Essential business skills for nurse managers

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For a bit more about the financial side of business, check out our book Finance and Budgeting Made Simple: Essential Skills for Nurses. And please vist Strategies for Nurse Managers site  and the Leaders' Lounge Blog for more articles on Nurse Management!

By Denise Danna, DNS, RN, CNAA-BC, FACHE

For a nurse manager to be successful in today's healthcare environment, mastery of basic business skills is essential. No longer are nurse managers expected to be clinical experts but, instead, must be equipped and skillful in "running their business." Each nursing unit is a component of a larger organization that depends on qualified nurses to manage the business and to understand the "big" picture. Nurse managers are the change agents and leaders in improving the work environment where nurses practice, so it is essential that they have the required skills.

What are the essential business skills?

As you think about business skills, the first thing that probably comes to mind is the budget or the finances, but business skills include so much more. Business skills frequently include human resources, strategic planning, and systems thinking, to name a few.

Several professional organizations have identified the essential business skills that nurse leaders need in their skill set to succeed. The American Organization of Nurse Executives (AONE) is one such organization. AONE publishes a manager leadership collaborative and a nurse inventory tool that lists core business skills for nurse managers (AONE, 2004).     
How does a nurse manager acquire essential business skills to be successful?

The following three categories identify several of the business skills that are essential for nurse managers:

1. Financial management

  • Become knowledgeable with basic financial terminology and definitions. Develop a plan to educate yourself and your direct reports.
  • Become proficient in reading and understanding organizational budget reports.
  • Be able to develop a basic unit budget. As a nurse manager, it is important to be able to develop a basic unit budget and recognize the different line items and categories that are included in the budget.
  • Learn how to monitor and analyze budget variances and be able to develop strategies to address the variances.
  • Establish strong working relationships with the finance personnel at your organization. Invite the chief financial officer, controller, or staff accountant to nurse management meetings when appropriate.
  • Participate in the selection of programs that influence nursing such as productivity programs, inventory management, and documentation systems.
  • If consultants are hired to work with the organization, ensure that nursing has input into the process and outcomes.

2. Human resources

  • Identify and develop recruitment and retention programs. Successful recruitment and retention strategies are vital to the long-term success of the organization, so nurse managers should take the lead in identifying successful strategies.
  • Monitor employee satisfaction on your unit through both informal and formal processes. By being available, open, and visible to your staff, you are able to gauge the satisfaction of the employees on the unit. You should be knowledgeable in the formal survey process that the organization uses and be able to analyze the data and develop strategies for improvement.
  • Similar to your relationship with the finance department, you should also develop a strong working relationship with the human resources department.
  • Learn how to effectively handle conflict, negotiation, and delegation.
  • Keep current on policies and procedures relating to running your business, including employment issues, salaries, benefits, policies addressing attendance, corrective action, performance evaluations, and legal and regulatory issues such as licensure and accreditation surveys. As a nurse manager, you should fully understand the policies and procedures and be able to effectively discuss with your staff when questions or issues arise.

3. Strategic management

  • Familiarize yourself with the components of a business plan. As a nurse manager, you should have the skills to write a simple business plan and be able to conduct a SWOT (strengths, weaknesses, opportunities, threats) analysis.
  • Since emergency preparedness has become such an important part of the strategic planning process for all organizations, you should participate in the emergency preparedness process, and be knowledgeable about the incident command structure, regulatory and accreditation standards that address emergency preparedness, and specific organizational policies and procedures.
  • Participate in the strategic planning process for the organization. As a nurse manager, you should provide input into this process and share in the plan's responsibility for implementation.
  • Become proficient in writing organizational and personal goals and objectives.


American Organization of Nurse Executives. (2004). Nurse Manager Inventory Tool. Available at

American Organization of Nurse Executives. (2004). Nurse Manager Leadership Collaborative Learning Domain Framework. Available at

Editor's note: Denise Danna is an assistant professor and acting associate dean for Professional Practice, Community Services, and Advanced Nursing Practice Education at Louisiana State University. She has 17 years of experiences as a chief nursing officer and over 25 years experience in various nursing management positions.