A Day in the Life of a Chief Nursing Officer (CNO)

Chief nursing officer (CNO) is one of nursing’s most coveted jobs. It takes you right to the top and puts you in charge of managing nurses in your healthcare facility. Although some nurses rise to this position because they have many years of experience, the fastest way is to earn the right educational qualifications. An MSN/MBA program for nurses gives you the skills that employers are looking for. 

Before you commit to an MBA or MSN program, it is important to know as much as possible about a CNO role. What is it and what are you expected to do?

What is a chief nursing officer?

A CNO is the head of nurses. The role combines administrative and leadership duties. They do everything, from hiring new nurses to supervising them as they work. 

Their role is to maintain high clinical and patient care standards. The CNO in a hospital works closely with top management to help improve overall facility care. They develop protocols and processes to deliver the best care to patients. 

You may have chosen to become a nurse because you enjoy the direct contact you have with patients. You find it fulfilling to interact with them and deliver the care and treatment they need to get better, which may cause you to wonder whether you will perform this role when you become a CNO. 

In the CNO role, your interaction with patients will be reduced. You will not be doing ward rounds with doctors, administering medications or ordering tests. However, you will supervise nurses who perform these duties. You may be called on from time to time to see special cases that require your input and experience. 

One commonly asked question is: Where do CNOs work? 

It is not just hospitals that need these professionals. If you have the right qualifications, you can be employed in an outpatient care center, a clinic, a nursing home or a group physician practice. Some CNOs work in rehab facilities and government agencies. 

This article by Spring Arbor University explains everything you should know before you start looking at an MSN/MBA program for nurses.

What are the roles of a chief nursing officer?  

The role of a CNO varies depending on where they work and the patients that they deal with. The duties of a CNO in an oncology hospital, for example, may vary from those of one working in a nursing home.  Nonetheless, certain duties come with the job:

·         Administration

This is a broad role, and a CNO may sometimes find themselves performing the duties of the CEO. It involves planning and overseeing daily activities and ensuring that everything is running as it should. 

A CNO organizes and coordinates the delivery of medical services, ensures compliance in all departments, evaluates, hires and trains nurses, and guides hospital employees on best practices. 

This may also include being involved in the planning and execution of budgets. 

·         Liaising with physicians and specialists

Maintaining a good working relationship between nurses and doctors is not easy. It is the CNO’s job to iron out as many kinks as possible. They provide support to RNs and LPNs so they, in turn, can support the doctors they work with. 

A CNO, for example, ensures that nurses retrieve the patient information that doctors need, provide diagnostic tools and carry out doctors’ orders. 

They also coordinate nurses so that they can provide support to visiting specialists. 

·         Maintaining the best quality of nursing care

This is a broad role, and it can vary depending on where one works. It involves ensuring that patients receive the best quality of nursing care. The CNO will provide all the resources and training that nurses need to undertake their duties. 

They fight to make sure that nurses have good working conditions, and act as representatives when nurses have grievances. 

These duties require extensive knowledge of nursing procedures. A good CNO is up to date with staff rules and procedures as well as policies regarding patient care. 

·         Compliance

Although there may be a specific department that deals with compliance, it is the job of the CNO to ensure that nursing staff deliver care according to accepted industry standards. They must also ensure that state and federal laws are observed. 

They are charged with making sure that nurses know what is expected, including the best healthcare practices and also what is not acceptable. This involves observing nurses and evaluating them to ensure that they comply with regulations.

·         Advising

In many healthcare facilities, the CNO is expected to play an advisory role. They work with top management to improve healthcare standards and ensure that the hospital or clinic runs smoothly. They research best practices, evaluate results and prepare reports. 

·         Evaluation of patient healthcare

A CNO must evaluate the quality of patient services from time to time. It may be once a quarter or once every six months. They measure healthcare services against hospital guidelines. They also check whether care delivery follows state and federal laws and guidelines.

After each evaluation, they must prepare reports and offer suggestions on how to make improvements. 

·         Nurse education and training

In many job descriptions for the CNO role, this is highlighted as one of the key duties. They research industry standards and prepare training courses for new and old nurses. They teach them best practices and evaluate their skills every year. 

To do this, the CNO must attend seminars and workshops and work closely with others in similar positions to keep up with the best practices. 

How do you become a chief nursing officer?

As you can see from the role of a chief nursing officer, they are almost a jack of all trades. How do you prepare to rise to this top role in clinical management? 

The first step is to start exploring an MSN/MBA program for nurses. 

As long as you are already an RN, you can pursue an MBA or MSN in nursing. Apart from imparting additional nursing skills, these courses have modules that teach leadership, administration, business, finance and even law and compliance.

These courses are now available online through many universities, so you can work and study at the same time. You can check whether your current employer is willing to help you meet some of the tuition costs. In many hospitals, nurses qualify for benefits to help them further their careers. 

Soft skills needed to be a chief nursing officer

Although there is a lot of information about how an MSN/MBA program for nurses can help you become a CNO, not much is discussed about the soft skills needed for success. To be exceptional, you need the following set of skills:

  • Leadership – You should be able to step in and guide your team at all times. You should also be an example to those you supervise. 
  • Empathy – As you are already a nurse, it is likely that you are an empathetic individual. In the role of CNO, you will need to know when to set aside empathy and make hard decisions. 
  • Attention to detail – You have a lot of responsibilities, and it is your job to make sure nothing falls through the cracks. 
  • Multitasking – Imagine a busy ER, with critical patients being wheeled in through the door every few minutes, each requiring immediate attention. Can you cope with directing staff to help all of them?
  • A good bedside manner – This is the oldest soft skill required of any nurse. Although you don’t often come in direct contact with patients, you need to be kind, pleasant and compassionate when you do. 
  • Flexibility – Hospitals have lots of moving parts and being too rigid can cause bottlenecks in the system. 
  • Listening – You supervise a lot of nurses, and you liaise with almost every department in the hospital to deliver patient treatment. Being a good listener will help you solve many problems. 
  • Efficiency – You should be able to maximize the resources available to you and your staff. 

Are there downsides to being a CNO?

Every job has pros and cons, and you may be wondering about the cons of becoming a chief nursing officer

The fact that you need more education is off-putting for some. However, remember that you will earn more and you will rise to management after a couple of years of study. 

Some nurses also worry about the fact that if they rise through the ranks then they will not be in contact with patients anymore. If direct patient care is your passion, this may not be the job for you. 

The biggest con, however, is the additional responsibility and long hours required for the job. Apart from directly managing those who work for you, there is a lot of paperwork to attend to and you will spend many hours in meetings. 

You should also be prepared to make decisions that may be unpopular with some of the staff. 


If you are determined to rise to the top of the nursing profession, consider becoming a chief nursing officer. It puts you in charge of all the nursing staff and you work closely with management on all aspects of healthcare delivery. 

An MSN/MBA program for nurses will help you reach this position. If you choose an online program, it can commonly be completed in two to three years. 


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