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Nine principles of successful nursing leadership - American Nurse

Nine principles of successful nursing leadership

By: Naté Guyton, MSN, RN, CPHIMS, NEA-BC

There is an extraordinary quality of spirit that prompts one to aspire to lead. These nine principles will help you tap into that spirit and improve your effectiveness as a leader.

#1: Commit to excellence

As a leader you must be committed to your passion and purpose, and have the type of commitment that turns into perseverance. Many nursing leaders are committed patient advocates, clinicians, or employee advocates but the true test of commitment comes when it’s difficult to get out of bed and go to work with a smile, yet you do because you know you are there to serve a purpose.

To get through these challenging times and make a difference, establish three priorities every 90 days and commit to seeing them through. Obtain your staff’s insights on the priorities so the team will stay focused and have a stake into the strategic plan.

Commitment to excellence starts with the leader, so know in your heart that where you are is where you were placed to serve and share your skills and talents. If you question or have doubts about where you are, you may want to reevaluate your next move because eventually it will show through in your performance. This will allow you to fulfill your purpose, thereby increasing satisfaction for you.

#2: Measure the important things

Service. Patient satisfaction parallels staff satisfaction, so measuring employee satisfaction benefits the unit, department, and team. Develop realistic action plans to build employee satisfaction, involve all staff levels, and reassess every year. Become familiar and well versed with your patient satisfaction measurement tool. Share and explain data to your employees often.

Quality. Become familiar with and incorporate core measures into daily practice and communication. Make them breathe in your department. Convey to your team, staff, and other employees that patient safety and maintaining quality standards are a way of life. Develop unit- and department-specific performance improvement processes that the staff can articulate and implement in daily practices.

People. Be the resident role model; who you are is whom you will attract. Take notice of the employees who require a lot of cheerleading and motivating to do their jobs. They have a tendency to become negative when they don’t receive feedback on a consistent basis and can infect the entire staff.

Growth. Develop unit-based and departmental volume projections and business plans. If you have a unit where you are not meeting your department average daily census or productivity, look for and measure potential growth opportunities. For example, if your unit is a 30-bed monitored surgical unit, develop a plan to add another service line similar to your existing clinical services. You may want to think about combining cardiac transplantation services with nephrology services and open beds for patients who receive kidney transplants.

Finance. Too often clinicians focus on improving people, quality, and service and leave finance far behind. However, your follow-through of your business plan for your unit or department will likely realize a financial savings, which can be reinvested into your clinical services. Build your unit-based financial plan for the year, based on your annual budget that includes salary, expenses, supplies, and capital requests.

Use your biweekly and monthly financial reports to keep on target. When you are off target, develop a variance report with a specific and detailed action plan to get back on line for the next month. Share the report with your staff in monthly staff meetings, post it on a bulletin board for staff to see, and develop a staff financial newsletter to help staff understand how they play an important part in financial management on a unit level.

If you have a problem with meeting the standard for admissions, transfers, and discharges on your unit or in your department, create a bulletin board and display the number of delayed admissions, transfers, and discharges and how much it costs the organization to hold patients in the emergency department, intensive care unit, and other areas.

#3: Build a culture around service

Teach your staff to appreciate patients and families as their customers. Encourage them to use scripts and prompts when answering the telephones and consistently greet patients when entering and leaving their rooms. You may or may not have a new state-of-the-art facility and the latest technology, but if employees treat patients and their families with personalized care and compassion, they will always come back. Expect your employees to behave as if they worked in a five-star resort. Role model how to be a servant-leader. As the leader it is imperative to be humble, open, and available to learn every day. Remember, if you lead, they will follow.

#4: Create and develop leaders

An old adage is, “If your unit or department can run without you, you have done your job.” This is true, so develop your succession plan early. You can’t do it all alone. Identify your informal and formal leaders and invest in them. Take them to meetings with you; have them provide presentations to the staff and senior-level leaders. Find opportunities to highlight their strengths and minimize their weaknesses. Train them to be the next leaders.

#5: Focus on employee satisfaction

Make your work environment a great place to work. Celebrate what each individual employee can bring to the team. Make rounds daily to connect with your employees on the unit or in your department. Focus on establishing a relationship with each staff member by knowing their names and their children’s names. Send staff thank you cards and birthday cards, and recognize key events in their lives. Communicate with your employees frequently on all levels: An informed employee is a satisfied employee. Have daily team meetings or huddles to review pertinent information, new changes, celebrations, or other factors.

#6: Build individual accountability

It’s imperative to hold all employees accountable for the part they play in the overall goal. Develop a scorecard for each employee and meet with them every 3 months to measure their progress, accomplishments, and opportunities for growth. The SWOT approach—strengths, weaknesses, opportunities, and threats—tends to work well. Provide employees with a copy of the SWOT document you complete when conducting their 3-month 1:1 meeting; be sure to write specific goals and dates for when they must be accomplished. This is an easy way to keep accurate records on each employee’s performance, which can be used when completing their annual performance evaluation.

#7: Align behaviors with goals and values

Set behavioral standards for all employees that are aligned with the organization’s values, mission, and standards. Celebrate the initiative of using the standards and have everyone sign a commitment. As a leader, role model the standards and use them in everyday conversation with your staff. Refer to standards when you’re developing or counseling staff.

#8: Communicate on all levels

To serve our patient population as an interdisciplinary team, we need to communicate as an interdisciplinary team. Incorporate support services, physician staff, and senior leadership into daily rounding on all units. Each week, have a member of a different department or service round with you and your staff on the unit or in your department; this will assist in fostering trust and opening the lines of communication. Invite senior leaders to your staff meetings so your staff can see the collaborative relationship that exists among senior leaders and frontline leaders.

If you are battling high turnover and vacancy rates, invite your recruitment and retention department to your unit or department to explain retention and recruitment efforts; this may stimulate your staff to refer a friend.

#9: Recognize and reward success

Too often we save recognition until Nurses Week, which may be too late to retain staff. Ongoing rewards and recognition go a long way to motivating staff and enhancing innovation and creativity. Offering words of praise and encouragement and taking the time to meet with your staff 1:1 say you are interested in them. Set goals and objectives for your staff and as they meet them reward them with a paid day off for relaxation, an all-expense-paid conference, a thank you note, or a small token of appreciation.

Success will follow

As a nurse leader you will face many trials while you’re blazing the trail of success. But if you make up your mind and manifest in your heart that you will stay committed and focused and build a team that will assist in meeting the goals and objectives in serving the community, you will be successful.

Don’t follow the path that lies ahead; instead, blaze a new trail!

Naté Guyton is the clinical nurse informatics officer for Mercy Health System in Conshohocken, Pennsylvania.

Selected reference

Studer Q. Hardwiring Excellence. Gulf Breeze, FL: Fire Starter Publishing; 2003.


  • Malerie Cummings
    April 21, 2023 12:48 pm

    The 5-star resort comment is being taken too literally. We’re not standing there feeding them grapes and fanning them (or are we?) – but we can answer their call bell and acknowledge their needs/wants, and that acknowledgment is sometimes all they need to distinguish us from another, less responsive and considerate facility. Popping in to say “Hey, I’ll be in as soon as I’m done with this…” is also well appreciated. I would not expect that kind of consideration from a 1 star hotel, but from a 5-star, yes.

  • These nine priciples encouraged me to strictly following my career path as a nurse leader.

  • I am new msc nurse manager, this information gave me a great insight of how a leader should be.

  • this article has been helpful for public health leadership class thanks

  • The comment about treating our “customers” like a five-star resort”. If that is the case, then I only want the five star resort type of customers. When I see articles like this, I feel that a business person and not a true healthcare worker paid someone to write it. I also feel that the person who wants me to treat the patient (not customer) as if they were at a five star resort has never worked in the ER or a hospital that is does not serve a “five-star resort” population.

  • Nana akosua amissah
    March 21, 2021 11:48 pm

    Very great information helped me thru my course

  • Why do much concern over the comment of working in 5 star resort? Customer Service is Key that’s why we are there to take care of them, exceed their expectations and be recognized for the quality care and service. That’s what separates sons places from others. Great article, I’m a nurse supervisor going to school for Clinical nurse leader and loved this article! We have a fine task to articulate everyday in nursing it really is an art. ♥️

  • Very informative and sets the right baseline for the healthcare industry. If we can implement the 9 principles then yes……our behaviours will be aligned to those of employees working in a five-star resort. First we must define our individual purposes and values and to see to what extent they are aligned to the organizations we work for. Am I adding value to the patient and the organization or am I not?

  • James Lawrence
    May 19, 2019 9:24 pm

    Informative article on nursing leadership.

  • I realized once I read the follow that this was a US-based only article – as there are some countries where we Don’t want the patients back, we have free hospitalization and it is not our goal.

    “but if employees treat patients and their families with personalized care and compassion, they will always come back. Expect your employees to behave as if they worked in a five-star resort.”

  • The five-star resort may be a hotel but also would likely include restaurants, pools, areas for recreation, exercise etc. I think the reference was to the service one receives in a resort. The employees are there to make the visit welcoming and comfortable. They respond to the needs of the guests/customers within reason. They are not at their beck and call but are responsive to their needs. I think the offense in that nurses do respond to patient’s needs but also have expert knowledge and technical skills and do not merely serve drinks and rub your back.

  • What the ANA says in the code of ethics preface says it all” nursing encompasses the protection promotion restoration of health and well-being ;the prevention of illness and injury; and the alleviation of suffering in the care of individuals families groups communities and populations. All of this is reflected in part in nursing to persisting commitment both to the welfare of the sick injured , and vulnerable in society and to social justice”.
    I see no cooralation with your coment of working at a 5 star hotel . Please explain that comment . I very much disagree with it as part of the nursing profession.

  • carrie gander
    October 8, 2018 7:16 pm

    who is the author of this article please? Thanks

  • Anita Oforiwaa Obeng
    May 13, 2018 3:56 am

    This article has been helpful for my MSN nursing leadership class. Thank you

  • Anna Marie Keenan
    April 24, 2018 10:38 pm

    I have to agree with Heather’s comment. Nurses historically have been treated more like maids and servants that professional so to say that we need to behave like that is offensive. I would rather strive to let my patient’s know that they are in a quality health care world where their care is patient centered and collaborative in nature. This is what we tell them we are, why isn’t it what we are showing them we are?

  • I understand what the author is saying and I do agree with expecting your employees to behave as if they work in a five start resort. High Quality Customer Service.

  • I appreciate your article. Only one aspect I completely disagree with and that is ” Expect your employees to behave as if they worked in a five-star resort.”

  • Sharon A Sutherland
    April 25, 2017 1:04 pm

    This article has been very helpful. Thank you.

  • thanks

Comments are closed.

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