It was the summer of 2015, and I just finished my 1st year in the Emergency Department as a nurse practitioner. During my annual evaluation meeting, I told her, “Thank you for everything you have done for us. I could never do what you do. Thank you!” Four years later, I was the Manager of the Emergency Department. I learned that day and forevermore, “NEVER say never.”
Your best skills will always shine
A nursing leadership role was never part of my plan for my career. I recall a day that I finished a clinic session in Brooklyn. One the physicians told me, “You will be a great nursing administrator someday.” I laughed with surprise and said, “I don’t think so. I love clinical care too much.”
Fast forward to 2017, I was almost 3 years into my ED NP and was in a great space overall. I worked 4 days a week, participated in projects that I cared about including Behavioral health in pediatric patients, and then traveled the world. My manager approached me one day to ask if I would consider applying for the Team Lead role. I was shocked. There was someone else applying with more experience and who truly wanted the role. Once again, I thought, “No way.”
However, if I was honest with myself, I had been an NP for 9 years and was becoming fatigued by clinical work. I loved being a Nurse Practitioner and loved advocating for more roles and telling everyone how special we were. So why not advocate on another level? Furthermore, someone thought you would be good at it? Shouldn’t I at least apply and see what happens. And so I did, and I got the promotion. My next lesson learned, listen to people when they notice your best characteristics.
Leadership roles
The Team Lead role was the best transition for me from all clinical into leadership. My manager taught me about leaders, systems, how to manage the team, and how to grow as a leader. I had the best of both worlds as I practiced clinically and had dedicated time to work on projects. However, middle management can also be challenging when you may not agree with a change you have to implement or an approach.
By the end of 2018, I was in a groove. Life was great. I had just traveled to my 5th country of the year by September. And then, my manager informed me that she was leaving. I was devastated! I knew that I would be asked to consider the role and had already told my manager that I could not do what she does. Imposter syndrome and self-doubt stepped in. I thought of all of the reasons why I could not do the role.
As I talked myself out of the role, I remembered stories that my cousin shared about how I would boss around her adult friends at a volunteering event as a child. In high school, I nurtured my love for my Caribbean culture by becoming president of our high school Caribbean club and subsequently the Vice President of the Caribbean organization in college. Then, in my early days of bedside nursing, I would advocate fearlessly for additional pain meds for my patients. Reflecting on these moments, helped me to realize that I was already a leader.
Next, I had to understand my why. “Are you excited about the possibilities of the role,? “ “Are you passionate about the work?” “Do you think you can make a difference?” The answers were all yes. I knew that I had to do it.
My tenure as the Advanced Practice Provider Manager in the ED was one of the most exhilarating experiences of my career with the highest of highs and lowest of lows. I recently watched an inspirational video that described that once you reach the top of a mountain your at the bottom of another, so keep climbing. Landing the promotion was one thing, but doing the work successfully was a whole other beast.
Challenges became lessons learned
My goals were lofty as a new manager but my intention was to do the best that I could. Of course, I encountered many challenges but they became lessons learned. Here are my top 5 :
1. Identify your gaps in knowledge early.
How was I going to lead this team? I have no formal leadership training? I recognized my gaps in knowledge immediately. It was important for me to evaluate where I needed assistance and create a group of resources around me to support the transition. This included weekly meetings with HR, business partners, and my boss to ensure I was moving in the right direction. You cannot do this work in silo. Building relationships is key
2. Listening is a necessary skill.
Managing former peers is not easy. I was still a fairly new NP in the ED as some NPSs had been there for over a decade. I did not want to change their practice but find ways to make their work easier. It was key for me to listen, understand the challenges, and collaborate with them on improving systems. I was transparent when I didn’t know something and was always open to listening to different points of view. My team grew to respect me and know that they could come to me with any concern.
Learn about finances
Budgets and FTEs, Oh My! When applying for the role, I thought for sure I would need an MBA. The managers eased my concern when they informed me that we had access to resources that would help us navigate the budget process. To this day, I am so grateful for the finance and operations managers who met with me weekly for almost a year to help translate my vision into numbers. If you have a person such as them in your organization, become friends, and find them! If not, seek out a course or fellow leaders who have done this work in your organization. DO not do this solo!
4. Time Management is Key
Transitioning from shift work to primary admin is a shock to the system. Initially, I had no idea how to adjust to the 9-5 pm lifestyle. It seemed like work never ended. Some days were packed with back-to-back meetings which did not allow bathroom breaks, lunch breaks, or time to check in with the team. Emails never ceased even when you cleaned your inbox. It seemed as though I was always working! I learned boundaries, maximizing Microsoft office to support how I work, and the beauty of managing your calendar to what works best for you. It became a lifesaver that I then would share with other leaders. A simple Microsoft office add-on called “Find time” could eliminate countless emails and self-schedule emails. Use it!
5. Define your leadership style
What type of leader am I?This became the most important self-discovery question as I ventured into leadership. I was surrounded by phenomenal leaders who managed the day-to-day work seamlessly. Somehow, I had to define how I wanted to work, lead this team, and the culture of the team. Through reading many leadership books, Harvard Business Review articles, and practicing calm in chaos, II discovered that I was a visionary leader who was passionate about advanced practice nursing, diversity, and improvement projects. I wasn’t always going to get every decision right, but I would always learn.
As a nurse, you are inherently a leader. If you are contemplating leadership, always evaluate your why and if it excites you. It may not be the easiest role, especially in healthcare today, but it will be rewarding once you are open to the process and know that your biggest challenges will always be your lessons learned.
