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How to Become a Chief Nursing Officer: Salary & Job Description


Registered nurses (RNs) interested in advancing their education to pursue nurse leadership positions have several career options to choose from, including nurse manager, nurse practitioner, and chief nursing officer.


Chief nursing officers (CNOs) hold the highest-ranking RN positions in a hospital or healthcare facility. They report directly to the chief executive officer (CEO) and are responsible for directing, monitoring, and overseeing all RN services. CNOs make high-level decisions relating to policies, procedures, and clinical standards, and their leadership style influences employee recruitment, retention, and morale.


Licensed RNs interested in pursuing CNO roles should start by developing the knowledge and skills to supervise and hire staff, manage resources, and oversee RN operations. Completing an advanced degree such as an online Doctor of Nursing Practice (DNP) can provide graduates with the clinical and leadership proficiencies to excel in leadership positions at the highest levels of healthcare.

What Is a Chief Nursing Officer?

A chief nursing officer is a C-level executive who is the highest-ranking RN in a healthcare organization. In addition to overseeing all nursing activities, they manage staff levels, oversee budgets, plan for equipment purchases, and ensure that RN staff members are trained in the latest best practices for patient safety, infection control, and patient care procedures.

Chief Nursing Officer Job Description

The exact job description of a CNO may vary based on the size of the facility they work for, but common responsibilities include the following:


  • Overseeing recruitment, hiring, and training of RN staff
  • Developing and managing budgets
  • Overseeing clinical operations such as staffing levels
  • Improving protocols for allocating resources
  • Collaborating with other C-level executives, board members, and managerial staff
  • Developing, directing, and enforcing departmental policies
  • Creating performance goals for RN staff
  • Developing and reviewing standards for patient care
  • Developing and reviewing goals for the nursing department, such as acquiring technology and ensuring RNs remain compliant with their licensing requirements
  • Participating in nurse training and new-hire orientations


Most chief nursing officers work 40 hours per week onsite, Monday through Friday, during standard business hours. Travel for this position may be required to attend seminars and conferences and conduct site visits to other healthcare facilities.

Chief Nursing Officer Salary and Job Outlook

The median salary for chief nursing officers was about $139,000 as of March 2023, according to Payscale. Chief nursing officer salaries can vary based on factors such as experience level, the specific facility, and the cost of living where they work.

CNO Salary by Location

Salary ranges for chief nursing officers can vary widely by location. Some of the highest approximate median salaries by city according to 2023 Payscale data included:


  • Los Angeles: $235,000
  • San Jose, California: $235,000
  • New York City: $220,000
  • San Francisco: $220,000
  • Orlando, Florida: $196,000


Among the lowest were:


  • Cleveland: $118,000
  • Des Moines, Iowa: $112,000
  • Tucson, Arizona: $110,000
  • Oklahoma City: $102,000
  • Grand Rapids, Michigan: $95,000

CNO Job Outlook

The U.S. Bureau of Labor Statistics reports that positions for medical and health services managers, including chief nursing officers, are projected to grow by 28% between 2021 and 2031, which is much faster than the average growth of all occupations. Approximately 56,600 openings for medical and health services managers in the U.S. are projected to become available each year during that period.


Openings in the field will result from the need to replace professionals who leave the workforce to start a family or retire. The aging baby boomer population is also expected to increase demand for healthcare services in the coming years, which will increase the demand for physicians, nurses, and other healthcare workers — including chief nursing officers.

How to Become a Chief Nursing Officer

Professionals interested in becoming chief nursing officers often need both an undergraduate and graduate nursing degree. Common steps to become a chief nursing officer include the following:

Complete a Bachelor of Science in Nursing

A key step in becoming a chief nursing officer is to complete a Bachelor of Science in Nursing (BSN) at an accredited institution.

BSN Admissions Requirements

Enrollment requirements for BSN programs vary by school and can also change depending on whether an applicant has already completed a two-year nursing degree.


For example, whereas standard BSN programs do not require students to have prior college experience, RN to BSN programs are designed for registered nurses who already have an Associate Degree in Nursing. Other common admissions requirements for BSN programs may include the following:


  • Minimum grade point average (GPA) or quality point average (QPA) requirements
  • Completion of an application
  • Payment of an application fee
  • SAT/ACT scores (varies by school)
  • Submission of prior college transcripts, if applicable
  • An active nursing license (for students applying to an RN to BSN program)

BSN Degree Completion Timelines

Most full-time students find they can complete an RN to BSN degree in as little as 24 months, while the average completion timeline for full-time BSN students is approximately four years.


Students enrolled in part-time RN to BSN programs may take three to four years to complete their degree, whereas part-time BSN students may find it takes as long as six.

Pass the NCLEX-RN

After completing a BSN, future nurses need to pass the NCLEX-RN exam. This exam is administered multiple times throughout the year at testing centers across the U.S. The purpose of this exam is to assess an aspiring RN’s ability to make sound nursing judgments and provide safe care to patients.


Nursing students will receive an application to apply for state licensure and an application to take the NCLEX-RN exam approximately six weeks before graduation. As of April 2023, the cost to register for the NCLEX-RN exam was $200; however, additional fees may be due to the state licensing board in the state where the applicant plans to practice.


This computer-based, six-hour exam is graded in a pass/fail format and can consist of 75 to 265 test questions. Test results are provided immediately following the exam. RN candidates who fail the NCLEX need to wait a minimum of 45 days before retesting. The National Council of State Boards of Nursing (NCSBN) allows applicants to retest up to eight times a year.

Gain Professional Experience

BSN-prepared nurses interested in pursuing leadership and managerial roles often need to gain clinical experience before applying to an advanced degree program. Most programs prefer applicants with three to five years of nursing experience. This helps ensure that applicants have developed the patient-centered, action-driven skills needed to excel in a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program.

Earn an Advanced Degree

The next step in how to become a chief nursing officer is to complete an advanced education. Baccalaureate-prepared nurses have three learning paths to choose from.

Earn a Master of Science in Nursing

An MSN is an advanced nursing degree designed to prepare future nurse leaders with the clinical and managerial skills needed to expand their career opportunities. Common admissions requirements for online MSN programs include the following:


  • An active nursing license
  • One to five years of full-time paid RN work experience (varies by school)
  • A BSN from an accredited college or university
  • Applicants also need to meet minimum grade point average (GPA) or quality point average (QPA) requirements


Completion timelines for MSN students can vary depending on whether they’re enrolled in full-time or part-time coursework. Whereas full-time students often find they can complete their studies in approximately two years, part-time students may take longer.

Earn a Doctor of Nursing Practice

The DNP degree is designed for experienced nurses interested in advancing their careers by earning the highest nursing practice credential. Graduates of DNP programs often find they’ve developed the clinical experience and leadership expertise needed to pursue high-level managerial and C-suite level roles, such as chief nursing officer.


Common admissions requirements for DNP programs include:


  • An active nursing license
  • An MSN degree from an accredited college or university
  • Minimum GPA/QPA requirements
  • One to five years of full-time paid RN work experience (varies by school)


The time it takes students to complete a DNP degree largely depends on whether they are enrolled in part-time or full-time coursework. Full-time students often find they can complete their degree in as few as three years.

Streamline the Process with an Online BSN to DNP Degree Program

Baccalaureate-prepared RNs aspiring to pursue CNO and other DNP careers can also opt to enroll in an accredited online BSN to DNP program. This accelerated study track is designed to teach students the skills to work as engaged, educated, and compassionate nurse leaders at the top of their profession.


Admissions requirements for online BSN to DNP programs often include the following:


  • An active nursing license
  • A BSN degree from an accredited college or university
  • Minimum GPA/QPA requirements
  • One to five years of full-time paid RN work experience (varies by school)


Although the time it takes students to complete a BSN to DNP program can vary based on several factors, such as whether a student is enrolled in part-time or full-time coursework, most full-time students can complete their degree in less than three and a half years.

Choosing a DNP Specialization

The core curriculum in a BSN to DNP program includes a variety of courses that blend theory, research, and evidence-based practice to educate students on how to provide compassionate, holistic care.


For example, BSN to DNP foundation courses in Maryville’s online program include the following:


  • Professional Role Development
  • Evidence-Based Practice in Nursing
  • Health Promotion/Disease Prevention
  • Advanced Pathophysiology
  • Advanced Pharmacotherapeutics
  • Organizations Theory and Systems Leadership


In addition to completing core classes, Maryville University students also have an opportunity to specialize in one of five concentration areas:

Adult Gerontology Acute Care Nurse Practitioner (AGACNP)

Aspiring DNPs interested in working as adult gerontology acute care nurse practitioners are trained to assess, diagnose, and treat acutely ill patients aged l8 and over. AGACNPs also provide care to patients seeking assistance in managing chronic conditions (such as heart disease and diabetes), critical illness, or life-threatening conditions that require medical care.


Some courses in the AGACNP specialization track include the following:


  • Adult-Gerontology Acute Care Diagnosis and Management I, II, III
  • Adult-Gerontology Acute Care Diagnosis and Management Practicum I, II, III

Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)

Adult-Gerontology primary care nurse practitioners also provide evidence-based care to patients aged 18 and over. Unlike adult-gerontology acute-care NPs, who tend to see patients on an emergency basis, adult-gerontology primary care NPs specialize in providing primary care designed to help patients maintain their health. Sample responsibilities of AGPCNPs include ordering diagnostic tests, diagnosing illnesses, and prescribing treatment.


Coursework in Maryville University’s BSN-DNP AGPCNP specialization track includes the following:


  • Adult-Gerontology Health Care I, II
  • Adult-Gerontology Nurse Practitioner Practicum I, II

Family Nurse Practitioner (FNP)

Family nurse practitioners provide primary and specialty care to patients of all ages. They routinely order diagnostic tests, treat acute conditions, and treat other conditions and illnesses that fall within the scope of primary care.


Sample courses in Maryville’s FNP specialization track include the following:


  • Family Nurse Practitioner Practicum
  • Pediatric/Family Health Care
  • Adult-Gerontology Health Care I, II
  • Adult-Gerontology Nurse Practitioner Practicum I, II

Pediatric Primary Care Nurse Practitioner (PNP)

Pediatric primary care nurse practitioners specialize in providing primary care services for newborns, toddlers, and children through young adulthood. Whereas FNPs provide care to patients of all ages, PNP training focuses on the well-being of children. PNPs are also trained in the prevention and management of common pediatric illnesses and conditions, such as asthma and chickenpox.


Sample courses in Maryville’s PNP specialization track include the following:


  • Health Promotion of the Pediatric Population
  • Pediatric Assessment and Diagnosis I, II
  • Pediatric Assessment and Diagnosis Practicum I, II

Psychiatric Mental Health Nurse Practitioner (PMHNP)

Psychiatric mental health nurse practitioners evaluate, diagnose, and treat patients seeking mental healthcare. In addition to providing physical examinations, PMHNPs also provide psychological assessments, prescribe medication such as anti-anxiety medications and/or anti-depressants, and monitor and assess the effectiveness of patient treatment plans. They may also provide emergency psychiatric care to patients in crisis.


Sample courses in Maryville’s PMHNP specialization track include the following:


  • Psychopharmacology and Mental Health Assessment
  • Psychiatric Mental Health Diagnosis and Management I, II, III
  • Psychiatric Mental Health Practicum I, II, III

Become a CNO and Embrace Leadership

The future of healthcare relies on the talent and leadership skills of medical and nursing professionals just like you. Are you ready to take the brave step toward a healthcare leadership position that will allow you to lead projects, motivate staff, and set policies for a hospital or healthcare organization?


Find out how the online BSN to DNP degree at Maryville University can prepare you with the foundational knowledge needed to become a leader at the highest levels of the nursing profession.


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