What I Know for Sure About Nursing Leadership

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Oprah Winfrey has written a book about what she knows for sure. This is a good exercise for nurse leaders. Not everything that I once believed about leadership is still true today. Times change and the context of leadership changes with it. But there are some things that will always be true about leadership – here are 10 things that I know for sure.

Leadership is ultimately about influence – if you are unable to influence those who follow you – you will not be effective even if you are in a leadership role. All a leadership role does for you is to buy time. To have credibility and engage staff, you need to be able to positively influence them to follow you.
Leaders need to walk their talk – nurses will watch how you behave and it is so much more powerful than what you say. This can be uncomfortable but it is true. Trust in leadership needs to be earned, it is not a given. Following through on what you say you will do, promptly answering emails/calls will build confidence in your leadership.
Leaders must be willing to challenge their own assumptions – and be prepared to sometimes be wrong especially in today’s environment. Actively seeking out divergent viewpoints and asking staff to challenge your assumptions are good leadership practices.
Leaders need to actively listen and communicate – all the time and in many different ways (emails, texts, on paper, in conversation). Leaders need to say things repeatedly because often messages are not heard the first time (second time or third time). The evidence indicates that our brains need to become familiar with the message so communication is never a one and done thing.
Leaders need to keep the bigger picture in mind – short term thinking does not lead to long-term accomplishments. Establish some long-term goals for your leadership and then ask yourself whether the decision today is moving the needle closer or further away from what you would like to accomplish.
Leaders need to watch the signposts of change – there are many disruptive changes that could potentially rock the healthcare world. It will be interesting to watch the Amazon/JP Morgan/Berkshire Hathaway venture. This could lead to more companies self-insuring or perhaps joining their efforts to reduce costs. Driverless cars are only a few years away and have the potential to disrupt areas of healthcare that serve patients involved in motor vehicle accidents. The Apple Watch and heart study is Apple’s first baby step into wearable devices which has the potential to be a game changer. So read, listen to podcasts and scan the environment outside of nursing and healthcare to find those signposts.
Leaders should be coaches first and foremost – research indicates that staff highly value managers who adopt a coaching style of managing performance. Yet for many leaders, this will change how they look at their leadership and a different mindset. If you perfect your skills as a coach, you can help staff to grow and put them on a path to success and greater ownership of their professional practice.
Leaders need to give people second chances – it can be a very powerful impetus to help a staff member change their behavior and move from failure to success. The world today is complicated. Our younger staff are often anxious and sometimes naive about the impact of their behavior in their professional life. Wise leaders work to help their younger colleagues turn around when they are on the wrong track.
Leaders need to recognize when something is not working – and not struggle to hold onto a sacred cow. The current nursing shortage is very stressful for staff yet many organizations are doing nothing to change their delivery models in response to what is happening. Just because this is how we have always done does not make it right for the current environment.
Leaders need to be willing to admit their own mistakes openly – it sends a powerful message and builds trust. Ultimately, trust is the currency of leadership which is why personal accountability is so important.

Take the time to ask yourself – what do you know for sure about nursing and leadership. Gaining clarity on this will help to connect you to your own values and help guide you in the decisions you make.