The charge nurse quit during my first week.
She told me the working environment had been unbearable for a long time and that she could not keep going. The next day, more resignations landed on my desk.
I brushed the concerns aside. I told myself they owed me time to fix what I had walked into. I was wrong, and I was the reason that week went the way it did.
Being handed a team and knowing how to lead one are two different jobs, and nobody hands you the second one.
So I stopped defending and started listening. Every complaint that team had fell into five categories... growing people, dealing with performance, building a team, fixing the work itself, and getting results. Those five became a framework, built over a career in hospital leadership and honed hardest in the last ten years of it.
That framework is this book.
Developing People - Managing Performance - Building Teams - Improving Operations - Achieving Results
Five elements that hold each other up. Let one go slack and you feel it in the other four, which is why fixing one thing at a time never holds.
Inside you will find how to build a development plan a person will use, how to run accountability huddles that change what happens on Monday, how to set expectations clear enough that nobody has to guess, how to put a scorecard on the wall without it turning into a weapon, how to make a bold decision without treating people as line items, and what to do about the fear of failure that keeps capable leaders from deciding anything at all.
It is written by a nurse who climbed every rung, from nursing assistant to a health system's Executive Vice President of Hospital Operations and Chief Nursing Officer. The stories are hospital stories. The five elements are not.
For the first-time manager, the charge nurse who just got promoted, the director carrying a department that is not working, and the executive who got the title and never got the instructions.