How To Become a Nurse Leader

“What you do makes a difference, and you have to decide what kind of difference you want to make.”
— Jane Goodall

Nurses who excel in their clinical practice and gain satisfaction from mentoring others might consider pursuing a nurse leader role. Advantages of leadership roles — besides a higher salary and prestige — are a greater ability to make a difference within their healthcare organization, positive impact on those they lead, and ultimately, more power to improve patient outcomes.

But how do they take that step?

What is a nurse leader?

Nurses who have practiced for several years, gained solid experience in one or more care settings, improved their skills through continued education, and mentored other nurses are leaders — even if they do not have a job title specifically designated as a leadership role.

Nurse leaders fall into two categories.

The first category of nurse leaders are experienced nurses who serve as shift leaders, help train new nurses, and are recognized as experts in their teams and departments. They can earn higher salaries due to meeting higher performance and leadership benchmarks but do not necessarily hold a leadership title on the organizational chart.

The second category of leadership roles in nursing are those that the organization and industry recognize as official leadership positions, such as nurse managers and nursing officers. These roles are often filled by nurses with even more years of experience and who have demonstrated proven leadership abilities in previous roles.

The best way for a nurse to progress to either of these levels of nurse leadership is to develop leadership competencies whenever opportunities arise. Then, when designated leadership positions open, aspiring nurses may be able to fulfill the qualifications and advance their careers.

How to help nurse leaders develop

The American Nurses Association (ANA) provides competency models for both nursing practice and nurse leadership. Not surprisingly, the ANA model for excellence in nursing practice includes multiple leadership competencies. Leadership is part of every nursing role — not just officially recognized nurse leader roles.

Organizations that pay special attention to nurturing and developing the leadership attributes of their nurses, beginning from their first days on the job, have a greater probability of identifying nurses who have both the desire and characteristics to lead. These nurses will be the ones to not only provide leadership for others but also develop into some of an organization’s most valuable staff members. They will provide a high level of service, improve the retention of those they lead, and stay in their organizations longer.

Identify and retain talent

A high-quality nurse onboarding experience determines a nurse’s employment experience far beyond the first few months. Emerging RN Leader cited a study that found that a new hire’s first 90 days can influence the rest of their time within that organization. It also found that a structured onboarding process increases the likelihood of that individual remaining with the organization for three years by 58%.

During the hiring and onboarding processes, organizations should conduct assessments to identify nurses who have the aptitude and characteristics to lead. Provide education and incentives to keep future leaders on track for reaching their potential. Doing so will pay off in the long-term in both employee satisfaction and value to your organization.

Perform regular assessments

There is no set timeline for when a nurse will show leadership potential and then become an experienced, highly competent nurse. Many factors can influence a nurse’s development. Growth could be internally motivated — such as when a proactive nurse seeks out additional experience and education. Or it could be externally motivated — such as when staff attrition or a crisis accelerates a nurse’s level of responsibility. The latter is sometimes called adaptive leadership.

Measuring the current competencies of all your nursing staff regularly is necessary to accurately assess your resources. A cohort of nurses who onboarded two years ago, for example, could have advanced at different speeds, with some beginning to take on leadership responsibilities and progressing toward acquiring the competencies needed to advance.

Encourage leadership skills

Just as a gardener wouldn’t sow seeds and then neglect them, it’s necessary for healthcare organizations to cultivate their nurses. After bringing in new nurses with a high-quality hiring and onboarding process, regular assessments can show how they’re doing and help you provide the right resources to develop them into leaders.

Nurses’ first priorities may be to complete their continuing education and certification requirements, but also important are career and professional development opportunities to hone their leadership skills. For nurses who do not yet have them, that may mean a BSN degree program and/or RN certification. For others, it may mean leadership training opportunities on the job, such as shadowing a nurse leader or participating in a seminar or conference.

Facilitate mentoring opportunities

Mentoring can be an effective way to train new nurse leaders. Employees commonly have mentors when they begin their careers. Employers may formally create these relationships through mentor assignments and preceptor programs. Once employees have gained experience, they may not sustain these mentoring relationships even though mentors can provide substantial advantages at any career stage.

The American Association of Colleges of Nursing (ANCC) defines mentoring as a formalized process where a more knowledgeable and experienced person supports “reflection and learning within a less experienced and knowledgeable person, so as to facilitate that person’s career and personal development.” To ensure your future nurse leaders gain the advantages of one-on-one coaching and guidance, formalize the mentoring process throughout your organization. While some employees might not want to participate, provide the opportunity for those who do, and educate your staff on the benefits that a mentor can provide — individualized guidance on what they need to do to advance as well as instrumental organizational or industry connections.

Reduce nurse burnout

Ideally, nurses will move forward in their careers by advancing from one rewarding position to the next. But with so many nurses currently experiencing burnout due to staffing and resource shortages that worsened during the COVID-19 pandemic, they may set aside aspirations of advancement while struggling to uphold performance and quality standards with high patient-to-staff ratios and insufficient time for self-care.

Organizations must invest in their current nursing staff to stabilize retention before they can maximize advancement. Our Nurse Salary Report revealed that nurses want better pay, benefits, and other considerations to help overcome the significant challenges of their jobs. Once these issues improve, organizations will have a better chance of keeping and developing their nurses.

Provide additional training

When a nurse is ready to advance, what types of training are most useful to provide the needed skills? A wide range of continuing education exists for every care specialty. Additional education also covers specific leadership skills, such as Nurse Manager and Leader (CNML) Certification Review courses.

When recommending training, healthcare organizations should select a recognized and respected education provider. A robust platform of personalized, blended online digital learning solutions can encompass onboarding, assessments, continuing education, certification reviews, compliance management, competency evaluations, and more. Online learning communities can also provide helpful career resources and connections. Offer a wide array of learning that can help develop healthcare staff in the ways that best align with their career goals.

Types of nurse leaders

The term “nurse leader” often refers to a nurse who both provides care and holds a leadership position. Other nurse leaders hold higher-level roles that are entirely administrative. The two types of positions have distinct differences.

Frontline nurse manager

A frontline nurse manager leads a team or teams within a healthcare organization. According to the Agency for Healthcare Research and Quality (AHRQ), this type of nurse leader has two major areas of responsibility, serving in both nursing and administrative capacities.

These individuals manage a budget, organize shift schedules, monitor compliance, and maintain and secure patient records. The hands-on part of their role includes hiring, training, and evaluating nurses, setting departmental goals, observing patients, and providing medical care.

Institutional nurse manager

An institutional nurse manager is responsible for reporting and has a big-picture focus. Individuals serving in this capacity might concentrate on organizational goals and serve on task forces and committees. These individuals usually do not interact with patients and instead oversee higher-level operations within a hospital or healthcare facility.

This type of nurse leader may help set standards and best practices to improve patient care, identify areas for improvement, develop and implement processes and strategies, meet with stakeholders, and ensure that the work of nurses and other staff align with the organization’s mission. Salaries for this type of nurse leader can be significantly higher than those of frontline nurse managers.

Qualities of a nurse leader

All nurses can benefit from developing the broad range of nursing and leadership skills that comprise excellence in nurse leadership. Regardless of their career aspirations, becoming well-rounded and accomplished in these areas will improve a staff member’s value to an organization.

Drawing from both business leadership and professional nursing organizations, the intersection of top nurse leader characteristics and skills from these areas is broad and numerous. But nurses may discover that they already have many of these traits. By developing additional competencies to round out their skills, they can position themselves to become tomorrow’s nurse leaders.