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Journey to Becoming a Chief Nursing Officer (CNO/CNE)

by Melissa Bell
7 minutes read

There are sound reasons why so many people aspire to train as a nurse, including helping those in medical need, exceptional career progression options, continual opportunities for ongoing professional development and the prospect of selecting from a fascinating range of specialized nursing roles, and that’s to name just a few. 

nurse doctor paperwork

As Forbes noted in the wake of the Covid-19 crisis, nursing is a profession that certainly has periods of intense stress and, at times, arduous workloads – experiences that can lead some to approach ‘burnout’. However, as the article also emphasizes, it’s also immensely rewarding. The people that nurses help, many of them in their most acutely distressed moments, tend never to forget the way they cared for them and guided them to recovery through frightening and painful illnesses or injuries. Nurses make an immense, positive difference in people’s lives, often accompanying them out of their darkest moments.

Just as there’s a strong demand for talented people to become credentialed and enter nursing to embark on an immensely rewarding career, at the other, senior end of the profession’s scale there also exists a strong need for highly experienced and highly qualified nurse leaders.

In this article, we’ll explore how those with the aptitudes, credentials and resolve to get there can traverse the journey to enter one of the most advanced and prestigious roles in the profession: that of a chief nursing officer.

What is a chief nursing officer?

Essentially, this is an executive leadership position. Although fully credentialed and clinically experienced as nurses, chief nursing officers (CNOs) no longer work directly with patients. They focus instead on the senior administrative level of overall patient care services: how these various services operate and how nursing staff can play their part to maximal beneficial effect in these operations. 

Although no longer directly involved in patient care, that prior experience feeds into the CNO’s executive work. In reality, decisions and negotiations made by CNOs will affect the level of care patients receive and the work undertaken by nurses. CNOs not only develop budgets, they also ensure that all clinical practice under their supervision remains fully in compliance with local, state and federal regulatory requirements.

The leadership status of CNOs becomes apparent when one considers their role in the overall health system apparatus: their insights and input are required in a multitude of healthcare settings, from huge state-wide healthcare systems to individual hospitals and clinics. They have the special insight to create optimal outcomes for acute-care facilities, surgery centers, home care and rehab services.

So, a question that quickly arises is: how does one become one of these high qualified, and highly paid, professional leaders? What’s the journey one must travel to become a CNO? 

Let’s move on to that next.

Becoming a chief nursing officer

As one might suspect, the “road” to CNO stature is usually a lengthy and tough one. All CNOs have highly credentialed and in-depth experience working as Registered Nurses (RN). This equips them with invaluable hands-on, day-to-day “know-how” of what nurses do to achieve the best outcomes for their patients.

Quite often, this foundation of clinical experience leads to qualifications well above the basic requisites for entry-level RN status. Many have gone on to complete higher nursing degrees on top of the Bachelor of Science in Nursing (BSN). Some have already completed doctoral nursing programs at accredited nursing schools, obtaining the advanced Doctor of Nursing Practice (DNP) credential. 

So, what in total goes into the making of a CNO? As the ancient Chinese proverb attributed to Lao Tzu holds: “A journey of a thousand miles begins with one first step”. Or, more prosaically: “You can’t eat a whole elephant in one sitting.”

This role is the culmination of a progression, a step-by-step process of essential preparation, over the course of which deep learning and practical wisdom are accrued. The steps can’t be skipped; they’re integral components of the insight and expert overview required of a CNO.

Step one: Get an undergrad degree in nursing and practice as an RN

The first step is to complete a Bachelor’s or Associate degree in nursing, then pass the NCLEX-RN exam to gain a license to work as a registered nurse. 

Step two: Gain practical nursing work experience

It can’t be overemphasized how important this aspect of the road to becoming a ‘CNO’ is. Hands-on work as a practicing nurse is an indispensable initial, and ongoing, step in the journey

Step three: Progress to a higher-level degree

Most CNOs hold at least a Master’s degree in addition to their BSN. This level of higher degree is generally considered the minimum necessary pre-qualification to becoming a CNO. More often however, candidates for these coveted roles have gone even further, completing and graduating from doctoral nursing programs, such as the Doctor of Nursing Practice (DNP). This qualification is generally viewed more favorably for these roles than a Master’s alone.

Step four: Gain as much experience in RN roles as possible

The day-to-day practical application of clinical knowledge and methods in real-world settings is seen as a crucial element in the intellectual armory of a CNO. 

Step five: Gain executive certification

In addition to the above, graduating from a DNP executive leadership program is often what sets a candidate apart. Competition for these roles is intense, so the outstandingly experienced and credentialed will stand a better chance of “making the grade” and being appointed. The 100 percent-online Doctor of Nursing Practice – Executive Nurse Leadership (DNP-ENL) program offered by Texas’ Baylor University, for example, allows experienced nurses to gain this most coveted credential for the job without sacrificing their current employment or their family obligations. Graduates emerge as proven practice scholars and proven nurse leaders, with the advanced business acumen and leadership aptitudes to equip them for positively transforming the hospitals and healthcare systems they join.

These are the essential steps along the road to becoming a CNO, confidently able to demonstrate outstanding communication skills to patients, staff, expert colleagues and outside entities alike. CNOs are required to bring to the table not simply their in-depth knowledge of clinical practice but also the economics and governance of healthcare systems. In addition to their exemplary repertoire of business skills, interpersonal skills and professionalism, they also bring with them exceptional leadership abilities

If this seems like a lengthy and arduous road to travel, it is, but it also culminates in an almost infinitely rewarding and fulfilling career.

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