Skip to Main Content

How to Transition from Clinical Nursing to Nursing Leadership

A stethoscope and pink pills on a white surface.

Nurses are at the heart of patient care. They also increasingly represent patients and RNs in hospital and health care system boardrooms. Studies on health care leadership have shown that evidence-based nursing helps health care organizations improve productivity and quality of care. Effective nurse leadership reduces medical errors, boosts staff retention, and positively influences patient outcomes. As a result, there are more opportunities for nurses to step into leadership roles than ever before.

Yet many nurses report they are in the dark about how to advance into these roles. A New England Journal of Medicine (NEJM) report found that fewer than half of nurses surveyed could see a path to leadership in their organizations.

The Future of Nursing report from the Institute of Medicine states that nurses need foundational leadership skills and modernized, industry-specific leadership skills to be influential leaders and full partners to physicians. Those skills include “knowledge of the care delivery system, how to work in teams, how to collaborate effectively within and across disciplines, and the basic tenets of ethical care.”

Non-clinical master of science in nursing leadership programs are some of the only academic pathways that provide clinical nurses with these competencies — and the credentials to advance into managerial positions and the C-Suite. The University of Michigan School of Nursing’s Master of Science in Nursing in Leadership, Analytics and Innovation program gives nurses the data management and decision-making skills to lead in complex, technology-driven health care environments. If you are a clinical nurse looking to transition into nursing leadership but aren’t sure how to make the leap, this article can help you find a path forward.

The Demand for Qualified Nurse Leaders

According to the American Association of Colleges of Nursing, registered nurses less than 30 years old represent only 10% of the total working nurse population. An aging workforce is further straining the existing nursing shortage. The International Council of Nurses projects that up to 13 million nurses will be needed to fill the global nurse shortage.

The ongoing nursing shortage has also created a shortage of qualified nurse leaders. Just 7% of nurses say they plan to move into nurse leadership in the next three years. Yet, nursing leadership is crucial in a quickly evolving health care landscape, according to Assanatu (Sana) Savage, director of the American Academy of Ambulatory Care Nursing (AAACN). “In our 21st-century health care industry, increasing the number of nurses in leadership roles will allow nursing to have a greater impact on policies, strategies, and tactical health care decision-making for communities and health systems across the nation,” she told Minority Nurse.

Who Should Consider a Career in Nursing Leadership?

There are various nursing leadership positions for qualified, ambitious health care professionals. Registered nurses can become mid-level managers, members of hospital system administration, researchers, or case managers. They can also move into more nontraditional roles. But nursing leadership isn’t for everyone, especially when it means moving away from bedside care.

Generally, nurses who move into leadership positions do so because they see room for bigger-picture improvement in their organizations or health care. Aspiring nurse leaders must be able to drive change on a broad scale. With their industry-specific knowledge, nurse leaders are adaptable, good communicators, critical thinkers, and have technological proficiency.

While some of these skills are inherent — such as critical thinking and drive — others are teachable. U-M’s online master of science in nursing leadership program offers aspiring nurse leaders an edge because it includes core courses on data-driven decision-making. MSN courses such as “Foundations of Health Informatics” further broaden the job market by equipping nurses with data analysis skills that allow them to evaluate costs, outcomes, value, and efficiency in their organizations. In “Decision Science for Complex Health Systems,” students learn to use data analytic tools to improve health policy, resource allocation, and quality and safety in medical settings.

If using data and technological tools to improve health care and patient outcomes intrigues you, then taking the steps toward a nurse leadership position in informatics or quality, safety, and risk management might be the right move.

How Do Nursing Leadership Skills Differ from Clinical Nursing Skills?

If you are already working as a registered nurse, you may be wondering what kind of competencies will set you apart as you look to move into leadership. In addition to clinical skills, nurse leaders must understand conflict resolution, health care operations, negotiation, health care IT, project management, and more.

Depending on what kind of leadership role you take, required skills can vary. Nurse managers, for instance, are responsible for the success of their entire team. This job requires the ability to mitigate conflict, stay well-organized, and communicate goals clearly with other nurses. Success in this position is measured by the performance of the nurses on the floor and the well-being of patients in the unit. Nurse leaders empower their teams to positively impact patient care, so good nurse managers should be excellent motivators.

Nurse leaders who don’t work directly with patients or nursing staff often work in quality improvement, administrative, or informatics positions. They need to be able to delegate tasks, set continuous quality improvement goals, and focus on specific areas of change within their organization. For example, a Chief Nursing Officer (CNO) will be responsible for implementing new services to reduce nursing burnout and increase efficiency. They will also be responsible for developing and meeting department goals, creating budgets, and complying with laws. CNOs need to be excellent delegators. Unlike clinical nurses, they are directly involved in strategic planning, so they need to understand how to balance financial management with quality improvement in health care delivery.

Ultimately, leadership skills are useful whether or not you plan to move into nursing leadership. Health information technology and electronic recordkeeping are increasingly important aspects of the job. One study found that nurses spend about 25% of their time on documentation, including EHR and paper charting and reviews.

What Titles Do Nurse Leaders Have?

Although a master’s degree in nurse leadership can prepare you for several tiers of nurse leadership, there are key differences between nurse managers and nurse executives.

Nurse Management

Job titles and responsibilities vary by health care organization, so there are no strictly defined differences between administrators, managers, and executives in nursing. Nurse managers exist in the hierarchical middle ground between RNs and nurse executives. As a result, their responsibilities often fall into both of those categories. Charge nurses, for example, have clinical responsibilities related to patient care and overhead responsibilities, such as overseeing other nurses in the unit.

Nurse managers work in hospitals, private practices, urgent care facilities, surgical centers, and psychiatric facilities. They often have several years of experience and bachelor’s degrees or master’s degrees. Other nurse management positions include care coordinator, case management director, clinical nurse leader, and nursing administrator. The online MSN degree from U-M provides inroads to nurse management career paths.

Nurse Executives

Nurse executives represent the voice of nurses in the C-Suite, and advocacy is a big part of the job. Nurse executives hold titles such as Chief Nursing Officer, Chief Nursing Executive, and nurse executive. Where nurse managers make the connection between patients and teams of nurses, nurse executives bridge the gap between teams of nurses and health care system administration.

Nurse executives must speak up on behalf of nurses and patients and help develop and implement new operational, safety, and quality improvement policies to improve patient care. In today’s health care environment, they must also develop ways to reduce attrition, increase retention, and prevent burnout among nursing staff. To do this, they foster relationships with stakeholders within the hospital and the larger medical community. The ability to collaborate and communicate effectively is essential in this role.

Nurse executives often have several years of clinical and managerial or administrative experience. A master’s degree in nursing leadership has become standard for nurses who wish to reach this position, as it is the most senior nursing position in most health care settings. According to PayScale, nurse executives’ base salary is about $134,000.

U-M School of Nursing courses such as “Strategic Resources and Health Care Operations Leadership” teach nurses to lead teams strategically. Coursework covers financial and economic best practices, human resources guidelines, marketing, and applied technology principles.

How to Transition into Nursing Leadership Roles

Gain Clinical and Administrative Experience

If you want to move into a nursing administration or management position, assess the pathway from inside your organization. Ask: what background do nurse leaders have in your workplace? Generally, nurses need at least five years of bedside experience before being considered for a management position.

Seek opportunities to stand out and gain leadership experience at the clinical level. Many hospitals and private practices have assistant nurse manager positions or openings for shift supervisors. Doing well in these roles provides critical job experience and will enhance your resume.

Earn an Advanced Degree in Nursing

Increased earning potential is an obvious reason to get a master’s degree in any field, and nursing is no exception. There is also plenty of opportunity and room for advancement for nurses with a master of science in nursing leadership. Earning a degree from a top nursing school, such as the University of Michigan, helps nurses stand out in the job market.

There are other benefits to earning an advanced nursing degree for RNs who want to step into leadership roles. Master’s programs help nurses get better at utilizing evidence-based practice using data and research to improve patient safety and job satisfaction for the entire nursing staff. Earning an MSN can help you draw connections between personal experience and institutional policy.

A master’s degree that offers specialization — like any of the certificates and four concentrations offered by U-M — further qualifies nurses for leadership positions by enabling them with skills that others in the field may not have. For example, the U-M online Global Health Concentration teaches nurse leaders to serve diverse populations and influence global health policy.

Earn Additional Certifications

Professional development is essential in nursing. Some common certifications focused on nursing leadership include the Certified in Executive Nursing Practice (CENP), Certified Medical Practice Executive (CMPE), Certified Nurse Manager and Leader (CNML), and Nurse Executive (NE-BC) credentials.

The U-M MSN in Leadership, Analytics and Innovation teaches AONL and ANCC nurse leader competencies, so graduates are prepared to take related ANCC and AONL certification exams. U-M also offers a graduate-level Certificate in Health Informatics. RNs in this program prepare to sit for several exams, including the ANCC Informatics Nursing Certification, which grants the Registered Nurse-Board Certified (RN-BC) credential.

Challenges of Transitioning to Nursing Leadership

Changing Relationships With Former Peers

In any workplace, making the transition into leadership can affect interprofessional relationships. If you’re planning to move into a leadership position in the same workplace where you currently work as an RN, make sure your roadmap includes setting the tone with your team, establishing boundaries, and communicating up-front with your peers about how you plan to lead.

Acceptance of Nurse Leaders

The role of nurses is changing, but not everyone is ready to change their perspectives. According to a report by The New England Journal of Medicine (NEJM), nearly 75% of respondents said nurse leaders should be considered equal to physician leaders in care delivery. Yet there are several factors — including gender bias and lack of educational or advancement opportunities — keeping nurses from fulfilling leadership roles. The survey authors noted that nurses are often seen as “doers” rather than strategists. At more than half of the health care organizations surveyed, nurses filled 25% or less of leadership roles. Nurse leaders who move into positions right now can also help shift mindsets and pave the way for those to come.

Finding the Right MSN Program

There are several factors to consider when choosing a master’s degree program. Prospective applicants must consider their time constraints and outside responsibilities. For many RNs, online programs are ideal because they are more flexible. Cost is also an important consideration for most degree seekers. U-M School of Nursing offers financial aid and tuition support may be awarded based on a variety of factors, including donor-directed criteria, merit, and/or demonstrated financial need.

Finally, nurses should consider their career goals carefully. U-M’s program explores three non-clinical focus areas in leadership, informatics, and analytics. Data analytics will become an increasingly important skill. That’s why choosing a future-facing MSN program is an intelligent move. The U-M nursing leadership program is designed to equip graduates with the skills needed to navigate evolving technology-based nursing informatics and health care administration.

Transition into Nursing Leadership at U-M

Graduate schools offer benefits beyond the curriculum. In many cases, the people define the program. Faculty, alumni, and staff networks can support students and offer advice about career transitions. U-M faculty use real-world experiences to design the specialty nursing program, said Dr. Marjorie McCullagh, Sally L Lusk Collegiate Professor of Nursing, Director of the Occupational Health Nursing Program. Faculty members asked nursing leaders “What do you need? What kind of practitioner are you looking for? What kind of leadership do you want in your organization?”

U-M School of Nursing students can access Career Services’ resources, including an Office of Graduate Studies advisor who provides one-on-one guidance and counseling. The program is also flexible — students complete 34 credits of coursework in either two or three years.

There isn’t one particular path into leadership, but choosing an accredited and top-rated master’s degree program with strong faculty support and a healthy alumni network can help. For more information about the online MSN and how it can help you transition into a leadership nursing role, look at U-M’s online MSN FAQ. When you’re ready to advance your nursing career, apply online.