Issues Faced By Nurses In Management Positions

Author: Bells Breakthrough Leadership Coaching LLC | | Categories: Leadership Development , Nurse Coaching , Nurse Manager Coaching

Blog by Bells Breakthrough Leadership Coaching LLC

Sadly, many newly promoted nurse managers do not make the impact they – and their employer – had hoped for, resulting in stress for them and their manager, poor employee retention, and declining clinical and financial outcomes.

Bells Breakthrough Leadership Coaching LLC is dedicated to providing leadership coaching and training for nurses in management positions. I am committed to helping nurses overcome the challenges they face in their leadership roles. I help nurses transition from outstanding nurses to influential and impactful leaders. In this blog, I will discuss the various issues nurses face in management positions and how my nurse leadership coaching can help.

Nurse manager overwhelm

Stepping into a management position for the first time can feel incredibly overwhelming. As you know, healthcare is busy and often chaotic. New managers frequently feel stressed by a sense of urgency and a never-ending list of things to do with insufficient hours to get it all done.

Nurses are well-trained in identifying problems. It's critical to ensuring patient safety. Nurses are also fantastic problem solvers. However, in a leadership role, a problem-focused mindset can be detrimental to the health and safety of the team. Who wants to work for a leader who always points out what's wrong and what hasn't been done or done "right"? The "problem-focused mindset" leads to overwhelming and reactive leadership decision-making.

I help my clients shift from a problem-focused mindset to an outcome-focused mindset. Something magical happens when we shift our mind from "what's wrong thinking" to "what do I want, what resources do I have, and what can I do next?" This shift in thinking helps open our minds to possibility, collaboration, and the creativity needed to create better, sustainable outcomes.

Emotional reaction

Nurses are caring and compassionate, which are great attributes for nurses and leaders. Compassion, combined with the desire to serve others, including their patients, colleagues, and leadership team, creates an emotional challenge for new managers.

Fear, guilt, frustration, anxiety, etc., are frequently experienced due to workload and concern for employee well-being and patient safety. These emotions drive what is commonly referred to as "fire fighting "because if you eradicate a fire, the immediate problem is solved. However, the cause of the fire often is not addressed.

Healthcare is an emotional world. I help my clients develop an awareness of their emotions and the emotions of others so they can lead with a clear mind and make conscious, outcome-focused, sometimes challenging, but inevitably powerful decisions.

Team performance

Nurses get promoted to management positions because they know how to care for their patients and achieve exceptional outcomes. However, a nurse leader's success is not measured by how hard they work. A nurse leaders' success is measured by how well their teams take care of the patients, and performance is measured against success with Key Performance Indicators (KPIs).

I often hear new managers make statements like, "it's quicker and easier to do things myself." Doing things yourself at the moment is quicker and easier; it is also a form of rescuing or enabling, resulting in underdeveloped, poorly performing teams.

I help nurse managers transition from outstanding individual contributors to impactful, influential leaders. I help set realistic expectations, teach how to address conflict, and grow a team committed to delivering excellent patient care.


Feeling overwhelmed and allowing emotions to drive our actions is exhausting. Exhaustion is one of the reasons inexperienced leaders find it easier to do things themselves. It is not physically easier; it is emotionally easier. Avoidance is another strategy born out of frazzled emotions, particularly conflict avoidance.

When a leader is burnt out emotionally, they do not have the energy to engage wholeheartedly with their team. Lack of engagement with the team leaves an opening for others to fill the spot and become unofficial leaders who lack the knowledge, experience, and reasoning required to take the team in the right direction. The unofficial leader comes with their perspective, and many times more than one unofficial leader is vying for power. The result is drama and conflict.

I teach nurse managers how to engage with their teams in a way that brings the best out in others, helps them grow in their roles, and lead themselves and others out of drama into empowerment. Empowered teams focus on what matters most, "patient care.”

Not enough hours in the day

Not enough time is a common challenge and a fundamental cause of stress. There are only 24 hours in the day, and no one can change that; you can change how you choose to use your time. I know it might feel like you don't have the power to make this choice, but nothing will change if you don't make a change.

There will always be plenty to do, and if you stay focused on the overwhelming to-do list, you will feel like you will drown. The drowning feeling triggers your fight, flight, freeze response. Fight, flight, freeze is a stress response as if you're in a life-threatening situation. This state of anxiety drives the rescuing and fire fighting, or emotional reaction that results in feeling like you don't have time or energy to delegate or ask for help.

When you don't delegate or ask for help, your to-do list will keep growing while your team is underutilized and possibly feeling undervalued and disengaged. Undervalued disengaged employees cause drama because they don't have enough to do and are not growing or utilizing their skills and talents. Resolving drama takes more of the leader's time, and the overwhelm worsens.

The scenario above is common for new leaders from all walks of life and creates a bottleneck in which the work keeps flowing, the leader is stuck, and the team is underutilized. If you're experiencing the bottleneck situation, it is not your fault; you haven't yet received the training you need to develop a leadership mindset and make conscious choices that will support team performance, reduce drama, and carve out time in your day for you to get your work done and create a more balanced life.

Nurses in management face many challenges that can negatively impact their performance and overall satisfaction. However, with the help of leadership coaching, these challenges can be overcome, allowing these nurses to be more effective, confident, and fulfilled in their leadership roles. At Bells Breakthrough Leadership Coaching LLC, I am dedicated to helping nurses in management positions achieve their full potential as leaders. I offer my services to clients across Dallas Fort Worth Metropolitan Area and beyond.

Get in touch with me today!

To learn more about the services I offer, please click here. To get in touch with me, please click here or give me a call at (214) 546-3127.