Taking Charge: Manager vs. Leader in Nursing

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Nursing is about teamwork. Even nurses who often work independently, such as home care nurses, belong to bigger teams. Nurses who work in hospitals, doctors’ offices, outpatient facilities, assisted living homes, and other facilities often work on a staff of hundreds. Working together efficiently takes teamwork, communication, and an understanding of individual responsibility and how each team member contributes to an organization’s big-picture goals.

Nurses in leadership or management positions are critical in healthcare. It’s up to them to set protocol, outline training, define roles, manage scheduling, and more. With the help of managers and leaders, nursing teams become more efficient and can deliver better care. Though “manager” and “leader” may seem like synonyms, in the world of nursing administration, they are separate jobs with different responsibilities. Continue reading to find out more about managers and leaders in nursing, what their job outlooks are, and what it takes to step into one of these positions.

A team of nurses at the hospital

Manager in Nursing Overview

Nurse managers run units of many sizes in all sorts of healthcare facilities. They can lead a group of emergency room nurses in a hospital, a unit of nurses at a senior living center, or a small nursing staff at a doctor’s office. They often work directly with nurses and patients, treating individuals as necessary, as well as performing administrative duties such as scheduling and training. Nurse managers are registered nurses (RNs) who often have an advanced degree. Their professional background enables them to understand the demands of RN work. This experience is coupled with leadership abilities and an understanding of how to manage others.

Manager in Nursing Salaries and Job Outlook

According to the U.S. Bureau of Labor Statistics (BLS), there were 406,100 people working in the category of medical and health services managers, which includes nurse managers, as of May 2018. The median annual salary for all professionals in this category was $99,730; the lowest 10% earned around $58,680, and the top 10%  earned approximately $182,600 annually. Overall, the BLS expects the job market for medical and health services managers to grow 18% between 2018 and 2028, which is more than three times the national job market average.

Leader in Nursing Overview

Nursing leaders are upper-level healthcare managers, serving as nursing directors or in executive-level positions. They focus on organizational ideas and policies that affect everyone at a facility. For example, they might oversee the integration of new nursing technologies, set hiring practices, or participate in conversations with other leaders to identify long-term goals. Though they typically began their careers as registered nurses, nursing leaders have expanded their expertise and experience to the point where they can oversee several nursing units or an entire facility.

Leader in Nursing Salaries and Job Outlook

The BLS does not keep specific job data for nursing leaders. PayScale reports the median annual salary is around $89,000 for nursing directors and around $127,000 for chief nursing officers (CNOs), as of October 2019. The BLS projects the job market for all nurses to grow 12% between 2018 and 2028, meaning there will also be an increased need for leaders in nursing.

Similarities Between Managers and Leaders in Nursing

Both managers and leaders in nursing are RNs who’ve advanced up the career ladder to attain positions with more responsibilities. Managers and leaders alike are in charge of units of nurses. It’s up to these high-level administrators to set standards and goals for their departments. Both managers and leaders must have strong interpersonal and human resources skills, be effective communicators, and understand the importance of interdepartmental communication. They are able to multitask and stay on top of diverse responsibilities while keeping an eye on overall quality and efficiency.

Differences Between Managers and Leaders in Nursing

Though managers and leaders in nursing are both high-level nursing professionals with plenty of experience, there are differences between them. Their specific roles and leadership duties differ in meaningful ways.

Job Duties

Nurse managers work directly with the nurses they oversee. They might not perform rounds, but they often check in on certain patients or provide consultation in difficult cases. They primarily work in the office of a healthcare organization, serving as the liaison between the nurses on staff and upper management.

Nursing leaders are typically higher on the administrative chain than nurse managers. They might serve as the director of a unit or even in an executive role. They don’t typically perform nursing work but instead focus on setting long-term goals and plans, making hiring decisions, and setting practice and policy standards for their facilities.

Leadership Responsibility

Nurse managers focus on the realities of the job and ensuring their units are performing well. They’re responsible for setting schedules, making sure there are always enough nurses on staff and that all staff members are performing their duties adequately. They track patient intakes and discharges, assign nurses to different rooms, and conduct quality checks with patients.

Nursing leaders instead focus on big-picture goals, policies, and standards. They might oversee nurse managers working in a variety of units and also work with managers to improve some aspect of overall performance. They communicate with hospital executives to create institutional visions or change standards to improve a facility’s quality of care and overall efficiency.

Manager vs. Leader in Nursing: Which Is Right for You?

Registered nurses who want to step into a management or leadership position can benefit from an advanced nursing degree that emphasizes human resource management, healthcare policy, workplace dynamics, and leadership skills. Explore how Maryville University’s online Master of Science in Nursing with a concentration in leadership can equip you to make a difference in the healthcare community through a nursing management or leadership role.

Recommended Readings
How Mobile Health Tools Are Changing Nursing

Telemedicine in Primary Care

The Future of Nursing: Leading Change in the 21st Century

American Nurse Today, “Move Up to the Role of Nursing Managers”

American Organization of Nurse Executives, “Crisis Management: The Nurse Leader’s Role”

Houston Chronicle, “Difference Between a Nurse Administrator vs. Nurse Manager”

Maryville University, Online MSN in Leadership

The Online Journal of Issues in Nursing, “Growing Nurse Leaders: Their Perspectives”

PayScale, Chief Nursing Officer

PayScale, Nursing Director Salary 

U.S. Bureau of Labor Statistics, Medical and Health Services Managers

U.S. Bureau of Labor Statistics, Registered Nurses