I have been in hospital management for over a decade. I am currently at the director level -- totally hands off, patient wise, with clinical supervisors under me who occasionally see patients and actually manage the clinical staff. I enjoyed a more clinical role earlier in my management career as it gave me the best of both worlds. I've worked for large healthcare systems as well as a small community hospital. If you are wanting to go into management as a nurse, it requires a lot of luck -- being the right person at the right time. You typically have to work your way up. The usual progression is floor nurse, charge nurse, clinical supervisor, manager, director -- and if you are the right person with the cut-throat mentality and drive, you can go further. You will often have to change hospitals in order to get into a better position, professionally. Politics -- so much politics. And people management -- it's like herding cats to get everyone on board and doing the right things, continuously.
I'm mid-way through my NP program. Because I won't do another 15-20 years of this. And you're either working 40-50 hours a week in management, or you're not in management. There's no part-time management. No flexibility. And, I like interacting with patients. I will likely take a pay cut as a new grad NP. It sucks, but is part of my long-term plan. Ten to fifteen years from now, I'll work part-time as a NP, and have a much higher quality of life than if I was still in management, working 40-50 hours a week for no appreciation from above or below.
If you want to go into management: Get your BSN from a great university. Become the best floor nurse you can. Be dependable. Get certified in your area. Join councils and committees. And while you're doing that, get your MSN. Do not get a MHA. MHA's are worthless unless you want to be a nursing home administrator. The only time I would recommend getting a MHA is if you are already in management and you need to get a master's degree and want a relatively easy degree. Even then, suck it up and get a MSN. And network, network, network. It's easier to do all of this if you are an extrovert and enjoy schmoozing.