Ivy Tech CNA Program Practice Exam 2026 – Master Your Certification with the Ultimate All-in-One Study Guide!

The top of the nursing chain of command is the Director of Nursing. This role oversees all nursing services, sets policies, and ensures the overall quality of care across the nursing staff, reporting to the facility administrator. The Assistant Director of Nursing is next in line, helping supervise units and support the DON, but does not outrank the DON. Nurse Managers handle specific units or floors and report up to the DON (often via the ADON). Frontline staff like QMAs and CNAs carry out patient care under the supervision of licensed supervisors. So, the Director of Nursing sits at the top of the chain.