Can a non-licensed allied healthcare professional manage a licensed registered nurse?

Editorial Team / Admin · Jan 21

It would depend on the details. Administratively, such as approving time cards/payroll and things like that? Yes. In a nursing care sense? No.

Editorial Team / Admin · Jan 21

As Rose_Queen noted above, the non-licensed person cannot evaluate an RN's performance.

kbrn2002, ADN, RN · Jan 23

Depends on what you talking about as far as management. Non-nursing managers can manage nurses in an HR capacity; they can make schedules, do payroll, anything not nursing related. They can not manage anything specifically nursing so they can't do nursing performance evals or direct nursing staff on well, anything nursing related.

Barriss Offee · Jan 24

What is it exactly this manager does? That's my question. If they evaluate/direct/modify/etc anything related to your nursing practice and duties, then hard no. TBH, in a GOOD nursing setting, all supervisors and managers of nursing are experienced nurses in that setting from my experience.

lifelearningrn, BSN, RN · Jan 24

Barriss Offee said:

What is it exactly this manager does? That's my question. If they evaluate/direct/modify/etc anything related to your nursing practice and duties, then hard no. TBH, in a GOOD nursing setting, all supervisors and managers of nursing are experienced nurses in that setting from my experience.

I remember as a grad nurse applying at a local nursing home I had volunteered in when I was in high school (some 20+ years prior). When I was told the DON was never a nurse, I was shocked. Never got a call back.

klone, MSN, RN · Jan 26

The answer is yes, because at some point there is always going to be a non-nurse at the top. In my last 2 jobs as a manager, my immediate supervisor was a non-RN. At my last job, there were clinic managers within our network who were the direct supervisor of the clinic RNs, and about half of those clinic managers were not RNs. Who manages the CNO of a hospital? I can guarantee the CEO does that CNO's performance evals.

There is nothing n any nurse compact in any state that I'm aware of that states a non-RN cannot be the direct supervisor of an RN, including giving performance evaluations.

kbrn2002, ADN, RN · Jan 26

klone said:

The answer is yes, because at some point there is always going to be a non-nurse at the top. In my last 2 jobs as a manager, my immediate supervisor was a non-RN. At my last job, there were clinic managers within our network who were the direct supervisor of the clinic RNs, and about half of those clinic managers were not RNs. Who manages the CNO of a hospital? I can guarantee the CEO does that CNO's performance evals.

There is nothing n any nurse compact in any state that I'm aware of that states a non-RN cannot be the direct supervisor of an RN, including giving performance evaluations.

"When is it permissible for a non-RN (other than those healthcare providers listed previously) to clinically supervise or manage a licensed nurse?” A nonRN may NEVER supervise or manage the clinical performance of a licensed nurse. When a position requires an individual with a nursing license, or when a job description requires clinical nursing knowledge, experience, judgment or decision-making in order to successfully fulfillthe role, that position must be filled by a nurse with appropriate licensure. This includes the functions and responsibilities C of assignment and delegation (staffing), and the development and/or implementation of clinical policies and procedures.

I found that in a North Carolina nursing bulletin with a quick search so there's at least one state that addresses this. I have to leave for work soon so I didn't dig into my state's practice act but I know I've seen similar language buried in it somewhere, I'll try to dig it out later today.

UrbanHealthRN, BSN, RN · Jan 26

kbrn2002 said:

"When is it permissible for a non-RN (other than those healthcare providers listed previously) to clinically supervise or manage a licensed nurse?” A nonRN may NEVER supervise or manage the clinical performance of a licensed nurse. When a position requires an individual with a nursing license, or when a job description requires clinical nursing knowledge, experience, judgment or decision-making in order to successfully fulfillthe role, that position must be filled by a nurse with appropriate licensure. This includes the functions and responsibilities C of assignment and delegation (staffing), and the development and/or implementation of clinical policies and procedures.

I found that in a North Carolina nursing bulletin with a quick search so there's at least one state that addresses this. I have to leave for work soon so I didn't dig into my state's practice act but I know I've seen similar language buried in it somewhere, I'll try to dig it out later today.

I was curious so I went ahead and looked up North Carolina. And yes, they are VERY clear about nurses supervising nurses! (Though when it comes to things like attendance, dress code, etc they say administrative staff can supervise this). Here's two links I have to share:

https://www.ncbon.com/vdownloads/course-bulletin-offerings-articles/bulletin-article-Winter-2015-whos-your-supervisor.pdf

https://www.ncbon.com/news-publications-statistics-frequently-asked-questions-nursing-practice#:~:text=Licensed Practical Nurse.-,Can a nurse be supervised by an unlicensed person or,%2C attendance%2C dress code).

I've been supervised by both nurses and non-nurses over the years. I've had some great supervision from both sides. But when it comes down to having the kind of supervision that keeps me in my job long-term and keeps me feeling supported, then that supervision has usually come from a nurse.

I remember one time I worked for a public health program that was entirely nurse-staffed, but all of management and the public health administrators were non-nursing. Needless to say, there were some issues with that program, and the fact that there wasn't a nursing voice in leadership is probably what led to my leaving.

mmc51264, BSN, MSN, RN · Jan 26

I work in NC and almost everyone higher than me, that I have to have any contact with is a nurse or a physician. Up until recently, the president of our hospital WAS a nurse! Now a doctor. There are some administrative people that are more business people, but they don't have anything to do with day-to-day nursing stuff