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Journal of Nursing Administration:
doi: 10.1097/NNA.0b013e318252efbc
Departments: AONE/CGEAN Perspectives

CGEAN Position Statement on the Educational Preparation of Nurse Executives and Nurse Managers

Members of the Council on Graduate Education for Administration in Nursing (CGEAN)

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Author Information

Author Affiliation: Chair and Professor, Department of Health Restoration and Care Systems Management, University of Texas Health Science Center at San Antonio.

The author represents the Council on Graduate Education for Administration in Nursing in the submission of this article.

The author declares no conflict of interest.

Correspondence: Dr Reineck, Department of Health Restoration and Care Systems Management, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC7975, San Antonio, TX 78229 (

The Council on Graduate Education for Administration in Nursing (CGEAN)1 is focused on advancing knowledge through education, practice, and research for nursing administration and leadership. Members represent education, research, and service sectors throughout the United States and international communities. The vision of CGEAN is to achieve a dynamic, highly qualified nursing workforce prepared to lead, manage, and influence healthcare for positive outcomes. The CGEAN core values are innovation, intellectual inquiry, lifelong learning, relationships, stewardship, and wisdom. Given CGEAN’s expertise in education for nursing administration and its commitment to advance healthcare systems through strong nursing leadership, CGEAN is pleased to offer this position statement (Figure 1) on the desired educational preparation of nurse executives and nurse managers. As there are myriad nursing leadership titles in various healthcare settings and organizational structures, the term nurse executive refers to senior-level administrative positions, whereas nurse manager encompasses positions with responsibility for 1 or more organizational units.

Figure 1
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The significant challenge of promoting access to high-quality healthcare to improve the nation’s health has been increasingly acknowledged by a wide array of policy makers, providers, and consumers. With passage of the Patient Protection and Affordable Care Act,2 the contribution of nurses to improving healthcare services across settings has been widely acknowledged. This, in turn, has focused attention on the educational preparation of nurses for entry and advanced nursing practice roles. Recent publications have highlighted the impact of nurses’ education on several important aspects of quality and safety in care.3-5 The increasing complexity of individuals’ health status and healthcare systems requires advanced levels of education for nurses to achieve desired performance and outcomes. Nurse leaders with graduate degrees are also more likely to be included in executive roles and policy or governing bodies where they can contribute their expertise grounded in actual clinical care to improve healthcare systems.

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Tri-Council for Nursing

Recommendations regarding educational levels required for nurses has been long debated both within and outside the profession. In May 2010, the Tri-Council for Nursing6 issued a new consensus policy encouraging all RNs, regardless of entry point into the profession, to advance their education in baccalaureate, master’s, and doctoral programs in the interest of enhancing quality and safety across healthcare settings. (Note: The Tri-Council for Nursing consists of the American Association of Colleges of Nursing [AACN], the American Nurses Association [ANA], the American Organization of Nurse Executives [AONE], and the National League for Nursing.)

The Tri-Council further noted that without a more educated nursing workforce, the nation’s health will be further at risk. A recent report issued by the Institute of Medicine (IOM) on the Future of Nursing7 included a similar conclusion, recommending that nurses achieve higher levels of education, with a goal of 80% of RNs prepared with a minimum of a bachelor’s degree by 2020. The rationale for this recommendation included awareness that nurses are required to utilize technological tools and analyze and synthesize complex and expanding information; additionally, nurses must collaborate with many healthcare professionals who hold master’s and doctoral degrees to achieve optimal care. Both the Tri-Council and the IOM Future of Nursing panel called for enhancing education programs and access along with a strong focus on continuing competency through lifelong learning. Although there is no full consensus across the nursing profession, the ANA8 and the AACN9 remain committed to the bachelor’s degree as the desired minimal education for entry into practice.

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Nurse Leader Educational Levels: AONE

National nurse leaders have identified the increased need for knowledgeable and skilled nurses in 1st-line, midlevel, and executive management positions in the healthcare system.10 When availability allows, most hospitals prefer to hire baccalaureate-prepared nurses in 1st-line positions, including charge nurse roles. Charge nurses have delegated authority from nurse managers and serve as role models for staff in a variety of complex care settings. Many hospitals use either a differentiated practice model or a clinical ladder to distinguish the practice and pay of a baccalaureate-prepared nurse. In midlevel positions, nurse executives value the acquisition of a master’s degree as essential for nurse manager performance.11 As Kleinman11 noted, “the domain of nursing knowledge has exploded, scope of practice has increased dramatically… and the roles of the nurse manager and nurse executive have evolved significantly in response to changes in the healthcare industry.”11(p451) Increasingly, graduate preparation in nursing management, business knowledge, and leadership skills are needed for success in the complex healthcare environment. This is consistent with AONE’s position statement12 that, as nurse leaders assume more responsibility for specific units, departments, service lines, or system-level roles, the minimum educational preparation should be at the master’s level. Furthermore, as access to DNP programs with leadership focus has evolved, increasing numbers of nurse managers and executives have pursued achievement of this credential.

AONE12 released a position statement on the educationalc preparation of nurse leaders that included recognition of nursing administration as an advanced nursing practice role, a position that is congruent with the opinion published by the AACN.13 AONE supports a minimum of a baccalaureate preparation for nurse leaders, suggests a minimum of master’s preparation for nurse leaders with unit/department/service line/systems roles, and encourages nurse executives to seek doctoral preparation. The AONE position statement also called for continuation and expansion of master’s degree leadership education programs to ensure the desired nurse leader workforce. Current data suggest that there is a significant gap in desired versus actual educational preparation of nurse leaders. In a large national study,14 approximately 50% of nurses reporting titles suggesting leadership positions from across the United States reported having less than a bachelor’s degree as their highest educational credential. In a smaller study focused on charge nurses in acute care settings across 10 hospitals in South Florida,15,16 more than half of the sample (55%) listed an associate degree or diploma in nursing as their highest level of education.

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The authors acknowledge the editorial assistance of Ellen T. Hanks, MLS, AHIP, Research Area Specialist in the Improvement Science Research Network of the Academic Center for Evidence-Based Practice (ACE), University of Texas Health Science Center San Antonio School of Nursing.

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1. Council on Graduate Education for Administration in Nursing (CGEAN). Colorado Springs, CO. Available at Accessed February 10, 2012.

2. US Government Printing Office. Public Law 111-148—Patient Protection and Affordable Care Act. March 2010. Available at Accessed February 10, 2012.

3. Aiken LH, Clarke SP, Cheung RB, et al.. Educational levels of hospital nurses and surgical patient mortality. JAMA. 2003; 290 (12): 1617–1623.

4. Estabrooks CA, Midodzi WK, Cummings GG, et al.. The impact of hospital nursing characteristics on 30-day mortality. Nurs Res. 2005; 54 (2): 74–84.

5. Cheung RB, Aiken LH. Hospital initiatives to support a better-educated workforce. J Nurs Adm. 2006; 36 (7-8): 357–362.

6. Tri-Council for Nursing. Consensus Policy Statement on the Education Advancement of Registered Nurses. Available at Accessed February 10, 2012.

7. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2011.

8. American Nurses Association. Tri-council for Nursing Issues New Consensus Policy Statement. Silver Spring, MD. Available at Accessed March 20, 2012.

9. American Association of Colleges of Nursing. Tri-Council for Nursing Issues New Consensus Policy Statement. Washington, DC. Available at Accessed March 20, 2012.

10. Russell G, Scoble K. Vision 2020, part 2: educational preparation for the future nurse manager. J Nurs Adm. 2003; 33 (7-8): 404–409.

11. Kleinman CS. Leadership roles, competencies, and education: how prepared are our nurse managers? J Nurs Adm. 2003; 33 (9): 451–455.

12. American Organization of Nurse Executives (AONE). AONE Position Statement on the Educational Preparation of Nurse Leaders. Available at Accessed March 20, 2012.

13. American Association of Colleges of Nursing. The Essentials of Doctoral Education for Advanced Nursing Practice. Washington, DC: AACN; 2004.

14. US Department of Health and Human Services. Health Resources and Services Administration (HRSA). National Sample Survey of Registered Nurses. Washington, DC: US Department of Health and Human Services; 2008. Available at Accessed March 20, 2012.

15. Sherman RO, Schwarzkopf R, Kiger A. Charge nurse perspectives on frontline leadership in acute care environments. ISRN Nurs. 2011; article ID 164052. Available at Accessed March 20, 2012.

16. Schwarzkopf R, Sherman RO, Kiger A. Taking charge: frontline nurse leader development [published online ahead of print]. J Contin Educ Nurs. 2011;42(11). Available at Accessed March 20, 2012.

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