Joy in the unexpected journey to leadership

FigureNURSE LEADERSHIP WAS NEVER a thought in my early career development plans. As a matter of fact, I almost left nursing after my first year on the floor. I was a terrible medical-surgical nurse, working in a prestigious teaching hospital. Looking back, I was unorganized in my daily cares, struggling with time management, and confused who to notify when dealing with multiple medical services. Did I fail to mention that I received a total of 6 weeks orientation, and I was put in charge within 30 days of passing boards? I was no more capable of overseeing a unit than flying the space shuttle. This was nursing in 1987. A SOFT-SPOKEN SAVIOR I'm grateful every day that I stayed in the career that I know I was chosen to do. I married the summer of 1988, relocated with my military husband, and landed in a perfect position. The hospital had received a grant from a local community college that allowed new hires in the neonatal intensive care unit (NICU) to participate in a hybrid 12-week orientation program. There were didactic modules taught by college professors, neonatal nurse practitioners, and neonatologists combined with unit orientation with core preceptors. Sound familiar? Today, this is how we train new graduates transitioning from student to professional nurse. In 1988, this was a new concept, and I'm proud to say that it saved me, and, in turn, many babies in my 38-year career as a neonatal nurse. It was during that NICU orientation that I heard a phrase that has guided how I want to be seen as a nurse by other nurses: "silent nurse leader." My assigned preceptor had many years of experience at that hospital. Her name was Jackie, and she was soft-spoken, wicked smart, and able to redirect me when needed without being condescending. She was well respected by her peers, and they shared with me that she had been a lead charge nurse and nurse manager but had recently returned to the bedside. The staff looked to her as a leader because of her behavior. They wanted to work with her because of her skills and ability to manage a crisis with calm confidence. My one regret was that I never told her how lucky I was to have her guide me so early in my career. I only stayed at that hospital for 1 year due to being relocated with new military orders, but it was truly the most influential year. I learned the type of nurse I wanted to be—one who other nurses would want to emulate based on both behavior and expertise. A silent nurse leader. A FULFILLING CAREER Fast forward to the present. I've been a preceptor, charge nurse, transport nurse, and nurse educator. I've worked in 7 different NICUs throughout the country and learned behaviors from leaders that I wanted to take with me and other behaviors that I was glad to leave behind. Prior to my current position, I was a nurse educator for 10 years and helped develop the curriculum for the new graduate residency program for our NICU. I loved watching the nurses grow in skills and confidence throughout their immersion in the unit, and I've seen their progressions through the years. That's the pipeline I thought I was meant to build. A DETOUR ON THE ROAD TO RETIREMENT In 2017, I relocated to a new city after spending 22 years at my last hospital. My plan was to work part-time in a 9-bed, community, Level II NICU and sail into retirement. Once I had onboarded, it was shared that the goal was to expand the Childbirth Center to meet the needs of the growing population in our county. The culture of the unit when I started wasn't like the culture I had come from. Staff engagement scores weren't good. Staff lacked accountability and a safe space to share concerns and ideas. The culture was punitive and characterized by a top-down mentality to decision-making. After my first year, there was an opportunity for a change in leadership, and I was willing to try and make a difference. Did I have years of leadership experience? As I reflected on my career, I realized that perhaps I did. I'd become the silent nurse leader I'd observed in my preceptor early on in my career. Now it was time to find my voice as a nurse leader. Today, I'm the nurse manager of a 20-bed community-based Level III NICU. I've had amazing mentors who showed me how to lead by example. These leaders rounded in the unit—not to look for issues, but to connect with people. They wanted to hear firsthand what their team members needed and what brought them joy. I round every day on each of my staff members. Not in a formal way, but in a way that I hope helps my staff believe that I care for each of them as a person first and an employee second. I wear scrubs almost every day. We're a small unit, and I want them to know that I'm there to jump in when needed. The scrubs are my power suit. I've worn them in some color, shape, or fashion for 38 years, and they've served me well. Often, I'll go to the NICU and ask to feed a baby—I need that connection to my why. Why I'm first and foremost a caregiver. LEADERSHIP LESSONS What I 've learned as a leader is to be the person who everyone is eager to work with. Be the leader who isn't so removed from the bedside that you lose the view through that lens. Be the voice of your team—even if the topic isn't easy or popular. Be the leader who can hold people accountable with grace, dignity, and consistency. Be fair but realize that life isn't always as black and white as the policy appears. Take the leadership development courses but use them as a guide to be the leader you want to become. Connect with everyone and maximize the strengths of your team. Develop your people, even if it means they might leave for another opportunity. That isn't a failure but a tremendous success. And always be the silent leader that you hope others will want to emulate. That's the true definition of leaving a strong nursing pipeline.