The Job of a Director of Nursing

A Director of Nursing is a registered nurse who supervises and directs the program of patient care in hospitals, large health clinics and long term care facilities. It is typically an executive position reporting to a COO or CEO. A director of nursing has moved on from a purely care giving role to supervising those practitioners and providers under their span of control. A Director of Nursing will not only have sound clinical experience but also be a good organizer and administrator with strong interpersonal skills.

Director of Nursing Philosophy

Fundamentally, a Director of Nursing ensures the smooth running of the nursing care in a given health facility according to federal laws and regulations and those local to the state with adherence to standard practices of the profession. They usually work within a prescribed budget.

Education and Expected Salary

A director of nursing needs to be a registered nurse with a proven record of practical experience. Some jobs will require the RN certification to have been obtained through a Bachelor of Science Degree in Nursing while others will accept certification and an excellent work record. 30 percent of US Directors of Nursing have between 10-20 years experience.

The salary you can earn as a director of nursing depends on which state you work in, whether you are working in the public or private health sector and also on the size of the healthcare facility. Typically salaries fall in the range of $85,000 to $130,000. Directors of nursing with a master’s degree in nursing typically earn up to 30% more than those with other qualifications.

Scope of Director of Nursing Jobs

Most director of nursing jobs are in large institutions with a large number of nursing staff. Those are mostly made up of hospitals, large clinics and long term care facilities.

A director of nursing in a long term facility may need to have demonstrated experience in certain types of care. For instance, to work in a nursing home, experience in geriatrics will be required, as will experience in pediatrics if working in a children’s home.

Federal OBRA regulations set the requirements by which DNs undertake their jobs. Unlike in hospitals where the burden might be shared or wholly taken on by administrative management, legal responsibility of duty of care falls to the director of nursing.

Roles of a Director of Nursing

The roles of a director of nursing are varied and wide-ranging, but duties that are common to the role, irrespective of the type of healthcare facility where the work is undertaken might include:

  • Formulating, implementing and monitoring the application of nursing policies and procedures
  • Recruitment and employment of nursing staff including managing employment and personnel issues
  • Managing staff levels ensuring adequate cover across all departments
  • Assessment of the health needs of individuals
  • Communication of patient, resident and physician’s needs to hospital management

A director of nursing has a wider administrative role with more paperwork than a practitioner nurse. Included is the paperwork that evidences the policies and procedures and how they are delivered, maintenance of patients or residents’ record keeping and reports and statistics to federal and state health governing bodies. Other administrative duties include producing budgets and monitoring their performance, providing data to the hospital or facility’s financial staff and the administration involved in staff recruitment and employment.

A director of nursing may be required to stand in for any nursing related position in an emergency and also be called upon to prepare reports on incidents and provide evidentiary testimony in legal cases.

The role of a director of nursing is all encompassing. It’s a job for experienced career health practitioners who are ready to move on to a rewarding job where they can play an integral part in the overall running of a large hospital, clinic or long term care facility.


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