Leading people in healthcare is very different than managing operations. Yet most leaders are promoted because they’re exceptional clinicians or operational experts, not because they’ve been taught how to lead people. As we’re developing our new Charge Nurse Development Program, I realized something that applies to every leader, regardless of title or position.
Every leader has two primary responsibilities:
- Operations: ensuring the work gets done.
- People: leading, nurturing, and supporting the people doing the work.
Most leaders are promoted because they’re good at the first. Very few are promoted because they’re experts at the second. In fact, based on a study conducted by Gallup, 65% of frontline leaders were promoted because of their past performance, while only 30% were promoted based on supervisory or people skills.
Think about it. Organizations invest a tremendous amount of time teaching new leaders how to manage schedules, staffing, budgets, productivity, audits, quality metrics, and regulatory requirements. Those operational skills are essential.
But what happens when two employees stop speaking to each other, a charge nurse has to address gossip, an experienced employee intimidates a new nurse, or when someone who’s clinically excellent consistently treats others with disrespect?
That’s the people side of leadership. And for many leaders, it’s the hardest part of the job.
Why Leading People in Healthcare Is So Challenging
This leadership gap affects healthcare organizations every day. We see it in rising turnover, burnout, workplace incivility, and employees leaving because of how they’re treated, not because they stopped loving healthcare. Operational expertise may earn someone a leadership position, but leading people in healthcare is what determines whether employees stay, grow, and thrive.
Frontline leaders spend between 30% and 50% of their time dealing with conflict and disruptive behaviors, yet most receive very little formal preparation for this part of the job.
Isn’t it interesting? We prepare leaders to manage budgets, staffing, productivity, and quality metrics, yet they spend nearly half their time managing people.
The irony is that while operational excellence keeps the department running, people leadership determines everything else. Everything else being retention, employee well-being, morale, teamwork, engagement, and ultimately patient outcomes.
Over the past 15 years, we’ve worked with thousands of healthcare leaders, and one pattern continues to show up. Leaders are incredibly competent at managing the work but often feel unprepared to manage the people. Not because they don’t want to…well, maybe a few really don’t…but because no one ever taught them how.
The good news? These are skills that can be learned.
Three Strategies for Leading People in Healthcare More Effectively
If you want to strengthen the people side of your leadership, here are three places to start.
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Spend as Much Time Observing Behavior as You Do Reviewing Metrics
Most leaders know their staffing numbers, productivity targets, and patient satisfaction scores.
But ask yourself this question: How are people treating each other while they’re getting the work done?
A department can meet every operational goal and still have a culture that drives good employees away. Pay attention to how employees interact with one another because you can’t lead people if you don’t witness how they treat each other.
One manager in our Eradicating Bullying and Incivility program shared that she intentionally sat at the nurses’ station while answering emails. While she still accomplished her work, she also observed her team in action. She witnessed incredible examples of employees helping and supporting one another. But also saw gossip, arguing, dismissive comments, and other not so incredible behaviors that would have otherwise gone unnoticed.
Sometimes the best leadership happens simply because you’re present.
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Address Behavior Early
Culture isn’t created by one major event. It’s created by the behaviors leaders allow every day.
A sarcastic comment, an eye roll, or a dismissive attitude may seem insignificant in the moment. But small issues rarely stay small. When left unaddressed, those behaviors become the culture.
Having a brief, honest, and respectful conversation today is much easier than trying to repair a toxic work environment six months from now.
Your team may not think eye rolling is a big deal. It is.
It’s unprofessional and disrespectful. If ignored, it often leads to additional uncivil behaviors. Name the behavior. Reinforce your expectations. Make it clear that respect is simply how your team works together.
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Develop Your People Skills with the Same Intention You Develop Your Operational Skills
We would never expect a new leader to magically understand budgets, staffing matrices, or regulatory requirements without training. So why do we expect them to know how to coach difficult employees, navigate conflict, give feedback, or hold people accountable without teaching them?
Leading people in healthcare requires just as much intentional learning as managing operations.
Leadership isn’t just about improving clinical outcomes or operational performance. It’s about learning how to coach, communicate effectively, navigate conflict, establish behavioral expectations, and hold people accountable with confidence and respect.
These skills don’t develop by accident. They improve through intentional practice.
One simple strategy is to incorporate ongoing skill development for both yourself and your team by establishing weekly microlearning sessions. These can be done during huddles, followed by weekly newsletters, and other communication methods.
The key is to always be working on something that strengthens the “people” side of your department.
The Best Leaders Excel at Both
The most effective leaders understand that success isn’t measured only by what gets accomplished. It’s also measured by how people experience working on the team.
So here’s a question worth asking yourself: If someone described your leadership, would they say you were excellent at running the department…or excellent at leading the people?
Your organization expects you to manage operations well. Your team needs you to excel at leading people in healthcare.
If you asked your employees which one matters most to them, I think you already know the answer.
People. Every single time.
The strongest leaders become proficient at both.
