

The truth is, nursing leadership can take a lot of different forms. In this article, we’ll explore the different leadership roles available for nurses, the skills nurses need to lead, leadership styles, and more.

Nursing Leadership Roles

Nursing leadership roles can vary ranging from running a hospital to running a unit. Here are some of the leadership roles available in the nursing profession.

1. Chief Nursing Officer (CNO)

A CNO is a top-level, nonclinical, administrative position within a healthcare system. 

They are considered the top-level nurse within an organization and they oversee other nurses and the implementation of patient care. 

The CNO is the voice of the nurses in an organization and they must work together with the staff to deliver the mission, values, and vision of the healthcare organization. 

2. Clinical Nurse Leader (CNL)

CNLs provide oversight and improvement over much of the activity in a specific clinical setting. 

They coordinate collaborative care for patients, analyze outcomes and quality of care, act as mentors to staff and liaisons, and collect and integrate data to further their understanding of outcomes. 

CNLs work in the space between bedside and administration. 

3. Nurse Administrator/ Executive

Nurse administrators manage day-to-day operations for nursing staff either on a specific unit or throughout an entire hospital. 

Other responsibilities include budget and financial planning, creating operational strategies, as well as decision-making regarding staffing and protocols. 

Specific job duties will depend on the size and organization of the facility of employment. 

4. Nurse Manager

Nurse managers typically manage a specific unit or department. Nurse Managers create schedules for employees, give annual performance reviews, and help create policies within the unit. The average annual nurse manager salary ranges from $107,248 to $121,300, making it a lucrative leadership position for nurses.

>> Related: Charge Nurse vs Nurse Manager: What's the Difference?

5. Nursing Director

The nursing director's responsibilities include overseeing the nursing staff, as well as communicating between the nursing and medical teams and other healthcare professionals throughout the organization. They are responsible for reviewing policies and procedures, implementing changes, developing a budget, and supporting the staff.

This high level of responsibility warrants one of the highest nursing leadership salaries. Read our comprehensive guide to learn more about director of nursing salary expectations and factors.

Skills & Education Needed to Be a Nurse Leader

Nurse leaders are required to have a specific set of skills in order to be effective. Common skills include 

• Strong decision-making skills
• Conflict resolution
• Effective communication
• Adaptability
• Prioritizing quality and safety 
• Strong bedside clinical skills
• Knowledge of budget and policy
• Empathy
• Business mindedness
• Delegation skills 
• Strong critical thinking skills
• A positive attitude
• Honesty and loyalty
• Passion for their jobs

The education needed to become a nurse leader varies depending on the position. For example, a Chief Nursing Officer would benefit from a Master’s degree in Business Administration (MBA) or a Master’s Degree in Healthcare Administration (MHA). 

More education is always better for leaders in healthcare. Most nurse leaders can expect to earn a degree in an MSN to be an effective leader. Additional education and degrees open many doors for individuals and will make you more competitive with potential employers. 

What Does Effective Nurse Leadership Look Like?

This will vary depending on the location and position but ideally, a nurse leader should be committed to providing the best care to patients in the unit as well as the staff. 

Nurse leaders should be able to positively influence their employees and strive for excellence and commitment. 

A good nurse leader should be present on a consistent basis in the unit, department, or healthcare setting. 

Nurse Leadership Styles

There are a variety of leadership styles for becoming an effective nurse leader. These include, 

• Transformational
• Democratic
• Laissez-faire
• Autocratic
• Servant

Transformational leaders will utilize a collaborative leadership style by using a shared vision for a unit/department/healthcare setting to encourage and inspire change. 

Democratic leadership uses a shared leadership style in which others (staff nurses/other healthcare professionals) guide decision-making and management. 

A laissez-faire leadership style is a facilitative one in which a leader makes few decisions. Autocratic leadership is a unilateral style in which the leader delegates to others with rules and orders. 

Servant leadership is a supportive style in which the leader provides team members with the skills, tools, and relationships they need to perform to the best of their ability. 

Why Do We Need Nurse Leaders?

Nurse leaders are essential to the organization of a healthcare system. They allow bedside nurses to function effectively, patients to receive appropriate and safe care, and ideally will advocate for the nursing staff on a variety of issues. 

Nurse leaders can help create a positive work environment for staff and patients alike. 

Furthermore, nurse leaders will help alleviate staffing concerns, manage payroll, and should be available to staff on a regular and consistent basis. 

Next Steps to Become a Nurse Leader

If you are already an RN, becoming a nurse leader will take time and dedication. 

The first step is speaking with your nurse manager and inquiring about training to become a charge nurse on a unit or a nurse supervisor. This can act as an introduction to leadership positions. Responsibilities will vary but they will include multi-tasking, overseeing nursing assignments, reassignments and more. 

If the roles and responsibilities of a nurse leadership still excite you, consider gaining additional education in the form of an MSN, MBA, and/or MHA. These are often a requirement for most nurse leader positions.