Chief Nursing Officer vs. Director of Nursing

In large health care facilities, nurses work within a hierarchy. This hierarchy is built to ensure that the individuals in each role have the skills, knowledge, and qualifications they need to do their job well. At the top of the nursing hierarchy are chief nursing officers and directors of nursing. 

For nurses looking to become leaders within their organization, earning an advanced degree such as a Master of Science in Nursing can be a valuable stepping stone toward reaching their professional goals. Through higher education and workplace experience, future nursing leaders have the opportunity to build a fulfilling and meaningful career in health care and make a positive impact on the lives of patients, their families, and their nursing team.

Chief Nursing Officer vs. Director of Nursing: What Are Their Roles?

Health care facilities rely on a team of skilled leaders to ensure the organization functions efficiently and effectively. While both the chief nursing officer and the director of nursing are in leadership roles, their scope and focus are quite different, though they often rely on one another to achieve success.

What Is a Chief Nursing Officer?

A chief nursing officer (CNO) is an executive leader in a medical facility. Considered a member of the C-suite, a CNO typically occupies the most senior level nursing position within their organization. The CNO is responsible for overseeing their organization’s entire nursing operations and services, including its operational strategies and the allocation of its resources. 

As an executive, the CNO has a bird’s-eye view of the successes and challenges of the nursing staff in their organization and is focused on making large-scale strategic decisions. By collaborating with other members of executive leadership, board members, and department heads, the chief nursing officer determines how to best achieve the organization’s goals and provide high-quality care to patients. 

What Is a Director of Nursing?

A director of nursing is tasked with overseeing the entire nursing department within their organization. Within many large organizations, the director of nursing reports to the chief nursing officer or another executive level leader. 

As an administrative supervisor, the director of nursing manages issues such as staffing and recruiting of nurses, updating policies, setting departmental goals, responding to emergencies, setting budgets, and collaborating with the management of other departments. 

Chief Nursing Officer vs. Director of Nursing: How Are They Different?

While the chief nursing officer and director of nursing are both senior level positions in nursing, there are some key differences between the two in areas such as job responsibilities and salaries. 

Scope and Focus

The main difference between chief nursing officers and directors of nursing is in the scope of their jobs and the focus of the work they do. A CNO’s role is that of a top executive, concerned with the overall strategic direction of the organization. In contrast, a director of nursing is mostly concerned with the day-to-day functioning of a nursing department. Also, many directors of nursing provide bedside care or work directly with nurses and patients in addition to their responsibilities as an administrators, while CNOs do not.  

Education

Whether they are looking to become a chief nursing officer, a director of nursing, a clinical nurse specialist , or an advanced practice nurse, nurses interested in pursuing a higher level role often need to earn an advanced degree. 

Most health care organizations hiring for chief nursing officer or director of nursing roles will look to nurses who have both workplace experience as well as an advanced degree from an accredited nursing program , such as either of the following degrees:

• Master of Science in Nursing (MSN)
• Doctor of Nursing Practice (DNP) 

Many MSN programs balance their focus among technical skills in nursing , practical skills, and theoretical knowledge, preparing nurses well for either role.

Salary and Career Outlook

According to Payscale, the median annual salary for chief nursing officers was around $148,450 as of March 2025. For directors of nursing, it was around $102,220 as of April 2025.

According to the U.S. Bureau of Labor Statistics (BLS), employment of top executives, including chief nursing officers, is projected to grow 6%, which is faster than the 4% average growth projected for all occupations. Employment of medical and health services managers, including directors of nursing, is projected to grow 29%, which is much faster than average. 

Shape the Future of Nursing With a Master of Science in Nursing

Nursing leaders have the opportunity to impact the lives of both patients and the health care professionals providing care. Whether nurses are considering becoming a chief nursing officer or a director of nursing, they can make positive change as a nursing leader, shifting the way an organization provides care. 

By enrolling in the online Master of Science in Nursing program at The University of Tulsa, nurses can gain the specialized skills they need to become effective nursing leaders. 

Dedicated to providing individuals with the real-world education they need, TU’s well-rounded MSN program provides one-on-one support to students, is taught by accomplished faculty, and values teaching both clinical knowledge and the soft skills required to manage successfully. 

Discover how you can build a meaningful career in nursing leadership with an MSN from The University of Tulsa. 

Recommended Readings

How an MSN Can Increase Autonomy in Nursing

How an MSN Can Prepare You for Advanced Nursing Practice

Nurse Work Environments: How an MSN Can Broaden Opportunities

Sources:

American Nurses Association, “How to Become a Director of Nursing”

American Nurses Association, “What Is a Chief Nursing Officer/Chief Nurse Executive?”

Indeed, “What Is a Chief Nursing Officer and How Do You Become One?”

Indeed, “What Is a Director of Nursing? (And How to Pursue the Role)”

Payscale, Average Chief Nursing Officer (CNO) Salary

Payscale, Average Director, Nursing Salary

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

U.S. Bureau of Labor Statistics, Top Executives