1. Witt, Catherine L. MS, NNP-BC

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"She really needs to do something about this." "They need to do something about her." How often do you hear statements like this? How often do you make a statement like this? I have to confess that I have heard these statements a lot and unfortunately made these types of statements not infrequently. We expect things to be taken care of, usually by the nurse manager or director, or someone in charge. Sometimes we expect them to fix things they don't even know about.

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What do we expect from our nursing leaders, whether they are charge nurses, directors of nursing, deans of nursing colleges, or presidents of nursing organizations? For that matter, have we considered what we expect from all our leaders, in churches, educational venues, athletics, businesses, or politics? We expect them to do things right, the first time, sometimes with limited information. We expect them to hold all the people under them accountable, and somehow know what all of those people are doing all the time. We expect them to be honest, display integrity in their personal lives, and be considerate of others. We expect them to be successful, whether it is building church membership, fixing the economy, winning more games than losing, or compiling military victories. They should make sure the company makes a profit, and at the same time be sensitive to the personal needs of employees. We expect the nurse manager to fix the schedule, give us our vacation, take care of the person who is incompetent, and do something about the person who is not nice to us. She is also supposed to make sure the door to the break room gets fixed, even though no one has reported that it is broken. Obviously, if she were paying attention and cared about her staff, she would know something is wrong.


There is nothing inherently wrong in these expectations. Leaders and managers should demonstrate integrity and honesty. They should treat employees with respect. They should hold others accountable and they should be in touch with what is happening with their staff and in the work environment. What we should also do is expect the same from ourselves.


Imagine if your nurse manager did not have to spend any time counseling staff about time and leave issues. Or, spend time tracking down the nurse who let her neonatal resuscitation program card expire. Or, spend time talking to someone about the dress code. Or, spend any time at all mediating between professionals who cannot get along with one another. Not to mention many hours dealing with the schedule. Imagine, if the next time your coworker, be it a physician, nurse, or someone else does something that upsets you, you talked to him directly instead of to your manager. What if, when you see a new graduate struggling at the next bed, you went over and helped her, instead of talking about them behind their back and expecting someone to do something. What would happen if you put in a work order about the broken door? Might it actually get fixed?


In truth, we often expect leaders to do things we really could and should do ourselves. Whether it is in the workplace, in government, or in education, we expect things to go smoothly, and, let's face it, to go the way we want. Yet we fail to be involved in the political process, we don't join professional organizations, and we refuse to come in on our day off to be on a committee or task force. We won't fill out the work order ourselves.


We should not expect more of our leaders than we do of ourselves. We are quick to criticize every fault, real or imagined, and assume that they are not doing anything about our concerns. We expect them to take risks but make sure they are perfect while they are doing it. Most of all we forget that no one can do all of this alone, and that we bear much of the responsibility for our work environment and our profession. We can join our professional organizations. We can become involved in public affairs. We can do the literature review and change practice. We can help educate our coworkers. And, although we should hold our leaders and ourselves to high standards, we should also acknowledge that we are human and none of us will be perfect all of the time.


As one author points out, it is a small percentage of people who do the work of an organization or a unit.1 This small percentage writes the policies, examines the literature to determine best practice, volunteers for committees, or helps develop education. There is a large percentage that complains. As nurses we are accountable to our profession and the public we serve. If we want to be treated like the professionals we are, we have to treat our work like a profession, not just a job. Every one of us has a leadership responsibility. So, let's tell ourselves what we should do, not what "she" should do.




1. Porter-O'Grady T, Malloch K. Leadership in Nursing Practice: Changing the Landscape of Health Care. Burlington, MA: Jones and Bartlett; 2013. [Context Link]