At age 26, I was offered a supervisory position in an emergency department. I was eager to become a nursing manager: It was a career move that I had worked for, and I was excited that it finally had happened.

Here are some key concepts I’ve learned in the years since that first job. These 10 management pearls can help you on your journey to successful leadership and management.

1. Build trust. This simple concept is vitally important. When staff members trust their manager, they will move mountains and do almost anything to help accomplish the organization’s goals and objectives.

As a new manager, I wanted to change things overnight. I had come from an ED assistant charge nurse position on the 3 to 11 shift, and I wanted to make the new hospital a carbon copy of the old one. My rationale was that if it worked at the old hospital, it would work at the new one. I learned differently early on: The patients were different. The cultures of both institutions were different. I should have just observed, and I should have become better acquainted with the staff before implementing many changes. The staff didn’t even know me.
How could they trust me?

2. Never ask someone to do something that you haven’t done yourself. I learned this when I was 17 and employed after school as a shoe salesman for a major shoe chain. I was the new kid on the block.

One day when I went to work, Sam, the assistant manager, asked me to weed the tarred parking lot. Everyone loved it when Sam was working because he was a great guy who treated everyone fairly. But he was always joking around. So I asked him if he was serious about his request. I was dressed in a suit, and weeding certainly wasn’t part of my job description. Sam told me that it was my turn. He went on to say that he had done it himself many times before and he would never ask someone to do something he had not done himself. So, reluctantly, I headed to the parking lot and did the weeding. But from then on, I watched to see if Sam really lived what he told me. I saw Sam shampoo carpets and do many other chores. He did do whatever he asked someone else to do.

Sam’s actions garnered trust and demonstrated to the rest of the employees that he knew what it was like to be in the trenches. One reason I feel that I was so successful as a VP of nursing was that I had started as an orderly in the operating room. I knew what it was like to do a shave prep, transport a patient, and mop the OR floor.

3. Delegate. A manager and leader cannot do it all, so it’s important to learn delegation skills early on. Delegation frees leaders and managers to do what they should be doing best, that is, leading the organization in the right direction and managing the staff so that organizational goals and objectives are accomplished.

4. Replenish your cup. I learned this skill when I took a VP of nursing position. I lived and breathed my job and placed family second to it. I had reached my ultimate goal, so I wanted to be successful. A Catholic priest, our hospital chaplain at the time, became a good friend. One day he came to my office and asked me to to go to the community center for a workout and a swim. During our swim, he told me that people cannot give to others if they do not take care of themselves first. “You have to learn how to take time for yourself and replenish and refill your cup before you give to others,” he said.

Other great nursing leaders I know feel the same way. They all say that they work hard, but they play equally as hard. Replenishment for me comes in the form of workouts at the gym, long bike rides, and rock concerts. Replenishment comes to different individuals in different forms, but it is an extremely important concept to embrace and live.

5. Learn Politics 101. Nurses tend to be apolitical. Most do not even like the word “politics.” It is necessary to be politically correct to advance your agenda as well as that of nursing. For example, as a VP of nursing, I had to use agency nursing for a short time to stabilize staffing and ultimately
contribute to retention of staff by providing safe staffing ratios. Agency nursing costs more than regular staffing. This was the first time that the hospital was using agency nurses, and finance was really concerned about the additional cost.

So I went out of my way to bond with key individuals in the finance division. When the chief financial officer asked that I play golf with him at the annual hospital golf tournament, I graciously accepted the invitation. Now, I hate golf. It is not a fast enough sport for me. Nevertheless, I had a friend teach me how to play golf in 10 days so that I would be ready for the tournament and wouldn’t look like a total idiot. I played an entire round of golf. Finance became a ally, and I was able to make many positive changes in nursing as a result of this one political move. I will never compromise my value system for politics, but nurses need to become more politically astute to advance nursing.

6. Master change. There is no doubt about it, change never stops in health care. A colleague said that “managing today is like managing in white water — change is constant.” If organizations are going to survive, then change must be a constant, and leaders and managers need to embrace this concept.

7. Take risks. Nothing ventured, nothing gained. Analyze the situation. If it looks good and your “gut” tells you to proceed, then take the risk. Don’t panic if you fail. You can’t succeed at everything. If you don’t take a risk, you won’t grow. Learn from risk taking, and do it whenever you can.

8. Be a leader. Leaders do the right thing. At times, this may not make them popular. Leaders need to do what needs to be done, and this may mean sticking to their guns. As one colleague told me, if it’s lonely at the top, that’s a sign of good leadership.

9. Be willing to give up things to advance your career. As leaders and managers, we may manage our department or service extremely well and implement many positive changes. If an opportunity comes up, it may involve giving up what we are currently leading and managing for a promotion. Do not hold on — just let go and relish in the fact that you have an opportunity to develop in new and exciting ways. This contributes to our growth and development as leaders and managers.

10. Practice the piano. Consistently practice the nine management pearls for success. Just as one would ready a piano concerto for a recital, practicing these pearls until they are perfected can lead to true success.

Al Rundio, RN, PhD, APN, C, CNAA, BC, is associate
professor of nursing, program track coordinator, Graduate Leadership & Management Program; program track
coordinator, Graduate Nursing Education Program, Drexel University College of Nursing and Health Professions, Philadelphia.