Nurse Manager Career

Nurse managers are experienced health care profes­sionals who manage the operations of services and personnel in medical offices, hospitals, nursing homes, community health programs, institutions, and other places where health care is provided. Their responsi­bilities vary depending on their position and place of employment. They may be in charge of hiring and fir­ing their staff, as well as evaluating their performance. They are usually responsible for maintaining patient and departmental records, including government and insur­ance documents. They may be responsible for develop­ing and maintaining budgets. Nurse managers are often in charge of establishing, implementing, and enforcing departmental policies.

Some nurse managers provide nursing care to patients along with managing the floor or unit. They are referred to as charge nurses or working managers.

Nurse Manager Career History

Before the 19th century, the care of sick and injured indi­viduals was provided by concerned individuals who nursed rather than by trained nurses. They had not received the kind of training that is required for nurses today.

Nurse Manager CareerThe first school of nursing in the United States was founded in Boston in 1873. In 1938, New York State passed the first state law to require that practical nurses be licensed. After the law was passed, a movement began to have organized training programs that would assure new standards in the field. The role and training of nurses have undergone radical changes since the first schools were opened. Education standards for nurses have been improving constantly since that time. Today’s nurse is a highly educated, licensed health care professional.

Nurse managers have always been needed to manage nurses and nursing departments. They serve as an important link between health care management and nurses. In 1967, the American Organization of Nurse Executives, a subsid­iary of the American Hospital Association, was formed as an advocacy group for nurses who “design, facilitate, and manage care.” Today, it has a membership of 5,000 nurses.

Nurse Manager Job Description

Nurse managers are leaders in the health field. They are the professionals responsible for managing the staff that cares for patients. They are also in charge of the operation of their department or unit, and they perform adminis­trative duties related to patient care.

Debbie Robertson-Huffman, R.N., B.S.N., has 22 years of operating room experience and is currently director of surgical services for a 100-bed hospital in California. She is in charge of five departments within the surgical unit: central processing, operating room staff, ambula­tory surgery, recovery room, and special procedures, such as endoscopies.

Being in charge means she is responsible for the hiring, firing, and scheduling of all of her employees, scheduling the operating and special procedures rooms, and ultimately for the smooth operation of the entire surgical unit.

Although it is demanding, Robertson-Huffman enjoys her job. She loves working with her staff. “I have the greatest people working for me,” she brags. “The depend­able staff I have in all my departments makes it an easy job for me. Our group is like one big, happy family—with its dysfunctional moments,” she laughs.

“Nurse managers need to be people persons,” notes Robertson-Huffman. “They must believe in team work and that every member of the team is essential and that no one is more, or less, important than someone else.”

Although working with people is a plus, the paper­work involved is a minus. “It is so cumbersome,” says Robertson-Huffman. “Someone is always needing a report or statistics. We are losing sight of the people with all of the report requirements.”

Nurse managers are responsible for many aspects of the smooth operation of their unit. “I liked having the ability to get things accomplished,” says Sharon Stout, R.N., a nurse manager of a small pediatrics unit for four years. “I saw what needed to be done and knew who to call and what to do to get it done. I liked that.”

Some nurse managers are working nurse managers, meaning that they also care directly for patients along with managing the department. Robertson-Huffman will often help out in the operating room, or as she calls it, “the heart of the OR,” when she is needed. Stout was also a working nurse manager. She says the size of the facility usually determines if the nurse manager also cares for patients. “I liked being a working nurse manager,” she says, “because it put me in contact with the patients and their families.”

Nurse managers work long hours and are usually on call. Robertson-Huffman works eight- to 10-hour shifts, five days a week, and she is always on call for situations that might arise. “Nurse managers need to have stamina,” she notes.

In addition, downsizing at some health care facilities and mergers of institutions may mean additional respon­sibilities for nurse managers.

Nurse Manager Career Requirements

High School

If you want to become a nurse manager you will first need to become a registered nurse. To prepare for this career, you should take high school mathematics and sci­ence courses, including biology, chemistry, and physics. Health courses will also be helpful. English and speech courses should not be neglected because you must be able to communicate well with patients.

Postsecondary Training

All nurse managers begin their careers as registered nurses. The two most common ways to become a regis­tered nurse are to get a bachelor’s degree in nursing from an accredited four-year program or to get an associate’s degree in nursing from an accredited two-year program. Bachelor’s or advanced degrees may be required for some nurse manager positions. Nurse managers need to have considerable clinical nursing experience and previous management experience.

Some nurses combine their nursing degree with a business degree, or they take business studies or health care management courses to advance to higher manage­ment positions such as directors, health care executives, or administrators.

Certification or Licensing

All states and the District of Columbia require nurses to have a license to practice nursing. To obtain a license, graduates of approved nursing schools must pass a national examination. Nurses may be licensed by more

Other Requirements

Nurse managers must be good people managers and have the ability to work with all levels of employees and management, as well as patients and their fami­lies. They should have excellent organizational and leadership skills, and be able to make intel­ligent decisions in a fast-paced environment. They must also be assertive and demand that procedures are done correctly and quickly. They often need to set policies and see that they are followed and documented. New medical technologies and patient treatments are constantly being developed and implemented, so nurse managers must stay abreast of new information in the medi­cal field. They also need to stay up to date on new insurance and government regulations and reporting requirements.

Exploring Nurse Manager Career

There are many ways to learn more about nursing. You can go to your school or local library and check out books on nursing, or you can visit the Web sites of nursing associations (see the end of this article for contact information). You might also ask your teacher or guidance counselor to set up a presentation by a nurse or nurse manager.

You might also consider volunteering at a hospital or other health care facility. This will allow you to see nurses on the job. Some schools offer participation in Future Nurses programs. If you are interested in becom­ing a nurse manager, you might consider managing a school club, organization, or intramural sports team. This experience will teach you how to manage people, keep records, and maintain budgets.


Nurse managers are employed by medical offices, hos­pitals, nursing homes, community health programs, managed-care facilities, long-term-care facilities, clin­ics, industry, private homes, schools, camps, and gov­ernment agencies.

Starting Out

The position of nurse manager is not an entry-level posi­tion. Only experienced, well-trained nurses are trusted to manage other nurses as well as the health of patients. To begin your career path to nurse manager, you will first need to become a registered nurse. Registered nurses may apply for employment directly to hospitals, nursing homes and companies and government agencies that hire nurses. Jobs can also be obtained through school placement offices, by signing up with employment agen­cies specializing in placement of nursing personnel, or through the state employment office. Other sources of jobs include nurses’ associations, professional journals, and newspaper want ads.


Nurse managers may advance by taking positions at larger facilities with higher budgets and more staff. They may also pursue advanced degrees in health care admin­istration, which would allow them to manage nursing homes, hospitals, and other health care facilities.


Educational background, experience, responsibilities, and geographic location determine earnings as a nurse manager.

According to the U.S. Department of Labor, the median annual earnings of all registered nurses were $53,640 in 2004. Salaries ranged from less than $38,050 to more than $77,170 a year. Nurse managers, however, can usually expect to make more. The Department of Labor reports that in 2004 the median annual earnings of medical and health service managers, which includes nurse managers, were $68,320. The lowest paid 10 per­cent earned $42,300 and the highest paid 10 percent earned $117,730. According to, an online salary information provider, the national average salary for nurse managers in 2006 was $77,883. Some nurse managers advance into administrative or director posi­tions, where their salary is even higher. For example, reports that the mean average salary for nursing directors was $102,500 in 2006.

Employers usually provide health and life insurance, paid vacation and sick leave and retirement plans, and some offer reimbursements for continuing education expenses.

Work Environment

Nurse managers can work in any number of health care facilities including doctor’s offices, medical clinics, hos­pitals, institutions, and nursing homes, as well as other medical facilities. Most health care environments are clean and well lighted. Inner-city facilities in economi­cally distressed areas may be in less than desirable loca­tions, and safety may be an issue.

All health-related careers have some health and disease risks; however, adherence to health and safety guidelines greatly minimizes the chance of contracting infectious diseases such as hepatitis and AIDS. Medical knowledge and good safety measures are also needed to limit expo­sure to toxic chemicals, radiation, and other hazards.

Nurse Manager Career Outlook

Nursing specialties will be in great demand in the future. The U.S. Department of Labor predicts that employment for all types of registered nurses will grow faster than the average through 2014. In addition, a report by the Bureau of Health Professions predicts that 44 states and the District of Columbia are expected to have RN short­ages by 2020. These statistics support the need for nurse managers today and in the future.

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