Paying Your Dues in Nursing – An Old Paradigm

Paying Your Dues in Nursing – An Old Paradigm

By Rose O. Sherman, EdD, RN, FAAN

paradigmHow many years of clinical experience should I have before I seek a leadership position?  This is a question that I am frequently asked by novice nurses who are considering a career as a nurse leader.  My response is that there is no one right answer to this.  It would be easy to make a recommendation if a certain amount of time spent in clinical practice easily translated into superior performance as a leader but this is not true.  While it is true that clinical experience is important for leadership credibility in a practice discipline like nursing, it cannot be viewed in isolation without considering the ability and temperament of the individual.

Paying Your Dues – An Old Leadership Paradigm

Historically, clinical experience has always been an important criteria in the selection and career progression of nurse leaders.  Many current nurse leaders were selected for their positions based on their technical expertise.  Experience has generally been measured in terms of “years of experience”.  While at one level, it might seem logical that a nurse with five years of experience is a better candidate for a leadership position than a nurse with three years of experience, this is not always the case.  What a nurse really does within that time frame is often much more important.  In addition to working clinically, the nurse with three years of experience may have returned to school and begun graduate coursework, achieved certification or perhaps became a member of a key nursing committee.  The nurse with five years of experience may be just “doing the job” without any other professional enhancement or leadership development.  I have recently spoken with a number of nurse leaders on this topic to find out how they handling the issue of clinical experience in selection for leadership positions.  Most have told me that they use Patricia Benner’s Novice to Expert Framework to guide their decision making.  In this framework, nurses move along a continuum of practice from novice to advanced beginner to competent to proficient and some go on to become experts.  Progression to the competent stage which generally takes about three years but can happen sooner was felt to be essential for movement into a leadership position.

Leadership Aptitude and Interest – The New Leadership Paradigm

Beyond clinical experience, nurse leaders today look for candidates with leadership aptitude based on experience as a charge nurse or other unique experiences.  With the increase in second degree programs in nursing, some nurses today with relatively few years in nursing bring rich leadership experiences and skill sets from previous careers.  Looking for candidates who have a genuine interest in leadership is now crucial for organizational leadership succession planning.  Generally, nurse leaders seek positions in their own areas of clinical specialty expertise.  As their leadership careers progress, they may think about applying for leadership vacancies outside their traditional clinical comfort zone.  With the financial challenges in health care today, some organizations are merging clinical areas and the leader’s span of control may include specialty areas where they have no experience.  Thinking about leadership as a specialty area may be a way to frame your decision making on this topic.  With beginning leadership roles, it is probably wisest to stay in your clinical area of expertise.  As you develop competency and confidence as a leadership, you can consider and may be asked to take on new challenges where you need to build some clinical competency in the areas that you supervise.

If you are just beginning your nursing career and are considering applying for a leadership role but worry about whether you have enough clinical experience, ask yourself the following questions:

Key Questions

  • Am I confident about my clinical skills?
  • Do I have the respect of my peers?
  • Am I comfortable asking questions when I don’t know something?
  • What are unique leadership strengths and talents do I have?

Read to Lead

Benner, P. (2000). From Novice to Expert: Excellence and Power in Clinical Nursing, Commemorative Edition.  Saddle River, NJ.:Prentice Hall.

Gladwell, M. (2011).  The Outliers: the Story of Success. Boston: Back Bay Books.