“10 Things We Wish You Knew!”

What staff nurses and managers should understand about each other

Nurse manager wearing blue suit facing off against staff nurse in glasses and turqoise scrubs

I launched the Healthy Workforce Institute to help organizations navigate bullying and incivility concerns. In my role, I regularly talk to a lot of nurses and nurse leaders. Those conversations reveal that mutual understanding between staff and leadership is often lacking.

Mutual Misunderstandings

There are many recurring themes. For instance, I often hear from nurses who feel their leaders have forgotten what it’s like to be on the front lines.

I once spoke with a new nurse who was devastated to learn, after seven months on her first job, that her manager didn’t recognize her name when the department educator mentioned it. Talk about a sure way to make staff feel unappreciated!

On the other hand, many nurse leaders feel that their employees don’t understand that their leaders face burnout too. When I was a frontline manager, I remember how often my pager would go off — during dinner, during my daughter’s softball games, on weekends, while I was on vacation — over trivial issues that could easily have waited until I got to work the next day. It was frustrating for me as a manager.

Strong, cohesive teams require that both employees and leaders understand each other’s perspectives and needs. This article presents 10 things working nurses want their leaders to know, and 10 things nurse leaders wish their employees better understood about them.


Nurse Managers and Leaders: Here are 10 things your employees wish you knew about them.

1. They often act differently when you’re not around.

The way staff nurses behave when the boss is looking can be very different from how they act on your days off. For example, when I was a staff nurse, everyone did bedside report during the week when the manager was there, but on the weekend, almost nobody bothered. The solution is to treat your employees as colleagues rather than subordinates, so they aren’t so dependent on you to motivate them and keep them on track.

2. They want feedback now.

Your employees want to hear from you about how they are doing now, not just during their annual performance reviews. Delivering feedback effectively takes practice — I spend a lot of time helping leaders develop the necessary skills — but doing it regularly makes it easier to correct problems as they occur.

3. They want you to reward the positive and coach — not criticize — the negative.

If your nurses meet or exceed your expectations, make sure you show your appreciation. If they fall short, say so, but make it constructive, and keep an eye out for things YOU may need to fix (like unclear directions that need to be clarified). Approach your staff as a coach would: supportively, with the goal of helping the team grow and improve.

Nurse manager giving thumbs up to staff nurse, with "Nice Work Today" in conversation bubble.

4. When you criticize one of them in front of others, it makes everyone uncomfortable.

Can you believe that I still sometimes hear that nurse leaders are yelling at and openly criticizing their employees in front of others? If you’re prone to doing that, stop it! Airing your displeasure in front of others shifts the focus from constructive criticism to public humiliation, which is uncomfortable to experience and to witness. It also destroys trust, undermining both your staff’s trust in you and their confidence in each other.

Hiring Now

5. They want you to recognize and honor everyone on the team, whatever their roles.

Any time you show favoritism towards certain employees, whether individually or as a group — clinical staff over support staff, BSN-prepared nurses over nurses with a diploma or ADN, day shift over night shift — it makes the rest of the team feel unappreciated. Effectively caring for patients involves everyone, so make sure everyone feels like a valued member of the team who has something worthwhile to contribute.

6. The way YOU show up every day has a big impact on the way they perform.

Did you know that your employees watch you when you walk into work, when you enter into the nurses’ station, when you come back from a meeting, and whenever you step out of your office? Leaders set the tone for the work environment. When you’re in a good mood, your nurses are more likely to be a good mood. If you’re distracted or irritable, your staff may mirror your bad mood or worry that there’s something wrong that you’re not telling them. You need to model the professional behavior you want to see.

7. They need to be able to trust that you have their backs.

A new nurse once shared that when she told her manager she was drowning, the manager replied, “Well, you had better learn to swim,” and walked away without even asking what was wrong. When you take on a leadership role, it’s your responsibility to support and protect your nurses. If they can count on you to help and stand up for them when something’s wrong, they will love you. If they think you’d stand by and let them drown, they’ll lose faith in you, your leadership, and maybe even the organization.

8. They want you to roll up your sleeves and get your hands dirty — not always, but when it counts.

Even if your leadership role no longer includes directly caring for patients, your nurses want to know that you still can. Your staff doesn’t expect you to take an actual patient assignment, but showing them that you can help turn or transport a patient, insert an IV, or draw blood when the staff is crazy busy demonstrates your commitment to supporting the team. It also shows them that you haven’t lost touch with the day-to-day work nurses do.

9. They know you’re not perfect — so stop acting like you are.

One of the most powerful ways to establish trust with your employees is to be vulnerable. Leadership is not about having all of the answers. Leaders make mistakes; good ones admit it and try to do better next time. If you make a decision that wasn’t a good call, tell your staff that. (There’s a good chance they already know!) If you’re sincere, they’ll forgive you.

10. They need to know that you care about them.

At the end of the day, healthcare is not about numbers or data, it’s about people. Your staff wants to know their boss cares about them as individuals, not just as names on an org chart. Ask about their families, their hobbies, their joys, and their sorrows. Show you care, and your nurses will more than repay your investment of time and interest.


Staff Nurses: Here at 10 things your managers and leaders want you to know about them.

1. Leaders make mistakes too.

Just because someone is in a leadership role doesn’t mean they are infallible. Nurse leaders sometimes make bad decisions, for all kinds of reasons: wrong information, faulty assumptions, or just errors in judgment. When that happens, remember that leaders are only human and respect their sincere efforts to make things right.

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2. They don’t have all of the answers and need your input.

My good friend Michael Grossman, RN, MSN, DM, an amazing leader, puts it like this: “Your leaders can’t solve everything without your input. Don’t tell them to fix a problem and then sit back, complain that they didn’t fix it the way you wanted, and then complain further that they can’t help out because they’re too busy.”

3. What they WANT to do and what they CAN do aren’t always the same things.

Every leader has a wish list of things they want for their unit and their staff, from better equipment to less paperwork to a bigger budget for nurse salaries. Unfortunately, no matter how hard they try to advocate for those things, there are some times when a leader’s hands are tied. When I was a manager, I knew staffing was bad, and I wanted to add more positions, but I was limited by what the organization would allow, despite my numerous attempts.

4. They HATE having to discipline you.

Despite what you might think, most leaders are very uncomfortable with handing out criticism or punishment. A study in Nursing Management found that the No. 1 stressor for managers is having to discipline their staff. In fact, reprimandung employees for performance issues or behavior is so stressful for nurse leaders that some try to avoid it all together, even if that means ignoring ongoing problems.

5. They feel fatigue and burnout too.

Nurse leaders face many pressures, including some that most nurses are not directly aware of.  Especially at higher levels, leaders are accountable for budgets, retention and turnover, succession planning, and staff development, to say nothing of quality metrics and patient satisfaction scores. It’s a lot to juggle, and the stress of struggling to meet organizational expectations can lead to burnout.

6. They truly care about you.

All but the very worst leaders really care about your wellbeing, your personal and professional development, and your happiness!  They think about you when they’re home and worry about you when you’re sad or struggling. Even though they may get angry or frustrated with you sometimes, they care about you as a human being.

7. They have lives outside of work.

One of the biggest complaints I hear nurse leaders voice is that they are never truly off work. This doesn’t mean you shouldn’t call the boss after hours if there’s a real emergency, like a workplace violence incident, but I once had a nurse page me at 2 a.m. to ask if she could have a day off the following month! If something can wait, please think twice about dragging your manager away from their family, friends, and much-needed rest.

Nurse manager at daughters' soccer game with phone buzzing from staff nurse.

8. Hearing everyone complaining wears them down.

I don’t know a single manager who has ever gone an entire day without hearing one of their employees complaining about something, even when things are going well. It’s not that nurse leaders don’t want you to voice concerns, but a constant stream of negative chatter can be discouraging for the boss as well as the staff.

9. They are proud when you do well and disappointed when you don’t.

Like a proud parent, most nurse leaders are excited when their nurses earn certifications, complete an advanced degree, or step up as a charge nurse or council chair. In the same way, they find it disheartening when they have to chase you to complete your competencies, beg you to participate beyond just swiping in and out, or have to chastise you about your behavior.

10. They love to brag about you!

A study in the Journal of Occupational and Environmental Medicine found that what brings managers the most joy is someone complimenting their employees. Your leaders LOVE to brag about how awesome you are! Many nurse leaders say that watching their employees grow and succeed is the most rewarding aspect of their role.

The success of any organization lies in the synergy between its leaders and employees, so let’s all strive for meaningful connection, empathy, and mutual respect. As Stephen R. Covey wrote in his book Seven Habits of Highly Successful People, “Seek first to understand, then to be understood.”

RENEE THOMPSON, RN, DNP, CMSRN, is the CEO and founder of the Healthy Workforce Institute (healthyworkforceinstitute.com).

JASMIN MORA is a Los Angeles-based illustrator. Visit jasminmora.com.

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