Transitioning to Nurse Leadership Roles in Nontraditional Settings

Abstract

The COVID-19 pandemic prompted many people, nurses included, to re-evaluate their professional and personal priorities and goals. Nurse leaders have the opportunity to draw on their portfolio of experiences, strengths, insights, and accomplishments and apply them to alternative non–hospital-based leadership roles that are less well known but in just as high demand. This article describes how nurse leaders can align their experience and expertise with their personal and career goals as they explore career opportunities in nontraditional settings.

Key Points.

• •The experience of the COVID-19 pandemic resulted in many nurse leaders considering a transition to a nontraditional role.
• •Ensuring that any role change is aligned with both career and personal goals requires some self-assessment, reflection, and clarification.
• •With clarity about personal and career goals, the nurse leader can strategically and systematically explore nontraditional positions that provide a good fit.

The stress and uncertainty of the COVID-19 pandemic coupled with social unrest demanded intricate and sophisticated leadership. Nurse leaders applied evolving science, managed fundamental resource shortages, and adapted when neither science nor resources were sufficient. They supported themselves and their colleagues, patients, families, and communities though tumultuous changes, and complex and nuanced challenges, with a hefty dose of grit and grace. All told, the intellect, emotional resilience, interpersonal compassion, and innovation necessary to navigate the pandemic demanded the best of nursing leaders.

This has left nurse leaders in a different place than in the pre-pandemic state. Some may feel exhausted and depleted; others may have discovered new talents and strengths; most have experienced a bit of both. In this frame of mind, it is natural for nurse leaders to pause and re-examine their career trajectories and explore the next phase of their profession.

However, making a career transition, especially after such an unsettling year, is not something to take lightly. Rather, nurse leaders have the opportunity to draw on their portfolio of experiences, adventures, hardships, and failures along with their associated lessons, strengths, insights, achievements, and satisfactions to ensure that the next phase of their career is a satisfying one.¹ This article outlines the self-reflection and approach to explore new opportunities that can guide a nurse leader in making a well thought out transition to an alternative leadership role, including those in non-traditional settings. The goal is to ensure a successful role change that builds upon unique strengths, experiences, and goals. As Abraham Lincoln said, “The best way to predict your future is to create it.”

Self-Assessment and Reflection

Just as the nursing process begins with a holistic assessment, so does the process of making decisions about career transitions. Particularly after such a challenging year, it is important to distinguish the thoughts and emotions associated with the disruptive world events from the kind of work and role one wants in the future.²

Certainly, the past year tapped into the depths of internal and external resources to ensure successful leadership. Nurse leaders may legitimately be feeling exhausted, ineffective, or unmotivated and want to explore a less demanding, but still meaningful, role. And nontraditional nurse executive leadership positions offer a range of possibilities for using existing nurse leadership talents in a new and impactful way.

Before making a change, it is important to examine the forces behind contemplating a role change. The pandemic may have uncovered or intensified existing frustrations or dissatisfactions with work. In some cases, it may not be the role, but rather the team or organization, that may be the issue. In others, it may be the work–life balance or integration that no longer meets your needs. After the intensity of leading during the pandemic, you may not have the internal or external resources to sustain the necessary energy or enthusiasm for doing the work. Or you may just be ready for your next new challenge or phase of your life and career, enabling those you have been mentoring to further grow by assuming a formal leadership position.

Whatever the case, the dissatisfaction with the current role offers an insight for the need for a change. If you decide that a change is necessary or desirable, then a period of self-assessment and reflection can improve the likelihood of attaining a position that better fits your current career and personal goals. To ensure a successful transition, the key is not to focus on what you are running from, but to focus on what you are running toward.³

Self-assessment helps you identify what is important to you in your career and your life. A multifaceted appraisal includes aspects such as personality preferences, interests, values, and strengths. Reviewing or taking formal personality or interest inventories can sometimes be helpful in this self-reflection. Instruments such as the Myers-Briggs Type Indicator (MTBI)⁴ to attain insights into your preference for using perceptions and judgments, the Gallup CliftonStrengths Assessment⁵ to understand your natural talents, the VIA (Values in Action) Character Strengths Survey⁶ to leverage the positive parts of your personality to be your best self, and similar assessments can all be useful tools to garner insights into your approach and talents that you bring to your work.

Any of these assessments offer insights into what natural strengths and talents you bring to your work. In addition, spending time reviewing what initially attracted you to your current position and what you now feel is missing can offer valuable insights into ensuring you make a successful role change. When feeling frustrated with work, it is easy to become consumed with one’s dissatisfactions, but it is critical to reflect on both what you like and do not like about the work you are currently doing. This enables a more accurate assessment of whether the negatives are time-limited—related to the COVID-19 pandemic—or things that will persist well after the current situation is better controlled. It creates the freedom to examine the circumstances and determine a best path forward.

For example, an executive client that one of the authors (Sandy Somers) worked with was well-established in the tech field but unhappy with her work. She was exploring a career change to a different line of work, initially assuming that the tech industry was not a good fit for her. On further examination, she recognized that her current company team and culture was the issue. She found a role and company, still within the tech industry, that was a better fit for her and provided the work satisfaction she was craving.

Another effective strategy for uncovering what you enjoy in your work is to reflect every day for a few weeks on what gives you energy at your job. This enables you to be more expansive in thinking about what activities give you joy. For example, are you more engaged when you are working on a detailed project by yourself or when you are dialoguing about a complex problem with others? Do you enjoy activities that involve short-term initiatives where the impact can be seen within a few days or weeks, or do you prefer grappling with longer term initiatives that cause fundamental changes over months or years? This reflection can enable you to identify the executive leadership talents that can best be applied to nontraditional roles.

Equally important, reflecting on the things you have enjoyed in your past positions or volunteer work may offer valuable insights into what is important to you and what you want in your next role. For example, what is more gratifying to you—collaboration or independent projects, strategic planning versus execution or both, problem solving or policy development work? Identifying times in your career when things really “clicked” and when they did not will help to distinguish what you enjoy from what you endure and enable you to focus your search on what you want.

Pivotal life experiences can also be powerful motivators drawing you in a certain career direction. For example, Joyce Markiewicz’s volunteering for Meals on Wheels as a way to help the underserved eventually led her to transition from the hospital environment to work in home health care. In that practice setting, she demonstrated that she had a lot of talent for business development and currently serves as an executive vice president and chief business development officer.⁷ Working for MADD (Mothers Against Drunk Drivers) after a personal loss, deciding to work for the American Cancer Society after overcoming a cancer diagnosis because of advances in research, or helping with hospice respite care after assisting a neighbor who had an ill loved one can all be sources of inspiration for the next phase of your career. The COVID-19 pandemic may have been that pivotal life experience for you—shifting or increasing your interest in public health, pharmaceutical innovation and distribution, equity in health care, or improving accuracy in health information.

What is most important in the self-assessment is thinking about the whole of your life—work as well as your relationships, health, and activities of pleasure. The goal is to create balance in the work-love-health-play aspects for yourself (Table 1 ). Balance does not mean that all 4 components comprise an equal quarter of your energy or time. Rather, the goal is that balance among the 4 match your personal goals. For example, some nurse leaders may have found that the demands of caring for young children attending remote schooling during the pandemic shifted the need for their energy and attention, demanding more in the relationship sector of their lives. Others may have learned that working from home enabled more time for focusing on health—exercising, cooking healthy meals, meditating regularly—and concluded that they want to hardwire these changes into their future lifestyle. Travel limitations or a desire to geographically live closer to family may limit the scope of work that you want to consider. Or as remote work increasingly becomes the norm, perhaps new opportunities and positions are possible. Being clear about the personal requirements—from child or elder care to salary to geography—will help to focus pursuing and meeting your needs.

Table 1.

Four Critical Areas of Life

Work	Both paid and volunteer jobs
Love	Relationships with partners, children, friends, and pets.
Health	Emotional, mental, and physical well-being
Play	Activity done simply for fun

Adapted from Burnett and Evans.¹

The key in this phase of the work is to allow yourself to enjoy the process of reflection and exploration. Being comfortable with the uncertainty will enable you to be open to examining a wide range of possibilities. If you need assistance, your alma mater or an executive coach may offer career management support.

Examining Options: Possible Roles

A clear and complete self-assessment provides the basis for an expansive examination of options for future roles. Clarifying your desires, assets, and goals affords you the opportunity to think expansively about potential new roles, including nontraditional ones. Much like in the process of innovation, exploring this phase with a spirit of curiosity and openness will enable breakthrough thinking and more creative imaginings.

All of the tools and techniques that are used in innovating can be valuable here. For example, pure brainstorming, where you think of every imaginable potential position—even the outlandish, implausible, and ridiculous—can offer expansive thinking into new roles. The crucial approach to brainstorming at this phase is to suspend judgement or evaluation, which can be applied later. Similarly, mind mapping, napkin sketching, or vision boarding, using the life balance and role elements identified in self-assessment/reflection can create a robust list of potential opportunities. Table 2 offers some examples of nontraditional roles to stimulate your thinking. Once again, at this phase, being open to novel ideas, creatively exploring new options, and even chance encounters that pique your interest will generate a robust range of possibilities for you to consider.

Table 2.

Examples of Nontraditional Roles

	Roles	Organizations
Hospital and health care	Non-nursing positions such as COO, CEO, CFO, chief business development officer, chief wellness officer, philanthropy, community relations, human resources/recruitment, patient advocacy, chief technology officer, chief innovation officer, chief experience officer, chief policy officer, chief quality officer, board member	Hospitals, health systems, long-term care facilities, retail pharmacies, senior living centers, community health centers
Health care corporations (from startups to large organizations)	CNO, advisor, product development, product management, marketing, product sales	Medical device manufacturers, pharmaceuticals, health care services, insurance providers, retail pharmacies/clinics
Nonprofit	Board service, executive leadership	Nursing professional associations, non-nursing professional associations, disease focused association (e.g., Heart Association, Cancer Society), community service (e.g., YMCA), interest group (e.g., AARP), philanthropic organization, think tank
Consultant	Targeted focus (i.e., staffing, community engagement, employee wellness, bullying), coaching, public speaking, meeting facilitation	Self-employed, small firm, large firm
Academia	Dean, community outreach, faculty, adjunct faculty
Government	Elected leader, department related to health and human services	Local, state, federal levels

CEO, chief executive officer; CFO, chief financial officer; CNO, chief nursing officer; COO, chief operating officer.

Exploring Potential Roles

A clear self-assessment creates the ability to evaluate a wide range of potential roles and determine whether they will meet your needs and desires. Burnett and Evans¹ describe exploration of potential roles as akin to prototyping in design thinking. Just as prototyping in innovation is used to gain insights and test proposed solutions, exploring potential roles for a good fit enables the nurse leader to learn more about nontraditional nursing leadership roles, test assumptions about those roles, and more deeply examine whether or not the roles meet desired conditions.

Although reading about nontraditional nursing leadership roles can offer some information, an ideal way to learn more about potential roles of interest is to conduct informational interviews with colleagues who are currently or have recently served in similar positions. Informational interviews can be as short as 10 to 15 minutes and are an informal conversation to learn more about roles you are considering. Informational interviews enable you to get the data you need about the roles, test your assumptions about the positions, and provide the added benefit of offering exposure by communicating to leaders in other practice settings that you are exploring new roles and career paths.

To be effective and to be respectful of your colleagues’ time, be strategic in how you approach the informational interviews. To conduct an effective informational interview, prepare a list of informed, intelligent questions based on your self-assessment and what you identified as most important to you. Think through what exactly you need to know about each position to rapidly assess whether or not the proposed role provides a good fit. The goal is to understand the primary functions of a role and whether they align or misalign with one’s motivation and interests. Evaluate how you will test the assumptions that you have about each position and whether or not the positions you are considering meet your desired needs. For example, in contrast to starting with a statement of “I’m interested in this role because I want better work–life balance,” ask about how the workload compares to that of a hospital nurse executive. If you are looking for collaborative work, ask something like, “How does someone working in this role interact with others?” Powerful, penetrating questions can assist you to better understand market needs and how your expertise aligns, and create potential linkages for applying your expertise in new ways and in new practice settings.

In addition, nurse leaders would be wise to consider more creative ways to offer their leadership expertise to the world. In today’s gig economy, piecing together project work for several organizations or serving as a consultant can maximize your contribution if you have the flexibility to not need an employer. With the rise of remote work, increasing use of videoconferencing, and more readily available health insurance, nurse leaders may find that several part-time, temporary, or consulting assignments may offer more flexibility and may coalesce into full-time interesting work.

In addition to providing you the information you need to decide whether the role and organization are a good fit for you, informational interviews are a great way to strategically network and informally share why you would be an asset to the organization. Although the goal of an informational interview is not a job, sometimes through the experience, you build relationships that can lead you to the opportunity you want. For this reason as well, if the role seems intriguing, extending your exploration by asking for recommendations for 2 or 3 more people who could advise you can be helpful. For many nurse leaders, their next career opportunity will come, at least in part, through networking.

Finding The Fit

Once you are clear on the elements of a role or options that are attractive to you, begin by designing your professional presence for the opportunities you are pursuing. Craft all elements of your professional story—from your LinkedIn or other social media presence to your resume—to align with your future goals. Share your professional background in a way that it conveys your passion, interest, skills, and experience in a concise way that describes how you are a fit for your desired future work. What is most important is for the story to be cohesive and to pivot from portraying you as a competent hospital nurse executive to competent in your new desired role. For example, if you are interested in moving to a position with a health care startup company, in addition to networking and associating with other who do similar work, begin following them on social media, posting on health care innovations, and highlighting your contributions to transforming ideas into viable and profitable products in your resume, writings, presentations, postings, and networking.

As you increasingly target your communications to attain a position or role that meets your needs, your attention should equally evaluate the compatibility between the organizational culture and what environment brings out your best work. Ensuring the right work is done in the right context with the kind of people that you enjoy working with will maximize your satisfaction.

Conclusion

Hospital and health system–based nurse leadership roles are exciting, interesting, and a meaningful way to make a difference in the world. As health care increasingly moves beyond the hospital walls, the opportunities for hospital-based nurse leaders to emerge and fulfil new roles also increases. A clear picture of what you want in the next phase of your career emerges through an assessment of what brings you the greatest joy and motivation in your work coupled with an honest evaluation of your talents and your personal needs. With that foundation, you can design a strategy to learn more about potential roles, align the story of your career to match your desired opportunity and, most importantly, apply your deep nursing leadership expertise in a new role and in a new and satisfying way.

Biography

Marla J. Weston, PhD, RN, FAAN, is CEO at Weston Consulting, LLC, in Washington, DC. She can be reached at marlajweston@gmail.com. Sandy Somers, MS, PCC, is Career Coach at Career Discovery Services, LLC, in Scottsdale, Arizona.