I wasn’t promoted to management because I was a good leader.
In fact, I had never led anything substantial.
I was promoted because I was strong clinically, I got along with people, and I volunteered for the work others avoided.
My story isn’t unique. Nurses are often selected for leadership roles because of factors that have nothing to do with leadership skills.
Then you start, and realize how far in over your head you are.
Starting any new role has challenges, but your first leadership role hits differently. The learning curve is steep, and many of the expectations are unclear.
You may also find the leadership training in your organization underwhelming compared to what you feel like you need. I certainly did at times.
The reality is that while this transition is difficult, it is well trodden, and there are some best practices you can follow in your first 90 days.
They can be organized into 3 principles. Here’s a high-level overview:
First, learn.
Take deliberate action in your first 90 days to understand the people you’ll lead and the problems they deal with every day.
While you may be worried about the technical elements of your new role like finance, operations, and HR procedures, don’t sleep on the importance of simply getting to know people and orienting yourself to the situation on the unit you’re leading.
Second, clarify.
Many new managers find the ambiguity of expectations for leaders to be jarring.
As a frontline nurse, your job was relatively clear. Now it may seem to change on the daily.
Don’t expect anyone to hand you a clear outline of responsibilities. Even if you think your job description is really clear, they’re often incomplete or outdated.
Take the initiative to clarify your responsibilities by paying attention to how your work actually unfolds day to day.
You will have few opportunities as ripe as your first 90 days to do this thoroughly, so it’s worth investing in.
Third, focus.
Don’t try to do too much early on. Instead, intentionally set priorities on simple but impactful changes.
You want to do a few small things well, rather than several things poorly.
This builds trust, prevents unnecessary chaos, and leaves you more bandwidth to focus on the first two.
At this stage small wins matter more than big plans.
This is only a surface-level overview of what the first 90 days can look like.
If you want a more tactical breakdown, I’ve created a robust Survival Guide for New Nurse Managers. It’s totally free. I’ll link it below if you’d like to take a look.
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