Nurse leaders have traditionally advanced through years of clinical experience. While this approach provided foundational knowledge, today's fast-paced healthcare environment demands a more proactive approach to leadership development. Throwing someone in at the deep end doesn’t work. So, how do we enable our emerging nurse leaders in a situation with little time and more pressure?

Less Time to Earn Stripes

Healthcare leadership roles have traditionally required years of clinical expertise. For instance, I began exploring leadership opportunities only after 6 years of nursing. Building these pathways earlier could address today's urgent need for skilled leaders.

This approach may have worked until recently, but unfortunately, healthcare has changed. We don’t have time to waste! Younger generations are redefining career trajectories by prioritising adaptability and mobility over traditional notions of job security. Rather than pursuing a "job for life," they focus on gaining transferable skills to evolving roles. It is estimated that future generations will have 17 jobs across 5 different careers in their lifetime.

Don’t get me wrong, clinical expertise is significant, but long tenure is no longer a thing. Due to many factors, the average nurse's tenure is approximately 4 years (Sharma 2022). Traditional methods of selecting leaders based solely on clinical knowledge and years spent working in one environment are outdated and inadequate in today’s fast-paced healthcare environment.

Gone are the Days of Sink or Swim

Early career nurses are too often thrown into the deep end, finding themselves running a shift due to staffing shortages. Transition-to-practice programs have revealed trends concerning newly registered nurses' having limited patient safety knowledge. Although these programs offer clinical support, they often place minimal emphasis on practical, real-life shift leadership scenarios that nurses frequently face on the wards daily. This raises the question: How can we embed practical clinical leadership opportunities into these programs? Better yet, how can leaders facilitate this in their units? (Murray, Sundin & Cope 2017).

Embrace ‘in the moment’ learning for the practical transfer of knowledge, skills, and wisdom to help build the clinical confidence of our early career nurses. As one nurse said, “If someone just showed me once how to do it,” that could have been the moment that set the individual apart from the pack (Daws, McBrearty & Bell 2020).

Improve Retention Rates

Health workforce data shows the highest exit rates among nurses and midwives, partly due to limited opportunities to work to the full scope of their practice. If these health professionals experienced exit rates comparable to medical practitioners, who have the lowest rate of exits, thousands more could be retained within the workforce. When people feel valued and acknowledged for their skills, having the opportunity to work to the full scope of practice significantly enhances retention rates (Australian Government, Department of Health and Aged Care 2024).

How to Identify Emerging Nurse Leaders

The regular rotation of early-career nurses through clinical areas offers valuable opportunities for a manager to identify emerging talent and introduce leadership experiences early in their careers. As an Associate Nurse Unit Manager (ANUM), I recognised these rotations as a chance to encourage growth by providing leadership opportunities that these nurses might not typically anticipate at this stage of their professional journey.

I once met a nurse who was hesitant to take charge during a busy shift. With a little encouragement and a clear plan, she was able to lead the team and carry out managerial tasks with guidance and support. Moments like these highlight how small, intentional actions can help early-career nurses step into leadership sooner than they might expect.

Emerging nurse leaders thrive when they feel supported and have something to contribute. As an emerging leader, having a mentor to guide me through my first leadership challenge made all the difference. That experience taught me how important support is for growth. This works because early career nurses gain insight into what is expected of them when they are in charge. It is no longer a scary place; if anything, it is an opportunity to start their clinical leadership immediately.

Leaders sharing the workload helps create an environment of collaboration, knowledge sharing, and growth. To ensure this arrangement works, it is important to meet with the leadership team and ensure their support. I started to be excited about building trust and meaningful connections among the team. I wanted to enable new learners to explore leadership and what came with that responsibility early on in their careers, just as I would have wanted.

Before a shift, I would arrange an informal session with the staff member to discuss this exciting opportunity to shadow me for some of their shifts. We would begin by outlining what they would like to gain from the first shadowing sessions, typically to gain basic knowledge of in-charge shift management and what they could expect from the routine. From there, I went through the following:

Key Learnings

• Where the bed meeting occurs
• Ward round and documentation
• Nurse manager's daily routine

Challenges they might be faced with

• Managing sick leave
• Staffing for the afternoon shift
• Staff breaks
• Patient deterioration

Post-session, I prioritised debriefing with the learner first. During the debrief, I ensured we reflected on the experiences, discussed what went well on the shift, and identified areas that I, as a manager, could have done better. For example, "I should have ensured that the nurse accepting the post-operative patient had taken their break before giving the go-ahead." This demonstrates accountability and self-reflection on my behalf, which is suitable for the learner to observe so they, too, adopt this reflection moving forward.

Delegation is Code for Enablement

Delegation is a strategic management tool that enables leaders to focus on mentorship and broader team development. Identifying and nurturing individuals who confidently take on key tasks builds team resilience and trust. Balancing these responsibilities required careful planning to prevent disruptions in daily operations.

Some examples where delegation acts as an enabler include:

• Allowing staff to manage aspects of staffing for the afternoon shift
• Coordinating break schedules
• Responding to patient deterioration

Before delegation, I would provide context, set clear expectations, and offered support to prepare them for the task.

Be Proactive

Start the hands-on clinical leadership experience early. Identify, plan, and implement a shadowing experience within your unit. This shows the team that you have been observing, listening, and investing time in their career progression while acknowledging their strengths. When nurses see their efforts and growth consistently recognised, it boosts their motivation. Nurses who feel seen and supported are likelier to remain with the organisation or even return to your unit, reducing turnover rates.

The Path Forward

Supporting emerging nurse leaders requires more than expecting them to adapt to high-pressure roles independently. Replacing outdated 'sink-or-swim' methods with structured mentorship programs from the beginning ensures sustainable leadership development. By committing to mentorship and proactive leadership development, we can prepare today’s nurses to become the leaders our healthcare system needs.

References

Department of Health and Aged Care 2024, Unleashing the Potential of our Health Workforce, Australian Government, viewed 14 November, https://www.health.gov.au/sites/default/files/2024-11/unleashing-the-potential-of-our-health-workforce-scope-of-practice-review-final-report_0.pdf

Daws, K, McBrearty, K & Bell, D 2020,“If somebody just showed me once how to do it”: how are workplace cultures and practice development conceptualised and operationalised for early career nurses?, Nurse Education Today, vol. 85, p. 104267.

Claire Madden 2024, Gen Z Future Employability Skills, Claire Madden, viewed 13 November 2024, https://clairemadden.com/category/blog/gen-z-future-employability-skills

Murray, M, Sundin, D & Cope, V 2018, ‘New graduate registered nurses’ knowledge of patient safety and practice: A literature review’, Journal of Clinical Nursing, vol. 27, no. 1-2, pp. 31-47.

Sharma, G 2022, 'Retaining Australian Nurses: An Analysis of Nurses’ Wages and Exit Rates', School of Economics, The University of Sydney, pp. 1-47.

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