Making Nursing Leadership More Attractive

By Rose O. Sherman, EdD, RN, FAAN

In a new national study released by AMN Healthcare this week, 82% of the more than 3000 + nurses who participated indicated that more nurse leaders are needed BUT 61% said they would not consider leadership roles. This is very concerning given this study also found that 73% of the Baby Boomer nurses in the sample planned to retire in the next three years. The generational change in nursing is well underway and the healthcare environment has never been more challenging. The nurses surveyed indicated that they were disenchanted with their leaders, don’t trust them, don’t think their leaders care about them as an individual and don’t believe their leaders support their career goals.

We clearly have work to do in making leadership roles more attractive and satisfying for our next generation of nurse leaders. Based on my own research and work with frontline nurse leaders across the country, I have the following 5 recommendations:

Commit to the Improved Onboarding of New Nurse Leaders It continues to surprise me how few new nurse leaders have a structured onboarding program to transition into what is today a very complex role. We spend much more time worrying about new graduate transition than we do about leadership transition. Transitioning into a leadership role is extremely challenging especially from a staff nurse position where the role expectations were quite different. In a recent study done by one of my graduate students, a new millennial nurse manager talked about how she could not balance her checkbook but was now in charge of 70+ FTE and a multimillion dollar budget with no orientation. Every new manager/leader should have at minimum a 100 onboarding plan and ideally a basic leadership program.
Provide New Nurse Leaders with the Mentorship that They Need Every new nurse manager should be assigned to an experienced nurse leader for mentorship for at least six month. The relationship would ideally include regular scheduled meetings to discuss progress and challenges. What happens in too many environments are that experienced leaders tell a new manager to “call me if you have any questions”. The new leader may not even know what questions to ask.
Incorporate Leadership Development Plans as an Expected Personal Growth Activity for Every Nurse Leader Leadership development is a journey not a destination that we reach in 3-5 years. To be an effective leader, you must continually learn and challenge yourself to become better. What are you doing to grow your leadership should be part of every leadership performance evaluation discussion.
Pay Nurse Leaders Salaries that are Commensurate with the Responsibilities No nurse should ever have to turn down a leadership role because it will mean a cut in pay. We do our leaders a significant disservice when we undervalue the complexity and expectations of the role while paying staff high rates of overtime for shifts work beyond what is expected of them. I have had many conversations with young nurses with graduate education who were shocked at how little they were offered to take on a manager role (often involving multiple units) at a very low salary level. The courageous ones fight back and negotiate but I have also seen others just walk away feeling demeaned.
Teach the Leader-Coach Model of Leadership One concerning finding in the AMN study is the low number of nurses who indicated that their manager supports their career goals (only half). This is concerning when you consider that this is a significant priority for the Millennial workforce. Nurse leaders today must learn to be effective coaches in addition to manager. This is a skill set that not all manager have but need to learn.

Our challenging and often chaotic healthcare delivery system needs strong leadership. Yet to make to our nursing leadership roles more attractive to young nurses, we have work to do. Research evidence tells us that there is a window of time in a nurse’s career where they are attracted to leadership roles (the first decade of practice). We owe it to our next generation of nurses to create leadership roles that nurses will aspire to take. There is no time to waste.