What is the Role of an Executive Nurse Leader?

Historically, executive nurses were mostly career nurses who rose through the ranks. Today, the role of a nursing executive requires more than just experiencing different levels of nursing and learning on the job. 

This evolution has paved the way for anyone, including non-medical professionals, to quickly gain the competence and experience needed to lead a healthcare enterprise and secure the interest of patients, healthcare workers and the community. 

A nursing executive combines medical knowledge with administrative skills and leadership skills to manage policies, support collaborations, and drive a healthcare facility toward its vision and goals. They can dispense their duties from many different positions, from mid-level positions such as a clinical nurse leader and manager to higher-level positions such as a chief nursing officer. 

This article provides an in-depth analysis of the executive nurse leader, exploring their various responsibilities. We’ll also examine the competencies and qualifications required of the position, as well as the quickest route to becoming an accomplished nursing executive.

What is a nursing executive?

For every activity in a healthcare facility, there’s an executive nurse actively involved. Executive nurses participate at all levels of operations at a healthcare facility, using medical, leadership and administrative skills to supervise, teach, encourage and advocate for others to ensure the smooth flow of operations in the facility. 

They support unit-based activities and also facilitate cross-functional collaborations between different units. They interact with everyone from junior nurses to physicians, administrative staff, external stakeholders and members of the community at large. 

Their daily responsibilities include:

  • Managing unit operations.
  • Financial management and budgeting.
  • Strategic planning and organizational goal setting.
  • Facilitating personal and professional growth among employees.

As mentioned, executive nurses were once nurses promoted to an executive role after spending years working different levels of nursing jobs. But today, the bar of entry has become much easier to access. 

You don’t need to spend years or decades in a particular healthcare facility. Institutions such as the American Organization of Nurse Leaders (AONL) and the American Nurses Credentialing Center (ANCC) can license and certify nurses with advanced degrees for nursing management and nursing executive roles. Equipped with such licenses, nursing executives can take on many different high-level roles in a variety of health settings. 

What roles can you qualify for as a certified executive nurse? 

The role of the executive nurse has grown more complex over the past few decades, encompassing not only patient care and administrative duties but also financial management, advocacy and managing stakeholder relations. This multiplex of responsibility means that they can occupy a variety of roles and job positions, from clinical nurse leaders to chief medical officers, chief operating officers and executive vice presidents. 

Their work settings can include private hospitals, community care centers, outpatient clinics, nursing homes and long-term care facilities.

Some common responsibilities expected of an experienced nurse include the following.

Nursing duties

An executive nurse is a nurse before anything else. Their primary responsibility is to ensure high standards of patient care in a facility. Working closely with hospital staff and other relevant stakeholders, they use their extensive knowledge of nursing to ensure that patients can access safe, efficient medical care.

Managing cross-functional collaborations

Part of their medical and administrative responsibilities requires facilitating good working relationships between many different units in a facility, from nurses to physicians, pharmacists and non-medical staff. Executive nurses must play a major role in shaping many organizational processes, from patient care policies to hospital management procedures and communication strategies. 

Managing stakeholders

The daily interactions of an executive nurse don’t just end with patients and medical or administrative staff. They extend well beyond hospital wards, encompassing patients’ families, external stakeholders, inventory suppliers, regulators and policymakers.

Administrative responsibilities

On the administrative side, the role of an executive nurse is similar to those of a CEO or COO. They oversee day-to-day activities in the organization and also tend to high-level strategic decisions. 

These can include:

  • Ensuring compliance with care standards.
  • Setting the goals and vision for an organization.
  • Hiring new staff members and tending to the welfare of existing ones.
  • Budgeting and financial management.
  • Maintaining inventories and ensuring the availability of equipment and supplies.


Away from administrative tasks, a nursing executive serves as a leader, a mentor and a coach for others on the medical team. They set professional and personal standards for others to follow. They’re also responsible for inspiring others and looking out for ways to help them grow personally and professionally.

Advisory role

Executive nurses don’t usually have the last word on everything. Sometimes, they only act in an advisory capacity, advocating for progressive policies and recommending ways to improve the existing standards of healthcare delivery.

What does it take to become an executive nurse?

Many executive nurses today gained the required competencies and experiences through years of working in nursing management and other related fields such as business management and advocacy. 

However, getting a doctoral degree can be a quicker alternative route to becoming an executive nurse. A high-level program such as the Doctor of Nursing Practice – Executive Nurse Leader (DNP-ENL) program from Baylor University facilitates quicker, highly efficient professional development for nurse executives. The coursework aims to equip students with competencies in areas such as management and communication techniques, healthcare finances, cross-functional collaboration, high-level decision-making involving board executives, patient care modeling, analysis and data management, and business strategy.

The academic route to qualifying for an executive nurse role usually entails completing a Bachelor of Science in Nursing (BSN), passing the National Council Licensure Examination (NCLEX-RN) and gaining some work experience as a registered nurse. It also entails completing a master’s program in nursing such as a Master of Science in Nursing (MSN), Master of Healthcare Administration (MHA), or Master of Business Administration (MBA). 

It also requires obtaining advanced certifications such as the Certified in Executive Nursing Practice (CENP) credential through the American Organization of Nurse Executives, the Nurse Executive and Nurse Executive – Advanced certifications from the American Nurses Credentialing Center (ANCC), or the Certified in Executive Nursing Practice (CENP) and Certified Nurse Manager and Leader (CNML) from the American Organization of Nurse Executives (AONE)

Take the lead in healthcare delivery in your community today

Nursing executives are masters of communication, chief strategists and highly experienced medical experts. As a nursing executive, you’re a relationship builder, a coach, a mentor and an advocate. With your medical, leadership and administrative skills, you can ensure that the interests of your patients, healthcare workers and healthcare facilities are perfectly aligned to promote good health and wellbeing in your community.