The Path to Nurse Leadership is Paved with Fear of Failure

Understanding the factors that influence whether Millennials embrace or reject moving into nursing leadership is crucial.

This is the second in a two-part series on Millennials in the healthcare workforce.

"When nurses go to nursing school, not many of them go in saying, 'I want to be a CNO,'" says Dawn Pevey Mauk, RN, MBA, BSN, NEA-BC, and the system vice president of service lines at Ochsner Health System in Louisiana.

I thought back to my classmates in nursing school and realized how spot-on Pevey Mauk was. I went to school in the late 1990s and the bulk our class was Gen Xers—those born between 1965 and 1984. We wanted to become nurse practitioners, certified registered nurse anesthetists, and certified-nurse midwives, not nurse executives.

But, as Bob Dylan (born 1941, Greatest Generation) has said, the times, they are a-changin'. Research by Rose O. Sherman, RN, EdD, NEA-BC, CNL, FAAN, professor and director of the Nursing Leadership Institute at Florida Atlantic University's Christine E. Lynn College of Nursing in Boca Raton shows that members of the newest age-related demographic to join the nursing profession—the Millennials, sometimes called Generation Y, who were born between 1982 and 2004—see themselves as leaders and say they would consider taking on leadership roles.

This doesn't mean, however, that we can count our next generation of nurse leaders before it's hatched. Sherman has identified factors that influence whether Millennials embrace or reject moving into nursing leadership. If we want to grow future nurse leaders we need to keep these factors in mind.
 
'Y' of Course I'm a Leader
In 2013, the Health Resources and Services Association projected that over the next 10 to 15 years, one third of the current nursing workforce will reach retirement age. That's about 1 million nurses who could be out of the workforce in the next decade. And it's not just bedside nurses who will be hanging up their stethoscopes.

"Baby Boomer leaders still hold a significant percentage of nurse leader roles," Sherman says. "Many nurse leaders derive great satisfaction from their work and are reluctant to leave their positions. But the reality is that you cannot work forever, and we are beginning to see growing numbers of Baby Boomers make the decision to retire."

So who will replace these vital positions? Quite possibly the Millennials.

It's estimated that by 2020 they will make up 50% of the workforce, and, according to Sherman's study, 78% of the Millennial nurses surveyed said they would consider a leadership role. They reported that the top two incentives for becoming nurse leaders are the ability to "make a difference/inspire meaningful change" and "personal growth."

"Generation Y nurses believe, that given an opportunity, they would bring new ideas and creativity to healthcare," Sherman says. "They also think they bring a spirit of teamwork and cooperation that could improve work cultures."

Fear of Failure
It's worth pointing out that the Millennials' view of nursing leadership isn't all sunshine and rainbows.
There are specific factors that could dissuade them from pursuing this career path.

First off, the feedback they've received about leadership roles from current nurse leaders is not always glowing. The Millennials surveyed by Sherman reported that they heard nurse leader positions had a high-level of responsibility and accountability and that budget constraints were a major challenge to being an effective leader.

"I think that leaders don't always put a positive face on what they do," Sherman says, "and all [Millennials] see are either negative comments being made or what they see as pretty negative body language."

This may feed into what Sherman found to be the Millennials number one concern about taking a nurse leader position—fear of failure.

"The American Psychological Association has looked at the different generational cohorts, and this cohort is the most stressed," Sherman says. "We're seeing extreme anxiety levels among Generation Y because they fear failure."

This fear plays into whether they ultimately decide to step into leadership roles. "It's at the top of their minds when they think about [if they are] going to make this move or not make this move, she says.

Growing Leaders From the Ground Up
This is a generation that thrives on success and feedback, so the traditional "out of the frying pan into the fire" method of developing nurse leaders may not work for them. "You just can't fling them in there and let them sink or swim," says Sherman. "They need the mentorship. It's a challenging role and they need a lot of development and support."

Some may point to this need for feedback and mentorship as validation of the stereotype that Millennials expect to be coddled in the workplace. In their defense, Sherman points out that nursing leadership positions have become more challenging and intense over the past decade.

"Because of the changes in the economy and the pressures on hospitals, these leadership roles are very different than they used to be," she says. "There's a lot more pressure… and these leaders have been given more and more responsibility including multiple unit management in some situations."

Sherman suggests that leaders be on the lookout for nurses with "high-leadership potential." In other words, people who ask good questions, demonstrate good judgement, want to get involved in committees, are naturally curious, and attend continuing education opportunities.

"Those are the kinds of nurses that we really need to plant the seeds early," she says. "Many organizations today, when they identify nurses like that, are trying to look for ways to develop what they call the emerging leaders category of staff."

There also needs to be a commitment to mentorship and development of these new leaders because if support seems to be lacking, the Millennials are likely to balk at taking on a leadership role.

"[We need to look at] what we can do to begin to professionally develop them so they will start to see themselves as leaders and will be ready to move into charge nurse roles and will be ready, willing, and able to move into management positions if they're available," Sherman says.

For action plans, advice, and strategies for improving communication and engagement of your intergenerational nursing team, see the book, Managing the Intergenerational Nursing Team, by K. Lynn Wieck, PhD, RN, FAAN, and Kimberly D. Moss, PhD, RN.