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Being a nurse director: the challenges and opportunities

A member of Nursing Management's editorial advisory board offers some tips on what it takes to become a director of nursing
Vector image showing paper aeroplanes.To mark the International Year of the Nurse and Midwife, members of Nursing Management’s editorial advisory team reflect on nursing and advice for aspiring nurse leaders. This article is by  Alex McMahon.

A member of Nursing Management's editorial advisory board offers some tips on what it takes to become a director of nursing

As a young nursing student I remember vividly when, four weeks into our three-year programme, we had a talk from the chief area nursing officer. I was fascinated by the role, what it was and how a young keen nursing student could get to such a lofty and important post. Then, towards the end of my programme, when we were undertaking the management module, we had a talk from the nurse director. Again I found myself wondering: How do I become him?

I have always been curious as

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A member of Nursing Management's editorial advisory board offers some tips on what it takes to become a director of nursing

Vector image showing paper aeroplanes.To mark the International Year of the Nurse and Midwife, members of Nursing Management’s editorial advisory team reflect on nursing and advice for aspiring nurse leaders. This article is by  Alex McMahon.
Picture: iStock

As a young nursing student I remember vividly when, four weeks into our three-year programme, we had a talk from the chief area nursing officer. I was fascinated by the role, what it was and how a young ‘keen’ nursing student could get to such a lofty and important post. Then, towards the end of my programme, when we were undertaking the management module, we had a talk from the nurse director. Again I found myself wondering: ‘How do I become him?’

I have always been curious as a nurse but throughout my career, although I have always aspired to become an executive nurse director, my pathway and journey has been mine and not one that others might think makes sense. But along the way I have collected the qualifications, skills and experience that were needed.

A chance to influence patient care and the shape of the profession

When others, particularly junior nurses, ask me why I want to do the job I do, my response is that I have always wanted to do this. Also, it’s such a challenging but rewarding role, and you have a genuine opportunity to influence the safety and quality of patient care, while influencing the shape of the profession and indeed the wider professional and workforce agenda, along with the policy context. Why wouldn’t anyone want to do this job?

Is it easy? No. I have 10,500 nurses in NHS Lothian, and if you add midwives and allied health professionals it’s just over 14,000. It’s a huge responsibility, but you work as a team and not in isolation. Never have there been more challenges, but the opportunities are exciting and just as many.

Professional curiosity and ambition

Wherever I go in our system, I encourage professional curiosity and ambition, to whatever level people want to aspire. When I’m asked how I got to where I am, I tell my story but add a caveat by saying people need to steer their own paths. If they want to be an executive director, they should always have an eye to what it is they need to be able to do the job.

I remember as a nursing student reading and being inspired by Annie Altschul’s work, and I had the good fortune in later life to meet her several times. The impact she made on me has stayed with me to this day.

Amazing nurses who are ‘just doing their job’

These days I don’t have in mind a particular nurse leader I would highlight but I am struck every other week and in so many settings by the nurses who are just ‘doing their job’. Boy, they are amazing.

My job is to keep giving them the conditions and support they need to flourish. One day one of them will be sitting where I am. One day some of them may well be delivering care to me in my old age, I would like to think to the highest of possible standards because I gave them the conditions and support they needed.

Read more on celebrating nursing leadership


Picture of Alex McMahon is executive director, nursing, midwifery and allied health professions, and executive lead, Royal Edinburgh and Associated Services and prison healthcare, NHS Lothian, Edinburgh.Alex McMahon, @profalexmcmahon, is executive director, nursing, midwifery and allied health professions, and executive lead, Royal Edinburgh and Associated Services and prison healthcare, NHS Lothian, Edinburgh. He is a member of the Nursing Management editorial advisory board

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