If It’s Important to You, It’s Important to Them – Wise Words from Nursing Leaders

 Many years ago, when I was a Clinical Instructor in one of Vancouver’s major research-based nursing programs, I had the privilege of working with a group of senior undergraduate nursing students completing their final rotation in an acute inpatient mental health setting. If you are a nurse educator, you already know this: those final placements are often intense, students are balancing theory and practice, integrating new knowledge, and beginning to see themselves as professionals. These students are stressed out. There are sleepless nights, anxious moments with staff nurses and physicians, and there are tears. More tears than I would have thought before I became a Clinical Instructor.

At that time, the unit’s Patient Care Coordinator, who I will describe as a seasoned nurse (the spicy variety) nearing retirement, was a nurse I knew from when I started my career as a new graduate in the same hospital, on those same units. She had decades of experience in acute mental health care and had recently transitioned from her many years as a staff nurse, into leadership as a way to wind down from direct care and her nursing career. In addition to her plucky humour, she carried the kind of practical wisdom that only comes from years of being a staff nurse and mentoring other staff nurses.

Two pieces of advice she shared have stayed with me throughout my nursing career. One was uncomfortable but profoundly true. The other, deceptively simple, continues to guide my leadership practice to this day.

“You Have to Be Willing for Staff to Hate You”

The first lesson came as somewhat of a shock, although it shouldn’t have. She said: when you move into leadership, you have to be willing for staff to hate you. (That may or may not be a direct quote)

It wasn’t said harshly, and she said it quite matter of factly. In the decade following I have really grown to understand what she meant. She meant this literally, but also as a call for a reflexive check about understanding what the responsibility was of a nursing and health care leadership role. She meant that stepping into leadership fundamentally changes the relationship you have with the people you used to work alongside. When you become the supervisor or manager, the dynamic shifts. You are no longer a peer who secrets can be shared with, who is down in the trenches. You have become the face of authority.  You’re responsible for difficult decisions, hiring, disciplinary action, workload distribution, developing clinical standards, policy and guideline implementation. You have moved from a micro-level focus on a specific patient assignment to a systems-level role. It’s different and staff nurses do not have a robust understanding of what that entails, often until they get there. I can go on about the structural and systemic barriers that keep staff nurses and other direct care staff in the dark about these realities, but for brevity and to maintain your interest, I’ll save that for another day. 

Once you move into leadership there is a steep learning curve. Unfortunately, it’s often trial by fire. Some decisions will be unpopular. Some will challenge comfort zones. And if you are doing the right thing for patients and the team, you can’t let the fear of being disliked interfere with those decisions.

She embodied that balance beautifully. She was deeply respected, even if not always liked. She didn’t need to be liked to be effective, because her compass was clear, every decision was made in the best interest of patient care. Her integrity anchored her leadership.

As a young instructor just beginning to understand the complexities of leadership in healthcare, this was a revelation. I realized that effective leadership isn’t about being popular. It’s about being principled. It’s about having the courage to make hard calls, stand by them, and communicate with them with respect.

“If It’s Important to You, It’s Important to Them”

Her second piece of wisdom, and the one that still echoes in my brain, came during a conversation about implementing change. She said, “If it’s important to you, it’s important to them.”

At first, I didn’t fully grasp what she meant. But over time, I came to understand that she was speaking about influence, authenticity, and modeling commitment.

As nurses, we know (hopefully, especially if you have been doing this for more than a few years) that change is a constant. New policies, practice guidelines, documentation systems, technologies, and quality initiatives are always on the horizon. Change is rarely simple, especially in large urban hospitals and mental health settings, where care is relational, nuanced, and deeply human.

When I moved into leadership roles myself, I began to see how true her statement was. If I approached a new initiative with genuine enthusiasm, understanding, and clarity, my team responded differently. They paid attention. They asked questions. They got involved. But if I appeared unsure, uncommitted, or disconnected from the “why,” their engagement mirrored mine.

What she was really teaching me was that leadership is relational energy. People look to leaders for cues, how to feel, how to respond, how much to care. When you show that something matters to you, others are more likely to come along.

Modeling the “Why” Behind Change

Nurses are discerning. We don’t automatically buy into new processes or initiatives just because someone in leadership says so. We need to know the purpose. We need to know it makes sense for patients and aligns with our professional values. And that’s great. Keep that in your head and in your heart, whatever service you are working in, at whatever level. Knowing this, knowing that it’s part of the process, helps to reconcile that discomfort and resistance with new things, even when it might seem logical. That’s why, when introducing change, leaders must start by communicating the why, not just the what. I didn’t make this up, Simon Sinek wrote a whole book about it. If you don’t want to read his book, he did a TED talk on this. If you can show that the change improves patient outcomes, enhances safety, or aligns with nursing ethics, staff will listen.

In my own practice, I’ve seen how small actions can set the tone. If I take the time to learn a new electronic charting process before asking staff to use it, they notice. If I show up for a new quality improvement huddle and actively participate, they feel it matters. If I frame change in the context of our shared values, compassion, safety, respect, people engage more deeply.

The opposite is also true. When leaders treat a change as an afterthought or simply “another directive,” staff pick up on that energy. They mirror our ambivalence.

Leadership as Presence, Not Position

I think often about how leadership in nursing is less about hierarchy and more about presence. Whether you’re a charge nurse, educator, or manager, your presence, how you show up, sets the emotional climate for the team.

The Patient Care Coordinator who taught me those lessons led not through authority, but through grounded presence. She was calm, consistent, and transparent. She was also super funny which maybe also did a little something for her as a leader. She didn’t micromanage, but she was visible and available. When she said something mattered, people listened because they trusted her authenticity.

She understood that leadership in nursing is a shared act of meaning-making. It’s about helping people see the value in what they do, especially when change feels overwhelming.

The Emotional Landscape of Leadership

There’s an emotional weight that comes with nursing leadership. You carry not only operational responsibility but also the hopes, frustrations, and vulnerabilities of your team. You navigate competing demands, organizational pressures, patient needs, staff wellbeing. This isn’t new, and this isn’t unique to hospitals or health care. However, maybe our approach to preparing and nurturing nurse leaders has some room to grow to fully step into these roles in the system. 

In that complexity, those early lessons become anchors. When I start to feel resistance from a team, I ask myself: Have I shown them why this matters to me? Have I been clear about why it matters for patients?

Often, the answer lies not in pushing harder, but in connecting deeper. Nurses respond to authenticity, not authority. They want to know their leaders care, about them, about patients, about the profession. If at this point you are falling back to scratching your head and thinking about the fluffy side or nursing I hope you are also thinking about how the fluffy stuff may have not been so fluffy at all but an advantage that nursing education gave you, a wisdom imparted just like this Patient Care Coordinator imparted wisdom to me. 

Passing It On

Years later, I often share those same two pieces of advice with emerging nurse leaders and students:

• You have to be willing for staff to dislike you sometimes. Leadership means making hard decisions for the right reasons.

• If it’s important to you, it’s important to them. Your energy and conviction set the tone for how change is received.

These principles are simple but profound. They remind us that leadership isn’t about power, it’s about influence, trust, and shared purpose.

The Patient Care Coordinator who shared those words probably never knew how far they would travel. But they continue to echo in every conversation I have about leadership and in every new change I help guide.

Because she was right. If it’s important to you, it really does become important to them.