From the ER to the C-Suite, How to Take Your RN to the Top

Dawn Alexander was early into her nursing career when she worked under a manager, Pam, who left an indelible mark on her — and ultimately inspired her to take her own career to the executive level. 

“I was on the trauma unit as a new nurse and had the most fabulous mentor, a nurse manager,” she said. “She was pretty young and hip and had all this energy, and I just thought, ‘Wow, she’s amazing.’”

Decades later, Alexander, now Chief Nursing Officer (CNO) at Southern Regional Medical Center just outside of Atlanta, Georgia, ran into Pam again at a nursing conference. 

“I went up to her and she remembered me — which, here I am, 50 years old and still giddy because my manager from 30 years ago remembered me, but that’s the impact she had on me,” Alexander said. “That’s the kind of mentoring and development impact that I want to have on nurses… you’ve got to have some great mentors along the way and people you want to model yourself after.” 

As a CNO, that’s precisely the impact, and the level of influence, that she’s able to generate at work each day. And after more than a year of a pandemic that’s left nurses profoundly depleted, strong nursing leaders who can balance both efficacy and empathy, like Alexander, are more necessary than ever. In recognition of National Nurses Day (May 6th), we heard from Alexander and other leaders like her about the reasons to consider using your Registered Nurse (RN) license to become a nurse executive, whether that’s a career as a CNO, a Director of Nursing (DON) or a Vice President of Nursing.

Why Become a Nurse Executive?

Impact your industry and set the tone for your community’s care.

Merry Heath, Chief Nursing Officer at Piedmont Fayette Hospital, began working in health care at age 15. After 20 years as a nurse, she decided to push her career to the executive level, knowing it’d enable her to have a greater impact on the industry. 

“Nurses are the largest workforce in the healthcare industry, and leadership roles allow our influence to impact change that not only supports the profession of nursing but our communities at large,” she said. “The core of nursing is to help others, and becoming a nurse executive allows you to create and lead a superior workforce that provides a world-class experience and care.”

For Alexander, that same sense of impact was a major draw, as well. During the points in her career when she wasn’t at the executive level, she couldn’t help but feel like “I could be doing more on a larger scale.” 

“There was a period in my life where I went from being in a leadership role back to staff nurse for about six to eight months,” she said. “While I loved being back at the bedside, I recognized that I can impact so many more people than just those six patients. I always wanted to see, ‘Can I expand beyond six patients?’” 

Shape the day-to-day lives, and career trajectories, of your team.

Given the major drain COVID has put on nurses — regardless of whether you’re a nurse or a nurse leader, Alexander says those who have “truly committed and stayed the course are just emotionally and physically wiped out” — being in charge of your team’s culture is a critical responsibility. Ultimately, it’s you who’s setting the tone for how fulfilled your nurses feel at work.

“I really push my nursing leaders to support one another and take care of one another, because it’s a hard job,” she said. “It’s important to really watch out for one another and, especially with this past year, to keep yourself safe and healthy, including from an emotional standpoint… I really see my role as uplifting them and making sure that I don’t get caught up in the muck and mire of everything that goes on.”

At the end of the day, many nurses are spending more time with their colleagues than at home with their families. Because of that, Alexander sees it as essential that she promotes self care, both for herself and others, so that the environment her team inhabits at work is a positive, supportive one. 

“It’s really on me to make sure my energy is always as positive as it can be,” she said. “I add humor where I can and let them know it’s okay. As long as we’re doing the best we can with the resources we have, that’s what matters.”

Change and growth will be built-in functions of your job.

For Catherine Burger, a board-certified nurse executive and a Media & Brand Specialist for Registered Nursing, the ascension to an executive role “happened organically.” Gradually, she was moved into leadership roles that involved more and more responsibility and was ultimately given a director-level role before she’d even gotten her master’s degree. The opportunities to expand kept coming, making her career as a nurse executive an incredibly dynamic one. 

“I always advise potential nurse leaders that if you find yourself always asking ‘what if?’ for numerous processes or you’re never ready to settle for the status quo, you’re bound for an executive nurse role,” Burger said. “The reason nurses pursue CNO or CNE roles is because they are striving to make a difference for the nurses and the patients they serve.” 

These roles also “tend to be very progressive,” giving you plenty of opportunity to test out and confirm if an executive-level role is where you want to be: “Most nurses have served as charge nurse, assistant manager, manager, director and then executive,” she added. “You’ll know at the manager level if the executive suite is the right fit for you.”

How to Become a Nurse Executive

1. Go to nursing school.

Get your Bachelor of Science in Nursing (BSN). While you’re at it, it’s a good idea to take some business courses, or even minor or double major in business. As a nurse executive, you’ll do things like create budgets and manage finances, as well as oversee a variety of administrative responsibilities — so getting some business experience from the get-go is a good idea.

2. Pass the NCLEX-RN.

You’ll need to pass the NCLEX to become a registered nurse and eventually qualify for a management or administrative role, starting your climb up the ladder. But the hands-on experience you’ll get as an RN will be invaluable. 

3. Get some work experience, or go straight for your MSN degree.

Some BSN programs will let you get your Masters in Nursing (MSN) in one fell swoop as part of an accelerated program. Consider what your options are. If you’re accepted into an accelerated program that makes sense for you financially, you may consider it worth pursuing — but also know that the ground-level experience you’ll get by working in between your BSN and MSN really is valued by senior leaders. As Alexander put it: 

“If you don’t have the experience of what it’s been like to be in the trenches with your sleeves rolled up, then that just makes your journey a little bit more difficult.”

4. Work with a mentor.

If your sights are set on leadership, it’s imperative to find a mentor who can help you get there. Many organizations will offer Employee Resource Groups that can provide mentoring connections and support. If yours doesn’t, approach a leader within the path you’re pursuing directly and ask for their insight over coffee.

5. Climb the ladder.

Although it’s difficult to qualify for top-level nurse executive roles without a master’s degree or even a doctorate, at the end of the day, elbow grease is just as important for climbing the nursing ladder. As with most careers, some job-hopping may be required in order to advance, and a typical path will take you from staff nurse to assistant nurse manager to nurse manager, nurse director and beyond. Make sure your organization’s leadership knows you’re serious about advancing, and be prepared to put your time in.

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