When they considered the future of nursing in the next decade, the National Academy of Medicine (NAM) called for “a new generation of nurse leaders” to continue educating and inspiring others. Now is an opportune time for nurses to heed this call by taking advantage of pathways that boost their advancement potential. In a longitudinal survey of nurse leaders by the American Organization for Nursing Leadership(AONL), 76% of nursing directors, managers, chief nursing officers and chief nursing executives indicated that their employers have considered or are now offering increased wages, bonuses or incentives to new hires. These offers have been created to add thousands of nurses to the workforce, and additional nurse leaders will be needed to oversee them.
Experienced nurses can progress in their careers by practicing the characteristics of effective nurse leaders (also referred to as nurse executives) and gaining the education necessary for their ideal role. As a result, they can earn a larger salary and become advocates for health equity in their communities.
4 Qualities of an Effective Nurse Leader
Job requirements for nurse leaders can vary widely. Effective nurse leaderscan increase their ability to thrive by focusing on key qualities that will make their work more efficient and help their team move through challenges more quickly.
Because work environments for nurse leaders can vary widely, there is no prescribed set of practices that will lead to success in every role. Instead, Nursing Times said that effective nurse leaders are flexible enough to draw on different strategies according to the task at hand, the team’s needs and the local circumstances. What works in nurse leadershipcan vary by workplace, team and day.
In their exploration of key competencies, the American Nurses Association (ANA) said that nurse leaders should be flexible and adaptable, taking ideas from others seriously and never assuming that their own way is the best. Flexible leaders vary their approach with the situation, using professional and ethical discretion to make the best decisions for their team. Flexibility means that each person has a turn to speak in conversations with others, and all perspectives are given fair weight.
When circumstances change, which often happens in healthcare, nurse leaders should set the example for how to adapt. Techniques from the ANA for setting a positive example to change include:
- Accepting change as a positive
- Hearing and managing others’ reactions to change
- Straightforwardly discussing consequences of change with the team
- Adapting plans as necessary
As they guide their teams and mitigate individual reactions to change, effective nurse leaders model mindfulness as a tool for their emotional health.
Emotional health is important for nurse leaders because it helps them handle the demands of their job and maintains their focus on their goals. If they feel overwhelmed, effective nurse leaders know how to be mindful of the fact that they are human. Stress is a normal response to the fast pace and additional responsibilities of a leadership role. The opportunity to make a difference to patients and families during their time of need is what makes nurse leadership an exciting career.
Mindfulness is a helpful tool for nurse leaders to improve their performance. According to the Nursing Management journal, those who lead mindful practices were “more likely to be stronger advocates for patients and colleagues” while enjoying their work. Mindful nurse leaders are also more resilient, meaning that they recover quickly from setbacks and maintain a positive outlook. Cindy J. Rishel, Ph.D., RN, OCN® and nurse leader from the Oncology Nursing Society, said that “Resilient nurses are caring, compassionate, and create healthy work environments that improve patient care.” Nurse leaders must practice mindfulness and create mindful moments for their team. The quality of their patients’ experience depends on it.
Aspiring nurse leaders can build their personal leadership potential by practicing self-reflection through mindfulness, action learning and personal accountability, which were all key competencies identified by the AONL. The AONL encouraged nurse leaders to consider these guiding tenets as they self-reflect on their role in healthcare and the patient experience:
- Holding their integrity
- Accepting ambiguity
- Appreciating diversity in all its forms
- Seeing multiple perspectives without judgment
- Finding the potential in themselves and others
- Creating a constant state of learning
- Translating new learning to the task at hand
- Nurturing their intellectual and emotional self
- Keeping the commitments they make to themselves
Accomplishing these goals also requires that effective nurse leaders work well with colleagues, administration and the nurses they oversee.
Cooperation is necessary for any nurse leadership position. Whether the role is as an educator responsible for leading a class of students or a manager leading staff at a healthcare facility, nurse leaders need to motivate and inspire others to reach common goals. They might work with other departments, institutions, financial companies and even representatives from industries such as manufacturing and the supply chain. The ANA listed collaboration as another key competency in their leadership model because nurses frequently “collaborate with the health care consumer, family and others in the conduct of nursing practice.” In such collaborative roles, nurses must know how to establish a working relationship with a wide variety of colleagues.
Cooperating with others has become more important for today’s nurse leaders. The National Academy of Medicine recently called for all public and private health care systems to incorporate nursing expertise as they work with communities, federal agencies and other key stakeholders.
Dr. Susan Hassmiller, senior scholar in residence at the National Academy of Medicine and Senior Advisor for Nursing and Director, Future of Nursing: Campaign for Action, was quoted in the NAM’s 2021 report: Nurse leaders “should build on their current partnerships and be sure to include partners outside of health care, including organizations focused on housing, transportation, social isolation, and food insecurity.”
With successful cooperation among partners and community organizations, nurse leaders can make a big difference in the pursuit of health equity. The best nurse leaders cultivate healthy, respectful relationships among partners and among their team, which will help to accomplish their goals.
Effective nurse leaders “should be able to both maintain good relationships with the team and ensure that key tasks are done,” which Nursing Times says can positively influence nurse morale and increase retention: “Retention is an integral part of safe staffing, and good collegiate relationships between nurses and nurse leaders increase retention.” Nurses like to stay where they are valued as part of a team. Another way to increase retention is for nurse leaders to model effective decision-making skills.
Because they are team leaders and administrators, nurse leaders should be equipped to make decisions swiftly and surely. There are many ways a nurse leader can practice decisiveness. In a review of literature on decision-making in nursing practice, PhDs and RNs Christine W. Nibbelink and Barbara B. Brewer explored analytic and intuitive processes.
- In an analytic decision-making process, a nurse leader considers a chain of events and then forms a logical intervention plan. For example, a nurse leader might notice that too much of the nursing department’s budget is spent on supplies each month. Logically, they might conclude that the department should either spend less on supplies or investigate more economical supply options.
- Intuitive decision-making is based on experience and includes recognizing similarities between patient care situations and awareness developed over time. For example, an experienced nurse leader might notice that several patients from an underprivileged neighborhood are unaware of the healthcare providers in their area. Therefore, the nurse leader could increase awareness by disseminating lists of nearby providers and increasing outreach to the community.
While effective nurse leaders used analytic and intuitive decision-making, Nibbelink and Brewer said that expert nurse leaders tended to be more intuitive because they could draw upon more experience. Naturally, more experience led to more confident nurse leaders, but these nurses could also provide more consistent patient care because they recognized patterns as part of a larger perspective.
By practicing effective decision-making, flexibility, mindfulness and cooperation, nurses can enhance their potential to advance in their careers. With these qualities and the right qualifications, nurses can move into several types of in-demand leadership positions in many industries.
Effective Nurse Leaders are Found in Diverse Careers
Even though the American Association for Colleges of Nursing(AACN) reported a 5.1% enrollment increase in entry-level nursing programs in 2019, over 80,407 qualified applicants were turned away due to an insufficient number of qualified faculty to teach them. Registered nurses with bachelor’s degrees can fill nursing education gaps by completing an advanced degree and specialized training. This experience can lead to nursing educator careers in hospitals, trade schools, colleges, universities, treatment facilities and more.
Becoming a nurse educator can be just as rewarding as being a registered nurse. In an interview with the American Association of Critical Care Nurses, nurse educator Lynn Orser said, “As an educator, helping patients and nurses with healthcare decision making is still a passion for me,” and she gets to enact her passion through mentoring future nurses. In addition to impacting the future of the field, nurse educators tend to earn a higher salary than registered nurses. While the BLS reported that the 2020 median pay for registered nurses was $75,330, nurse educators made an annual mean wage of between $84,320 and $119,050 in 2020, depending on the type of institution they worked for. The highest-paying nurse educators worked in general medical and surgical hospitals, psychiatric and substance abuse hospitals, local government and business schools.
Another fast-growing, high-paying sector of nurse leadership careers is nurse administration. These professionals are needed in a variety of healthcare settings as nursing managers, directors and executives.
Nurse managers recruit, hire and train nursing staff. They need to be task-oriented because they oversee a unit’s nurses to deliver safe, quality patient care. According to the Agency for Healthcare Research and Quality, nurse managers’ job responsibilities also include setting the strategic mission of their unit and adhering to their organization’s interests and goals. They frequently report to a director of nursing or nurse executive about their team’s progress and must “wear two hats” as a colleague and administrator as their role requires.
Opportunities for nurse managers have grown since 2019. The results of the American Nurse Journal’s fifth annual Nursing Trends and Salary Survey revealed that over 70% of nurse managers had open positions in the past year, signaling a need for more nurse managers to hire and train new staff. Those who responded to the survey indicated that they were happy with these responsibilities, their current salary, amount of time worked, amount of authority, benefits and advancement opportunities. For nurses seeking advancement, a step up to nursing management is an ideal plan.
Experienced registered nurses can also become a director of nursing, who is responsible for overseeing a healthcare department or facility. According to Indeed’s career description, directors of nursing are usually the second-highest healthcare administrator at their organization. These executives ensure that nurses have all the supplies they need, that their team adheres to a set budget, and that patient care is delivered at the best possible quality.
Data from Indeed also showed that directors of nursing in the United States made an average base salary of almost $90,000 a year as of November 2021, and nursing directors who were experienced nurses earned almost 9% more than the average base salary. A career as a director of nursing is very gratifying because nursing directors get to work closely with patients, nursing colleagues, administration and the latest healthcare technologies.
Nurses who would like to extend their impact and grow a career have many other opportunities. Potential careers could include:
- Advanced practice nurse
- Chief nursing officer
- Clinical education manager
- Insurance regional director
- Nurse case manager
- Nurse practitioner
- Patient care coordinator
- Research nurse
In any of these roles, nurse leaders have a platform to witness the patient experience. Effective nurse leaders are continuously mindful of the role that socioeconomic status has on a patient’s care and can note patterns they see. As a result, nurse leaders are uniquely positioned to speak up on behalf of their communities.
Effective Nurse Leaders are Advocates for Health Equity
Nurses can advocate for patients and create positive change because they have promised to treat those from all backgrounds with the same standard of care. The Nursing Code of Ethics, also known as the “Nightingale Pledge” after Florence Nightingale, said that “Nurses must care for all patients with the same level of fairness despite the individual’s financial abilities, race, religion, gender, and/or sexual orientation.” This pledge directly aligns with the National Academy of Medicine’s goal for achieving greater health equity in the United States throughout the next decade of nursing. Effective nurse leaders can remind their team of the Nightingale Pledge, share their passion for equality in healthcare and motivate nurses to advocate for the ethical treatment of every patient regardless of circumstance.
The nursing profession has long been perceived as the most ethical profession in the nation. In Gallup’s annual Honesty and Ethics poll, nurses have consistently received the highest ethics rating of all professions. According to the poll, the exception is 2001, when firefighters were measured on a one-time basis shortly after the Sept. 11 terrorist attacks and earned the highest score to date for any profession – 90%. Nurses ranked one point shy of that mark in 2020, revealing the public’s faith in nurses to uphold a high standard of care for every individual. With such a high perception of their ethics, nurses and nurse leaders are responsible for acting on the public’s trust in them and working to make healthcare more accessible and consistent for everyone.
Because their role involves working directly with patients, nurses, healthcare administrators, and organizational executives, nurse leaders are especially unique to influence health equity. Kristen Azar, medical director of the Sutter Health Institute for Advancing Health Equity, said that nurse leaders can realize their potential as agents of change by “asserting themselves on matters of health policy and extending the role of patient advocate beyond the bedside and into the community.” While nurse leadership job titles may vary, Azar listed several tangible actions that all effective nurse leaders can take toward health equity:
- Ensure that the latest information and research is being used for improving care and care outcomes.
- Draw on patient information and understand patient experience to identify and develop new solutions to health challenges.
- Take an active part in local and national legislative discussions on healthcare and policy.
- Remove barriers to nursing education for students from socioeconomically disadvantaged groups.
- Create nursing education content intended to reduce racism and other forms of systemic discrimination.
As nurse leaders work toward these goals, the National Academy of Medicine said that those in the healthcare system, and especially leaders, “should seize this moment to support, strengthen, and transform the largest segment of the health workforce so nurses can help chart our country’s course to good health and well-being for all.” Opportunities for nurse leaders are plentiful, and nurse leaders strive to make their communities healthier. Now is the time to pursue a nursing leadership career that is emotionally and financially rewarding.
The University of West Florida’s online nursing degrees give nurses the interdisciplinary leadership qualities they need to advocate for individuals, families and communities and influence healthcare policy. UWF’s online RN to BSN program allows nurses to move up in their careers in just one year. Graduates of the accelerated, online BSN to MSN can go even further. For those interested in nursing education or leadership, the online MSN is available with three industry-leading specialties: Nurse Executive, Nursing Education and Family Nurse Practitioner.
Because all of UWF’s nursing programs are accredited by the Commission on Collegiate Nursing Education (CCNE), you’ll learn the most effective, innovative nursing practices for today’s healthcare careers. These programs feature affordable tuition, generous transfer credit policies and a convenient online curriculum. Get started now by requesting more information from our enrollment specialists.