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What You Need to Know About Nurse Management and Leadership Roles

A medical professional in blue scrubs.

Opportunities in nursing management have expanded rapidly in the past few years, driving an increased need for qualified nurses ready to step into leadership roles. In the next decade, the demand for nurse managers and other nurse leaders will likely continue to grow for several reasons. The nursing workforce is aging — 40 percent of the U.S. workforce is age 50 and many nurses are nearing retirement. The evolution of nursing leadership is also changing employment in nursing. Charge nurses once supervised staff nurses but were overseen by physicians and administrators. Today, leadership-focused nursing roles are more expansive. Nurse managers and other nurse leaders work in patient care units, administration, and hospital boardrooms. They are full partners in patient care, leading “their unit staff in preventing patient harm, empowering nurses to be the first line of defense,” says the Agency for Healthcare Research and Quality (AHRQ).

The education requirements for nursing leadership jobs vary by title and employer and are still evolving. What’s settled is that nurse managers and other leaders need outstanding medical expertise, administrative acumen, and leadership skills — all of which are part of the non-clinical Master of Science in Nursing (MSN) curriculum. “Nurses must understand that their leadership is as important to providing quality care as is their technical ability to deliver care at the bedside in a safe and effective manner,” reports The Robert Wood Johnson Foundation in its Future of Nursing report.

The Online Master of Science in Nursing Leadership, Analytics and Innovation program at the University of Michigan turns nurses into leaders. Coursework covers administrative decision-making, health care innovation, strategic planning, health care analytics, and the essential leadership skills RNs need to advance into leadership roles.

How Qualified Nurse Leaders Impact Care

According to AHRQ, nurse managers “embody both the nurse and executive roles,” and that “by ensuring that staff, patients, and patient families are communicating, nurse managers help unit staff members deliver the safest possible care.” Nurse leaders with master of science in nursing leadership degrees are change agents and innovation drivers in health care settings, bridging the gap between administration, physicians, RNs and nurse practitioners, and patients. They are well-placed to initiate new policies and practices that improve patient care and the patient experience.

As a result, nurse leaders directly influence care quality and patient outcomes. A 2020 Press Ganey Nursing Special Report found that nurse leaders positively impact safety, patient satisfaction, the quality of health care work environments, and staff engagement. And when nursing staff members feel empowered and engaged, patient care gets better and patient satisfaction goes up. Staff engagement also leads to increased facility performance, directly improving patient outcomes. Nursing leaders create cultures of safety, support interprofessional collaboration, promote engagement, mitigate nurse burnout, and spearhead value-based care and continuous quality improvement initiatives.

Why Nurses Make Such Strong Managers and Leaders

Nurses are ideally positioned to be influential health care leaders as they represent the largest segment of U.S. health care providers. They also spend the most time with patients compared to other providers. The Institute for Healthcare Improvement estimates that nurses spend 70% of their time on patient care — giving them a more thorough perspective on the needs of patients, families, providers, and facilities. Nurses also make great leaders because they are amongst the most honest professionals, leading annual rankings for workplace ethics for two decades.

Modern nursing leadership involves managing cross-functional care teams, overseeing quality improvement initiatives, revamping nursing processes and policies, and educating and mentoring new nurses. “Leaders do more than delegate, dictate, and direct,” writes Robin Schaeffer, MSN, RN, CAE, and Executive Director of the Idaho Nurses Association. “Leaders help others achieve their highest potential.”

The U.S. Bureau of Labor Statistics predicts the job sector of medical and health services managers will grow by 32% in the coming decade — much faster than the average for all other occupations. As the staffing landscape continues to evolve in nursing, so will attitudes toward collaboration between physicians and nurses. For instance, there is already a growing push to see nurses play more active leadership roles in quality improvement (QI). Nurses are the “eyes and ears of the hospital,” and when nurse leaders are at the forefront of new initiatives and promoting new practices, they are more likely to succeed long-term.

The Skills and Qualities Effective Nurse Managers and Leaders Share

Effective nursing leaders have first-rate medical skills but must also possess solid leadership, business, and data analytics skills. Nursing leaders work to engage the community, represent the nursing staff, advocate for patients, and improve equity and care by being agents of change for nurses, the health care system, and the community. The National Academy of Sciences Committee on the Future of Nursing 2020–2030 recently identified specific skills and competencies vital to nursing leadership in health care environments, including:

  • Visioning for health equity
  • Leading multi-sector partnerships
  • Leading change
  • Innovating and improving
  • Teaming across boundaries

Nurse leaders must have hard and soft skills related to critical thinking, team-building, people management, technology management, research, and multitasking. As the pace of innovation increases, a healthy appetite for discovery and learning, as well as an agile spirit, helps nurse leaders stay on top of new evidence and processes. Nurse leaders must also be decisive, ethical, emotionally intelligent, and strong communicators to advocate for the best possible patient care.

Future nursing leaders can develop these skills by learning from the richly qualified and innovative faculty of the U-M School of Nursing. Clinical Assistant Professor, Dr. Rhonda Schoville, focuses her research on technology and innovation adoption, clinical informatics, product/innovation development, implementation science, and the development of new processes and tools to enhance care on the cutting edge of medical technology. For example, Dr. Marie-Anne Rosemberg seeks to optimize health for diverse populations and teaches “decision science and complex systems, which includes decision-making from the policy level and at the organizational level of the workplace, all of which influences the health outcomes of the individual, their family, and the community as a unit.”

Is There a Difference Between Nurse Managers and Other Nurse Leaders?

Nurse managers supervise nursing staff and collaborate with other health care providers to coordinate patient care. They may have other titles, such as charge nurse, lead nurse, or nurse supervisor. Regardless of title, they have a hand in everything in their units. This can include budgeting and finance, human resources management, operations management, staff education and professional development, and EHR management. Some nurse managers are still active on the clinical side of medicine and oversee case management, discharge planning, and patient care standards development.

Nurse leaders — a class of role encompassing titles such as director of nursing, vice president of nursing, Chief Nursing Officer (CNO), and Chief Nursing Executive (CNE) — typically manage larger multi-provider teams or whole health care systems. They focus on the quality of patient care and patient safety at an organizational level and oversee teams of managers. Data management, financial management, resource allocation, and regulatory compliance may fall into a nurse leader’s wheelhouse.

The list of leadership roles open to nurses is expanding rapidly, and nurses are now parallel care partners in patient care and health care administration alongside other health professionals. The list is continually expanding as new demands on medical professionals and new technologies increase the need for more specialized nursing leadership.

U-M’s Master of Science in Nursing in Leadership, Analytics and Innovation curriculum teaches AONL and ANCC nurse leader competencies, and graduates can take ANCC and AONL certification exams. Nursing certifications that validate leadership skills include:

How to Become a Nurse Leader Isn’t Always Clear

The challenge ambitious nurses face is that many organizations still have no clear non-clinical advancement pathway for nurses and other clinicians. In the past, many nurse leaders assumed their positions based on expertise in clinical roles. They might have a BSN or another bachelor’s degree but little experience related to leadership before becoming a charge nurse or nurse manager.

Today, more nurses are forging their own career paths by seeking advanced education in nursing leadership. The National Academy of Medicine has asserted that nurses with advanced nursing degrees such as the MSN degree will “replenish the nurse faculty pool; advance nursing science and contribute to the knowledge base on how nurses can provide up-to-date, safe patient care; participate in health care decisions, and provide the leadership needed to establish nurses as full partners in health care redesign.” Master’s degree programs such as U-M’s online MSN program in Leadership, Analytics and Innovation already prepare nurses to meet the future of nursing head-on.

How the University of Michigan Prepares Nurses to Lead

The U-M graduate nursing program is at the forefront of modern nurse leadership preparation. “What is so special about this program is that it allows you to look at the big picture of populations, of systems of care, of health systems of care, and of leading groups of nurses,” says Dr. Medvec. “We have focused on how to build your analytic skills and how to continually tap into what nurses are well known for, which is innovation.”

U-M’s School of Nursing is a top-ranked institution, and the majority of the coursework for the 34-credit hour LAI program is delivered online and asynchronously. Registered nurses complete the leadership program in two to three years, and the University of Michigan School of Nursing is proactive about “working with students to change program plans so that they can continue their education while working, and do it the way they want to,” says Clinical Associate Professor Dr. Barbara Medvec. “If you’re an LAI student, we’re going to work and flex with you to meet your professional needs.”

Students complete much of the coursework independently but participate in annual four-day intensives to explore different roles in nursing leadership and participate in simulations. During intensives, they meet classmates and U-M faculty and participate together in in-person, activity-based learning that synthesizes the program’s online content.

The University of Michigan School of Nursing faculty specializes in areas of leadership like nursing informatics, evidence-based practice, and health analytics. Faculty members are active practitioners and internationally recognized leaders in their fields — some are former CNOs. Dr. Medvec has extensive experience in leadership, nursing practice innovation, value-based care, ambulatory/continuum of care, and strategic and transformational planning. She supports CNOs in organizational design, transformational leadership, and nursing excellence. Clinical Associate Professor and Faculty Lead for Innovation, Research, and Technology Development, Dr. Michelle Aebersold, has expertise in nursing technology — specifically high-fidelity and virtual reality simulation.

The University of Michigan School of Nursing also works closely with leading health care organizations, helping students build their professional networks and exposing them to a broader range of opportunities. Students can even explore global pathways in nursing leadership via the School of Nursing’s role as a World Health Organization Collaborating Centre.

According to a joint policy statement released by the American Nurses Association (ANA) and American Association of Colleges of Nursing (AACN), factors such as acute location-specific nurse shortages, fewer nurses entering the workforce, a changing health care landscape, and shrinking academic pipelines have conspired to create an urgent need for new advancement pathways and nurses who are ready to lead. With a master’s degree in nursing leadership from U-M, you can fulfill that need. You’ll have the skills, experience, and, importantly, the credentials necessary to lead health care teams, improve nursing practice, educate future health care professionals, make health policy, and innovate in the health care system.

Register for an upcoming online event to learn about who pursues the MSN and why, the wide range of Master of Science in Nursing career pathways, the online student experience at U-M, and financial aid options. Or take the next step in your nursing career and apply online today.