Hospital Administrator

[Arichter]

I am a recently graduated RN with a position in an ICU. I was looking at going back to school in the next year or two in order to progress towards an administrative role in the hospital. I have always been inclined toward business and leadership, although my only degree is my BSN. My question is what degree should I choose? An MBA in healthcare administration? An MSN with a focus on health admin? What do I need to do in my nursing career over the next year or two to make myself a better candidate for graduate schools? What should I do in graduate school, or before, to be able to get a position upon graduation? Thank you all for sharing your experience and knowledge. I literally eat this stuff up.

[HouTx, BSN, MSN, EdD]

I have a feeling that my input may rile some folks - but here goes.

Nurses are pretty much pigeonholed in most health care organizations... the fact that you're a nurse, will overshadow everything else. That does not mean that career advancement is not possible - it just means that we need steer into that skid and advance via a nursing pathway. Once a nurse reaches a higher echelon administrative position (director of multiple departments & service line directors) s/he is considered "promotable" into a more general executive slot, including organizational "C-suite" roles (CNO, CFO, CIO, CEO, etc).

So. . . you'll need that MSN to become eligible for nursing leadership positions. This is 'our' graduate education. A clinical MSN (NP) may be OK, but the curriculum will not include all of the 'business' education that prepares you for a leadership role. You may even want to explore a hybrid program such as an MSN/MHA, MSN/MHA, MSN/JD, etc. Keep in mind that the most well-regarded programs are NOT 100% online - they include management practicums which provide you with confidence that can only come with practical experience.

At the same time, you will need to take the initiative to increase your own leadership experience to ensure that you know more about our industry than just your day-to-day job. Get involved in 'functional' activities that are over and above your specific job such as QI, councils, committees, task forces, etc. Chances are, if you make sure your supervisor knows that you're interested s/he will give you plenty of opportunities -- volunteers are always welcome! This type of work will help convince people that you are capable of taking on more responsibility.

Be prepared for a major reality shock as you transition to management. No more overtime, despite the fact that you routinely work > 40 hours. "Extra" is expected. No more warm fuzzies from 'helping' patients - since this is probably one of the main reasons you became a nurse in the first place, it can be very hard to deal with. You're the designated scapegoat for everything that goes wrong... by subordinates as well as higher-ups and physicians. Your former co-workers are no longer 'friends'. And so on . . . Yeppers - management jobs are NOT the pot of gold at the end of the rainbow.

I hope you go for it! We need an ongoing supply of well-educated, highly motivated and competent nurse leaders.

[MrChicagoRN, RN]

Not riled, but disagree with a part of what you said. The rest I agree with.

An MSN is of less value than it used to be for a BSN. The marketplace is showing increased support for the MBA or other business degree.

Of course you can split the difference and go for a MBA/MSN combo pack.

[tytkhat]

After I obtained my dual MSN/MBA with the focus of healthcare systems leadership, I promptly sought a management position. I accepted a House Administrator position. There are definitely pros and cons about the role. One thing that affected me is the limited interaction with peer/friends. No more of that, can't be too friendly because you will be accused of favoritism or worse...Another tif is that the salary increased per year, but I took home roughly 600 bucks less a pay period because it is salary. No overtime potential, shift diffs, holiday pay, whaa, whaa, whaa. An advantage of this role was to engross myself into policy, procedure, and politics of my organization. I desired to be a change agent, this role did not allow me to do that. But overall, I am grateful for the experience.