CNO vs. Dept. Manager

jrt4 · Jul 9, 2015

It sounds like you are working at a small healthcare system since the manager reports directly to the CNO. The CNO position is meant to be an executive leader position to direct quality and productivity of nursing across the organization. Typically what I have seen is several "director" positions that report to the CNO. The directors have nurse managers who are the front line managers for individual units. The CNO is typically more of the face of nursing at the organization. I have also seen CNOs be responsible for ancillary departments as the executive leader. Its different in every organization.

owensmommy · Aug 7, 2015

Typically, unless you are working in a smaller hospital, there are nursing directors in between the CNO and nurse managers. The director role is a nice stepping stone to gain other important leadership skills before taking the responsibility of all nursing departments. As a nurse manager, I was not focused on the big picture. I was more focused on the day-to-day operations of my unit. Staffing and schedules took up a big part of my days. At the director role, you learn to think more globally. You become more familiar with overall hospital operations and see how each areas interlinks to one another. Director level also allows you to be more involved with projects and strategy.

SummerGarden, BSN, MSN, RN · Aug 8, 2015

OP: The other two posters are correct. In fact, I think you should actually look at becoming a director before becoming a CNO. If you jump right into CNO in any place other than what you have described in your facility, you are skipping 1-2 steps that are necessary in your career growth in order to be successful in the CNO role. For example, my manager does not work as Charge Nurse ever, she does not provide direct patient care when short staffed, she does not worry about staffing on a day-to-day-moment-to-moment basis, and she does not have to deal with disciplinary issues for the most part because most being disciplined are the direct reports of her Assistant Nurse Managers. Specifically we the Assistant Nurse Managers lead the way with issues at the department level, seek advice when needed, and keep our manager informed so she is never blind-sided. In fact, she gives us the authority to make many of the decisions to keep the department running on a day-to-day basis freeing her up to handle the overall operations for several departments and to work with other directors, the CNO, and other executive level managers to support the operations of the hospital.

On the other hand, if you have the opportunity to be mentored/trained well for the CNO role that can translate into working in a bigger facility or you are only interested in working as a CNO in smaller facilities, then go for it. I am one that believes in accepting opportunities when they are available because they do not come along often. Good Luck!

mommy2boysaz · Aug 8, 2015

Thank you all very much for clarifying the difference in positions among smaller vs. larger facilities. Gave me much to consider!