Grooming the next generation of nursing leaders

Nurse Manager Website, July 1, 2008

by Jo-Ann C. Byrne, RN, MHSA, director of healthcare education at Wuesthoff Health System in Rockledge, FL

After reading this article, you will be able to:

Recall three nursing leadership competencies

Describe three levels of proficiency

Healthcare facilities spend a great deal of time developing clinical competence in nurses but relatively little time developing nursing leaders. If we are to have competent nurse leaders, it is imperative for us to develop the ones we have and grow new ones from our ranks of entry-level nurses.

A question that needs to be addressed, and one that will be unique for each facility, is the level of clinical proficiency expected of nursing leaders as their leadership roles expand.

“A leader cannot provide direct care,” Karlene Karfoot wrote in a recent article in MEDSURG Nursing. “The leader’s obligation is to create the environment in which good people can provide good care.” However, many will argue that leaders can’t groom others, validate practice, and encourage growth in staff members if they can’t keep up clinically. Each facility must find an answer that works for them.

Developing existing, internal resources is usually the first step and commonly takes one of two paths: the generic leadership development program or the more customized nursing leadership development program.

Current nursing leaders, or those who have been identified as potential leadership candidates, can participate in a development program designed for all hospital leaders. The major advantage to this process is that nursing leaders develop their skills with leaders from other departments and develop collegial and collaborative relationships during the process.

Initially, the facility should identify those competencies for which successful nursing leaders must be proficient. These include:

People management, including communication and teamwork

Skill requirements, such as the management of customer relations

Operations, including finance and resource management

Once those competencies have been defined, a self-assessment follows, often paired with an evaluation by the candidate’s supervisor.

Candidates should be given the opportunity to rate themselves based on a level of proficiency relative to each identified competency.

Levels of proficiency might be defined as:

Beginner. A person who has acquired the essential knowledge but does not demonstrate the competency.

Intermediate. A person who has acquired the essential knowledge and who demonstrates the competency.

Expert. A person who has acquired the essential knowledge, demonstrates the competency, and is able to coach and mentor others.

Curriculum development for each level of proficiency will vary as well: The beginner needs more structured and content-rich presentations; the intermediate-level participant requires more application exercises; and the expert needs more case studies and opportunities to coach and mentor others.

With the learning needs identified in the self-assessment and validated by his or her supervisor, which includes an evaluation and a joint conference to discuss proficiency levels, the future leader is ready to begin the selected learning activities.

The most effective way to guide future leaders is to provide a variety of learning styles and involve students in the execution of a learning plan that works best for them. Such a model, the leadership learning cycle, was based in part on The Successful Leadership Development Program (see the sidebar below).

The idea behind this model is that content be provided three ways:

Assigned prereadings, in which everyone participates

General learning sessions or online modules for primary content delivery (using the participant’s choice of format)

Formal learning sets

With a combination of reading and exposure to content, participants can apply what they’ve learned from the leadership learning cycle program to their work. When they return to the learning set, they have the opportunity to discuss what works in their areas.

Likewise, nurses can share their experiences at the required learning set, thereby allowing the new leadership team to grow.


Byrne, J., and Rees, R. (2006). The Successful Leadership Development Program: How to Build It and How to Keep It Going. San Francisco, CA: John Wiley-Pfeiffer.

Kerfoot, K. (2001). “The leader as synergist.” MEDSURG Nursing 10 (2): 101–103.


The Staff Educator, May 2008, HCPro, Inc.