By Jessica Holbrook, MSN, RN

Many people who are drawn to nursing have traits that also draw them to leadership. Nurses are often the kind of people who enjoy helping others, can stay calm during stressful situations, enjoy learning new things, and are good teammates. 

Becoming a leader in healthcare requires more than just a desire to help. Leaders in healthcare must know how to navigate tough ethical situations, help staff through devastating loss, make quick decisions, and understand how healthcare systems work. Formal leaders must have an even deeper understanding of the healthcare system, helping their staff provide excellent care while being a responsible steward of resources.  

Related: Communication and Soft Skills in Nursing Practice

Even nurses with very little experience can become strong leaders within their teams. An informal leader does not have a title but can have an enormous impact on the team. Sometimes, informal leaders can have as much or more influence over a unit than formal managers. 

Nurses who aspire to become managers, supervisors, or even chief nursing officers should start by learning how to lead without a formal title. 

Part of helping a team work together includes understanding each of their strengths and acknowledging them. When working on a nursing unit, complimenting someone on their strengths and then trusting them with those skills can go a long way towards building trust within your team. 

In addition, it is important to learn each teammate's weaknesses and support them as they work through their challenges. Try to give them opportunities to grow while supporting them to prevent dangerous mistakes. 

A team will not trust or follow someone who is not confident and competent in their nursing skills. Whether you work in acute care and need advanced knowledge of vasopressors or work in the emergency department and need to master the art of placing a good IV line, you must show your team that you know what you are doing. 

While knowledge and skill often come with experience, there are ways to expedite the process. Study for and earn advanced credentials such as CCRN, ask for more challenging patient assignments, and ask the providers to explain more complicated disease processes when they have time. 

“Servant Leadership” is a term coined by Robert Greenleaf, and describes a person who leads by helping his or her team. The servant leader makes themselves invaluable by supporting the team in their roles, even when the tasks are not glamorous. 

Servant leaders do not ask their team to perform a task that they would not be willing to perform themselves. They can often be found doing things like taking out the trash or volunteering to help another nurse clean up their patient. Servant leaders in a nursing unit tend to follow the idea that no one nurse should have a bad shift. Either everyone has a good day or everyone struggles together. 

Related: Transitioning New Graduate Nurses to Practice

Once you have mastered the basics of informal leadership, you may feel ready to take on a more formal position. Whether that is becoming a charge nurse or a nurse manager, there are a few concrete steps you’ll need to take. 

First, you’ll need at least some experience in the field where you would like to become a formal leader. Deciding on rules or making practice changes when you don’t have first-hand experience can frustrate staff and make them feel unheard. Even if a leader has an intimate understanding of how their hospital or care area runs, having some on-the-ground experience builds trust. 

Most hospitals and healthcare facilities require their leadership teams to have an advanced degree in nursing. This is especially true for hospitals seeking magnet status recognition. 

If you are hoping to advance to a leadership position within your current organization, you must earn the trust and support of your team. Transitioning from peer-to-peer relationships to a formal leadership position can be tricky at the best of times, and nearly impossible if you don’t have the support of your team.  

Nurses who transition from part of the staff to one of the managers must first show that they are: 

• Reliable 
• Willing to help
• Understanding and empathetic
• Skilled
• Firm but fair

Some of the quickest ways to erode trust include: 

• Gossip
• Belittling others
• Poor understanding of the unit and responsibilities

Once you secure a leadership position, make sure that you continue to treat your team with respect and be open to new ideas. Many leaders make the mistake of becoming too firm in their decisions and are closed off to the opinions of others.  

While managers and nurse leaders often do have to make choices that are difficult for the team to accept, they should be willing to at least entertain alternative solutions. Maintaining trust, acting as a servant leader, knowing your team's strengths and weaknesses, and keeping up with your nursing skills will all help you become the kind of leader that a team willingly follows. 

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