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Confidence is in

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By: Peter Stoffan, DNP, MPA, RN, CCRN, NEA-BC, CPXP

Find the balance between confidence and arrogance, humility and insecurity

“Our doubts are traitors and cause us to miss the good we oft might win by fearing to attempt.”
– William Shakespeare, Measure for Measure

Takeaways:

  • The ideal of authentic leadership is rooted in confidence.
  • Even the most seasoned nurses and nurse leaders struggle with confidence and feel insecure during many points in their careers.
  • Overcoming insecurities can help ensure professional success.

Insecurity can prove toxic. We know this, so why do we let it overcome our confidence? We can’t overcome our insecurity without understanding where it comes from. Insecurity may be inherent or inherited. Ask yourself the following questions: Are you insecure because of the way you were raised? Are you shy and so you naturally present yourself as insecure? Or is the insecurity a result of the culture in which you find yourself?

Gaining confidence in public speaking

EVA, a professional practice coordinator, and her team of clinical educators are thrilled to learn that their abstract on an iLead in Nursing initiative…

Whatever the reason for your insecurity, remember that it’s common. However, maybe it’s time to examine it and work toward overcoming what’s holding you back. Taking a close look at our insecurities and then working to quiet our “inner saboteurs” (as drag superstar RuPaul labels them) can help us move toward a more confident space as nursing leaders.

Many consider arrogance, another toxic trait, the opposite of insecurity. However, I argue that the true opposite of insecurity is confidence. The line between arrogance and confidence may be nearly invisible at times, but the importance of understanding confidence and how it relates to our practice can save lives and improve our overall practice environments. So how do we own and live in our confidence without tipping over into arrogance? How do we define confidence and apply it to nursing and nursing leadership?

The role of confidence

Several nursing organizations incorporate confidence into their principles and competencies. For example, transformational leadership serves as one of the key components in high-performing healthcare organizations, as researched and outlined by the American Nurses Credentialing Center Magnet Recognition Program®. To be a transformational leader, you must employ one or more of the following traits: idealized influence, inspirational motivation, intellectual stimulation, or individualized consideration as outlined by the landmark study by Bass in 1985 and underscored later by Bass and Riggio in 2006.

What does this sound like to you? Can we influence, motivate, intellectually stimulate, and consider others without confidence?

The American Organization for Nursing Leadership (AONL) has developed core competencies for nurse leaders, which include professionalism, communication and relationship management, knowledge of the healthcare environment, and business skills and principles. To achieve excellence in the AONL nurse leader core competencies, we must have the confidence to look within ourselves, seek feedback, and pursue opportunities for growth and development. One of the American Association of Critical-Care Nurses’ standards for a healthy work environment includes authentic leadership, which stresses the belief in, the self-integration of, and the ability to influence others in a healthy and successful work environment. This ideal of authentic leadership is rooted in confidence.

In addition, the Agency for Healthcare Research and Quality’s TeamSTEPPS (Team Strategies & Tools to Enhance Performance and Patient Safety) includes communication strategies focused on assertive communication. They recommend adopting the CUS approach—I am Concerned, I am Uncomfortable, and this is a Safety issue—to ensure you’re heard when you witness a safety concern.

Meet the leaders

Linda Everett, PhD, RN, NEA-BC, FAAN, FAONL, is a professor at the Marian K. Shaughnessy Nurse Leadership Academy within the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, Ohio. She also works as consulting faculty at Duke University School of Nursing in Durham, North Carolina. Dr. Everett served as executive vice president and chief nurse executive at Indiana University Health, chief nursing officer at the University of Iowa Hospital and Clinics, and president of the American Organization for Nursing Leadership.

Stephanie Nolan, DNP, MBA, RN, NEA-BC, currently is the chief nursing officer at Providence Saint John’s Health Center in Santa Monica, California. Prior to that, Dr. Nolan has led many diverse teams at Memorial Sloan-Kettering Cancer Center and NewYork-Presbyterian/Cornell Medical Center.

Lystra Swift, DNP, RN, CNOR, currently serves as the corporate director of perioperative services at NewYork-Presbyterian Hospital in New York City, New York. Dr. Swift’s extensive career includes leadership experiences at Yale New Haven Hospital, New York University, and MD Anderson.

Leadership insights

Knowing that even the most seasoned nurses and nurse leaders struggle with confidence and sometimes feel insecure can help reduce concern about our own challenges. I asked a few of my nurse heroes and mentors—Linda Everett, PhD, RN, NEA-BC, FAAN, FAONL; Stephanie Nolan, DNP, MBA, RN, NEA-BC; and Lystra Swift, DNP, RN, CNOR—about their experience with insecurity, confidence, and arrogance.

As a nurse leader, have you ever felt insecure? How do you overcome this feeling?

Everett: I’ve felt insecure many times in my 54-year nursing career, over 45 in leadership positions. I felt insecure especially as an emerging novice nurse leader and whenever I assumed a new position. I think insecurity is part of the lived human experience.

As leaders, we need to cope with and manage our anxiety when encountering the unfamiliar and those issues that extend beyond our comfort zones. The best approach I use is to prepare for the best outcome and plan for the worst—always have at least a Plan B.

Nolan: There have been moments of “imposter syndrome,” where [I asked], “Do I really know what I’m doing?” As a newer [chief nursing officer], I had to give a presentation for my current board of directors, and it was my first presentation related to the institution’s Magnet journey. I went into the presentation nervous as nervous can be, even as a content expert, but realized during the presentation they were interested and engaged. I realized [my nervousness] was my own doing. They were looking to me for the knowledge that I know I have, but I was intimidated by their power status. It was a clarifying moment.

You have to be comfortable in what you know. I’m not trying to be something I’m not anymore. Moments of self-doubt will always occur but recognize that you’re qualified and were hired for a reason. The imposter syndrome is self-imposed. No one else is telling you that you’re an imposter. You’re the only person who has to realize that you’re here for a reason…all the time. This is a gift that you get to do good things with.

Swift: I feel the sense of insecurity as my roles change. When I went to a new role in a different hospital it was humbling. I was an expert where I was, but I found myself in “learner mode” again. Beyond praying and asking others to pray for me, I overcame my insecurity through humbling myself. I allowed [colleagues] to teach me while still understanding that I’m a master of my own craft. Overcoming my insecurity was about my approach—recognizing that colleagues were experts in their field, and I’m an expert in mine. I also had to have respect for what practices and cultures existed prior to me joining the team and learn, grow, and improve together.

How do you define confidence as a nurse leader?

Everett: Confidence means having self-awareness of what you know and what you don’t know. You gain confidence by extending beyond your comfort zone to gain new knowledge, learn new skills, and enrich your abilities and talents. To achieve this, engage in lifelong learning, network with peers and colleagues, and join professional organizations. Also look for new opportunities and challenges and strive to achieve new goals.

Nolan: Confidence is knowledge. I get my confidence through understanding and learning to better understand where my role is in different avenues. When you know more, you do better.

One of the most important things is being vulnerable, knowing what you don’t know, sometimes rethinking and unlearning what you’ve learned, and being open minded to others’ opinions. Diversity of thinking adds knowledge, draws innovation, and gives you confidence.

Swift: Confidence is knowing that you have the expertise [to prevent] harm and knowing that when you don’t have the expertise [you can] tap into resources to learn and improve. I remain confident knowing that I can say, “I don’t know, but I will find out…” I’m not afraid that others will think I’m “less than” because I don’t know something.

What would you say is the difference between confidence and arrogance and how do you navigate this line?

Everett: Confidence is grounded in your belief in [yourself] as a leader…the leader within you based on your knowledge, skills, and abilities. Arrogance is based on an inflated sense of self, a sense of accomplishment that’s not earned nor entitled. [There’s a] fine line. Know your True North, and use your moral compass to guide you on your professional journey.

Nolan: A good leader is one who finds the strengths [within] a team and pulls [them] together to build a collective. The confidence comes in when you realize what you don’t know and when you bring others forward. Arrogance is when you think people may never know more than you. We must realize that one person can’t be good at everything. Leadership is about leveraging everyone’s strengths.

I’ve been lucky that others have trusted me when I didn’t trust myself. I didn’t say no to opportunities, so I could build confidence as a leader. You must take risks and sometimes you fail…and that’s okay. It’s time for us to push the envelope as a discipline, and the only way to do this is if we embrace differences of opinion and learn together.

Swift: When I think of arrogance, it’s always at the cost of putting someone else or a group down; I stay away from that. I want to share everything that I can share so we all learn together and have success together. My favorite thing is to build confidence in my teams, so I focus on that.

Find the balance

The nurse leaders and mentors I interviewed, although diverse in thought and backgrounds, underscored the importance of overcoming our insecurities to ensure our success.
Whether you’re a new or experienced nurse leader, consider the following action steps:

  • Engage in mentorship. Have reflective discussions with your peers.
  • Own what you know and what you don’t know.
  • Take chances.
  • Remember your moral compass.

Finding the balance between humility vs. insecurity and pride vs. boasting can be a lifelong tightrope act, but with reflection, practice, and open conversations with fellow leaders and mentors, you can achieve success. Remember that confidence is in, and it’s necessary to ensure positive outcomes and practice environments for everyone.

Peter Stoffan is the Magnet® Program Director at NewYork-Presbyterian/Morgan Stanley Children’s Hospital.

American Nurse Journal. 2024; 19(6). Doi: 10.51256/ANJ062426

References

Agency for Healthcare Research and Quality. Pocket guide: TeamSTEPPS. December 2013. ahrq.gov/teamstepps/instructor/essentials/pocketguide.html

American Association for Critical-Care Nurses. Authentic leadership. aacn.org/nursing-excellence/healthy-work-environments/authentic-leadership

American Nurses Credentialing Center. 2023 Magnet® Application Manual. Silver Spring, MD: American Nurses Association; 2023.

American Organization for Nursing Leadership. Nurse leader core competencies. aonl.org/resources/nurse-leader-competencies

Bass BM. Leadership and Performance Beyond Expectations. New York City, NY: Free Press; 1985.

Bass BM, Riggio RE. Transformational Leadership. 2nd ed. Mahwah, NJ: Lawrence Erlbaum Associates; 2006.

Keywords: leadership, confidence, insecurity, mentors

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