Dual Nursing-Business Degree Prepares Nurses for Health System Leadership

'Nurse leaders with healthcare economics and healthcare finance acumen are important to advocate for the profession.'

A new dual advanced degree program aims to empower nurses with the expertise to advance in executive leadership and health system administration.

Graduates of the unique program, offered by the East Carolina University College of Nursing, in partnership with the ECU College of Business, will receive both a Master of Science in Nursing and a Master of Business Administration (MSN-MBA), a robust combination of qualifications that will arm graduates in tackling long-term challenges in healthcare administration. The dual MSN-MBA program isn’t the first in the nation, but the pool of schools that offer a similar pairing is small.

"As we navigate unprecedented nursing shortages, nurse leaders with healthcare economics and healthcare finance acumen are important to advocate for the profession and to partner with healthcare administrators to properly assess the nursing needs of health systems, and to make fiscally responsible decisions regarding staffing and other financial investments," said Bimbola Akintade, dean of the College of Nursing and an MBA graduate.

"Bringing their clinical backgrounds and leadership knowledge to the table, they will improve communication of financial decisions that impact nursing practice and direct patient care between administrators and bedside nurses," he said. "In addition, this knowledge will help graduates of the dual MSN-MBA program contribute meaningfully to the nursing workforce development solutions that will positively impact the health and well-being of residents of our region and beyond."

Indeed, nurses make up about 30% of a hospital's staffing, according to the U.S. Bureau of Labor Statistics, so a chief nursing officer's (CNO) financial acumen—good or bad—can play a critical role in an organization's financial health, writes Kathy Douglas, MHA, RN, in the frequently referenced article, Taking Action to Close the Nursing-Finance Gap: Learning from Success.

"Nurse leaders control the largest part of a hospital labor budget, in some cases the largest part of the overall budget," Douglas writes. "The effectiveness of overseeing this responsibility can mean the difference between an organization’s financial stability and financial turmoil."

ECU students will focus on business during the first semester, then on nursing coursework during the second semester. The remaining year and a half will consist of a blend of the two, according to the university.

The purpose of offering the two degrees in tandem is to give students knowledge and skills to bridge the cultural gap between frontline nurses and hospital administration, who typically don’t speak the same language, said Thompson Forbes, PhD, MSN, NE-BC, ECU assistant professor of nursing and one of the program’s directors.

"We need to have leaders who can understand health system organizational theory, nursing theory, and nursing evidence-based practice, and then pair that with an understanding of finance, accounting, and marketing," Forbes said. "They will be better prepared to translate decisions that are made in the clinical environment to business environment and vice versa, so the systems can be more efficient."

Nursing will always be the largest line item on any healthcare system’s budget because they are the most patient-intensive workforce in hospitals, Forbes said.

"Instead of just striking numbers from a budget, there needs to be someone who can interpret and say, ‘We can handle this much efficiency gain on the business side, but that savings is going to result in a reduced level of quality of care at the bedside,’" Forbes said.

When conversations between the healthcare workforce and administration on how to balance patient care with keeping the lights on don’t happen, Forbes said distrust naturally festers. Nurse executives with business administration education can foster "an environment of understanding amongst everybody."