Nursing Leadership Lessons Learned - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, FAAN

“A leader is one who knows the way, goes the way, and shows the way.” – John C. Maxwell

During the past few weeks, I have been speaking with nurse leaders who have mentored our emerging nurse leader graduate students over the past six months. We talked about their leadership lessons and wisdom that they have passed on to their mentees. One seasoned nurse leader laughed and said – I told her how completely annoying I was as a new manager. I don’t know how anyone put up with me. These shared leadership stories told by nurse leaders have been invaluable to the education of our students.

1. Stop Trying to Add Value in Every Meeting

I was the first to make a comment at every meeting. I guess I was insecure and felt I needed to let everyone know what I knew whether my comment added value or not. I don’t do that anymore. I do much more listening and much less talking. The truth is that people know I am smart and a good leader – I don’t have to prove it at every meeting.

2. Don’t Have a Knee Jerk Reaction to Conflict

Today was a good example of how much I have changed in how I manage conflict. I received a call from my Chief Nursing Officer. A conflict between one of my charge nurses and a case manager had escalated into the executive suite. The case manager was upset with the report given by the charge nurse. She said nothing to the charge nurse, but instead went directly to her boss who went to my boss. In the past, I would have probably been yelling into the phone when I heard this but I have changed. Instead, I went to my charge nurse and the two of us went right down to the case manager’s office to discuss the situation. I said nothing about my unhappiness about how she had managed the situation, but instead we talked about our desire to resolve the conflict.

3. Sleep on Your Anger

I am a very emotional person which can be good and bad. When I first started in leadership, I took every negative comment so personally. I sometimes had difficulty controlling my anger. I have learned the hard way that things said in anger can be very detrimental. I now sleep on emotionally ladened situations and question my own motives and reactions.

4. Choose Your Battles

I have learned that not everything is worth fighting for. My time is very limited. A good example is what is happening in our hospital with capital equipment. You have to move mountains to get a new piece of equipment because of our budget issues. In the past, I would probably be down there at every capital equipment meeting fighting to get new equipment, and spending hours on the justification. I don’t do that anymore – I have learned to ask for less but when I commit to a battle, I will really fight to get what we need.

5. Don’t Over-React – Things Have a Way of Working Out

Sometimes people do wonder how I have managed to stay so calm with the chaos that we have been through on this unit during the past six months. We have changed from a short-stay unit to a traditional Medical-Surgical unit then we unexpectedly had to move to another floor because of some safety concerns with the building. With the change in patient mix on our unit, I need to hire more FTE, but I have not been able to do this with the budget issues. What I have learned in leadership is to stay calm. Most things do have a way of working out. This is tough enough on the staff. If they had a manager who didn’t smile and even laugh about it, things would be much worse.

6. Take Time to Analyze Whether You Used the Right Approach

In the past when I counseled staff and the session did not go well, I would leave the meeting feeling like the staff member had an atitiude problem. What I have learned is that sometimes I don’t manage these situations as well as I could have. I am much more reflective now about my own leadership in situations. I have also learned to honestly question my own motives in situations – did I really have the best interest of the employee at heart.

7. Work Hard not to have a Transactional Leadership Style

The buzz word in leadership today is to be transformational in your style. That brings out the best in staff. But the truth is that as a manager, this is difficult. I find myself telling staff too often that I need them to do things for me – If you will work this extra shift then I will give you an extra day on your vacation, or I need you to precept this new graduate because you are the only experienced nurse on this shift. This sounds so transactional and I have to work hard to resist doing it.

8. Recognize that Health-care is in Turmoil

Things are tough right now in our hospital. We are a public, safety net hospital and every week are losing more money. Most of our patients are on Medicaid and with the state cutbacks in Medicaid, our future looks somewhat grim. Each week, I ask myself – how much more can we really take without closing our doors. There is only so much that can be cut. I have to remind myself that we are not alone. This is why we are in the middle of a health-care reform debate in this country. At some point, there will be a resolution and it will probably lead to needed innovation. When you are a seasoned nurse leader, you can remember back to times when it was not like this but you can’t dwell on that. It is what it is and health-care is in turmoil.

What has impressed me is how honest our nurse leader mentors have been with the students about their career mistakes. This helped to build trust with the emerging leaders. Knowing that nurse leaders can and do make mistakes on their journey has been reassuring to our nurses who are just beginning their leadership careers.

Are there additional words of wisdom and lessons learned that you would add to this list?