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Why Nurse Leaders Derail

Preventing and Rebounding From Leadership Failure

Bellack, Janis P., PhD, RN, FAAN, ANEF; Dickow, Mary, MPA, FAAN

Nursing Administration Quarterly: April/June 2019 - Volume 43 - Issue 2 - p 113–122
doi: 10.1097/NAQ.0000000000000345
Original Articles

To be successful, nurse leaders must be able to develop and articulate a vision for their areas of responsibility, build strong relationships with those they lead, and execute strategies and actions to achieve shared goals. Emotional intelligence and mastering self, interpersonal, and team relationships, while understanding organizational culture and systems, are critical components of successful leadership. Nurse leaders must be aware of their own strengths and weaknesses, be able to manage their emotions, exhibit social awareness of others' emotions, and successfully manage their relationships with others within their sphere of influence. Leaders who fail to manage themselves and their relationships with others fail to lead with clear direction and purpose, or fail to deliver results for their organizations, and risk derailing their careers. This article focuses on common behaviors and characteristics that cause leaders to derail as well as the risks for leadership failure (self-imposed, boss-imposed, situation-imposed), including common traps leaders can fall into in the first months of assuming a new leadership role. Risks for career derailment and opportunities for preventing or rebounding from leadership failure are reviewed.

MGH Institute of Health Professions, Boston, Massachusetts (Dr Bellack); and Director of Strategic Initiatives, Organization for Associate Degree Nursing, Pensacola, Florida (Ms Dickow).

Correspondence: Janis P. Bellack, PhD, RN, FAAN, ANEF, Office of the President, MGH Institute of Health Professions, 36 First Ave, Charlestown Navy Yard, Boston, MA 02129 (

The authors declare no conflict of interest.

LEADERSHIP FAILURE leading to temporary or permanent career derailment is, unfortunately, an all too common occurrence across professions and sectors.1–5 Leadership derailment can take several forms, ranging from stalling at a plateau that holds no hope of further success to being demoted or terminated before reaching what was anticipated for leadership advancement and success.

Leadership failure that leads to career derailment for an individual nurse is costly to the nurse as well as the organization in both actual costs and reputation and may stall, compromise, or preclude the nurse leader's future success in the profession.6 Organizations must bear the expense associated with a nurse leader's derailment in terms of what was invested in time, support, and money. They must also attend to the impact on continued motivation and engagement among employees, especially those who were team members and colleagues of the failed leader. Further, failure in a leadership role is nearly always personally devastating and demoralizing, even humiliating, to a nurse leader who fails.6

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A leadership framework

Having a leadership framework for thinking about nurse leaders who succeed and those who fail can be useful. For purposes of this article, we propose a framework that encompasses 3 broad skills, or competencies, we believe are essential for successful leadership: “Vision + Relationships + Execution.” If not rectified, failure in one or more of these areas is a prescription for leadership ineffectiveness and possible career derailment.

To illustrate, nurse leaders who clearly articulate vision and purpose for their area(s) of responsibility and relate well to others, but who do not follow through and deliver results that move the organization forward, will ultimately fail. Those with vision and the ability to execute the vision, but who do so by failing to support, develop, and nurture relationships or build an ésprit de corps with the staff who must carry out the vision, will eventually fail as well. And nurse leaders who have strong interpersonal relationships and attend to daily tasks and demands but who do not have, or cannot express, a clear vision will fail to lead with purpose and clarity. They create uncertainty, ambiguity, and even confusion among staff, who are left to wonder where the unit or organization is headed and what is expected of them. Thus, failure in one or more of the 3 areas is likely to lead to poor team morale, expensive consequences for the organization, and career-damaging fallout for the nurse leader who fails.

Within the Vision-Relationships-Execution triad, the Relationships dimension may be especially important, specifically as it pertains to a relationship with oneself as well as relationships with others. We believe that the “emotional intelligence” (EI) framework, first coined by Salovey and Mayer,7 offers a useful lens for considering the Relationships dimension.

Emotional intelligence is the ability to recognize, understand, and manage one's own emotions and to harness and channel them in ways that build effective relationships with others.7 Doing so, in turn, helps nurse leaders effectively express their visions and goals for their teams or organizations, and to inspire, motivate, and engage team members in actions that lead to desired outcomes.

While effective nurse leaders must have the necessary skills for a given leadership role (specifically the knowledge, expertise, and experience required to fulfill the role), such skills are not sufficient in and of themselves to ensure leadership success. The additional ingredient of EI is essential for a nurse leader to be successful, regardless of the level or sphere of leadership.8,9 In fact, most stories of leadership failure, regardless of setting, include at least some element of the leader's lack of self-awareness and effective self-management as well as failure to create and sustain strong interpersonal relationships that inspire others to action.3,6

When asked what derailment behaviors they have personally observed in ineffective or failing nurse or other health system leaders, most people will mention behaviors that fall into 1 of the 3 leadership categories—Vision, Relationships, Execution. In a recent workshop we conducted with a group of executive nurse leaders, a range of observed behaviors was noted. It was not surprising that the majority fell into the Relationships category, including such behaviors as arrogance, lack of authenticity, failure to listen, disrespect of others, and insensitivity. Leaders with relationship problems were seen as temperamental, overreactive, untrustworthy, emotionally aloof, inconsistent, and rigid. They were perceived to “play favorites” or exhibit a “my way or the highway” attitude.

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Characteristics and behaviors of leaders who derail

The leadership literature is replete with research on characteristics and behaviors that cause leaders to derail.5,10–13 Among the most frequently cited reasons, in addition to those mentioned above, are:

  • lacks clarity of purpose and direction;
  • lacks insight about own behaviors and their impact on others;
  • lacks openness and transparency;
  • lacks confidence or exhibits overconfidence;
  • lacks motivation, energy, and enthusiasm;
  • is complacent and lacks a sense of urgency;
  • fails to communicate effectively—up, down, and sideways;
  • is disorganized, has difficulty managing priorities and daily details;
  • is indecisive;
  • is inflexible, unable or unwilling to adapt to changing circumstances, holds onto the status quo;
  • instills a culture of fear and intimidation;
  • fails to build and lead a team;
  • fails to meet goals and deliver results;
  • takes the credit for successes and blames others for failures;
  • fails to mentor and develop others, including delegating effectively; and
  • fails to learn and rebound from mistakes, losses, or failures.

The Chally Group14 points out that leadership derailment is usually related to personality and relationship factors, noting that “These are almost as varied as the individuals themselves, ranging from impulsiveness, arrogance, and melodrama, to excessive caution, perfectionism, and mistrust. When magnified by the spotlight of a leadership position and the stress of the job, they are often tacitly recognized and accommodated, as long as things are going smoothly. Eventually, if organizational or a personal crisis dials up the stress, the leader reacts by doubling down on the familiar behavior, and the situation accelerates, hurtling past the breaking point. In the aftermath, observers often say, ‘we saw it coming from a mile away, but what could anyone do?'” (p. 1).

Nurse leaders who have been successful in times of stability may begin to exhibit behaviors that can lead to derailment when they find themselves facing stressful situations or crises. Such circumstances may include disruptive organizational change or challenges, mounting workload or work complexity, transition points such as a new job or promotion to a higher level of leadership and responsibility, and times of high personal stress.5,6

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Types of leadership derailment

Leadership derailment can be self-imposed, other-imposed, or situation-imposed. Self-imposed leadership failure most often results from one or more of the characteristics and behaviors cited previously.

Other-imposed leadership failure may be caused by one's manager or supervisor or others in the organization. For example, a manager-imposed threat to one's leadership effectiveness and success can occur when a manager becomes jealous and sees a protégé's success as a threat to the manager's own credibility and stature, causing the manager to withhold or remove continued leadership responsibilities and opportunities from the individual. A supervisor may decide, for known or unknown reasons, to suddenly terminate a member of the leadership team, causing the fired leader distress and forcing the individual to seek alternative employment while also creating uncertainty, even fear, among other team members. The ability of nurse leaders to rebound in such circumstances will depend on their personal resilience as well as leadership qualities, skill set, political and social capital, and professional networks.6

Workplace incivility may also be a source of other-imposed threats to career success. Incidents of incivility can lead to poor morale, self-doubt, emotional distress, and even career derailment.6,15 Jealousy, gossip, bullying, and other forms of peer-to-peer harassment can be damaging to one's sense of self, as well as one's leadership effectiveness. This can cause nurse leaders to leave their jobs, which may curtail future leadership employment and advancement opportunities.

Workplace bullying has long been an issue in the nursing profession. More than 3 decades ago, Meissner16 published a now classic article, asking “Nurses: Are we eating our young?”, which first raised the issue of workplace bullying in the practice setting. In 2015, Brunworth17 repeated the question and wondered “Are we full yet”? That same year, the American Nurses Association published its position statement mandating that nurses and employers take responsibility for creating and sustaining “a culture of respect, free of incivility, bullying, and workplace violence.”18 Nevertheless, workplace incivility has not abated to any great extent and remains a significant issue for the profession.

Situation-imposed derailment may be related to several factors, which are often beyond the individual nurse leader's control. Bias, conscious or unconscious, and discrimination may be among the most common factors that prevent a leader's success. These issues may precipitate loss of a leadership role or prevent an individual from securing a desired leadership role or promotion. These may stem from bias or discrimination related to gender, race, ethnicity, national origin, religion, sexual orientation, appearance, age, disability, and even political beliefs.

Another situation-imposed cause of derailment may be a toxic or demoralizing workplace culture, which can be due to multiple and varied causes. Trying to lead day to day in such an environment can be exhausting and can interfere with a nurse leader's attention, interest, motivation, and ultimately effectiveness. This, in turn, can curtail or derail the nurse's leadership career and limit future opportunities.5,6

Closure or reorganization of a nurse leader's employing organization may lead to an unexpected job change, position elimination, or layoff, over which the nurse leader rarely has control. Such an occurrence forces reconsideration of career goals and necessitates seeking new leadership opportunities. In some instances, limited local leadership opportunities may make such a shift difficult or impossible, especially if the nurse is place-bound. Finally, an unexpected career change may occur for personal reasons. Serious personal illness or serious illness of a loved one, caretaking demands, relocation occasioned by a spouse's or partner's job transfer, or a family crisis is among such reasons. Depending on individual circumstances, a nurse leader may find the situation requires taking a leave of absence, or stepping back into a more flexible work role. In certain instances, the leader may need to leave employment altogether, if only temporarily.

Organizations themselves may be a source of leadership derailment.3,5 Common causes include poor selection of leaders due to failure to assess capabilities and cultural fit of new hires, failure to communicate clear expectations and parameters for success, failure to create appropriate reward systems or overrewarding underperformers, failure to hold leaders accountable, premature promotion to a new level of responsibility before the individual is ready, failure to provide proactive leadership assessment and development opportunities, overlooking negative behaviors in those who are otherwise effective, intolerance of new ideas and risk-taking, precipitous firing or demotion in lieu of creating a culture of feedback and learning from mistakes, favoritism and inequitable allocation of resources, and departmental silos that lead to competition among departments and a one-upsmanship mentality. Nurses who hold leadership positions must remain ever mindful of ways they can help change organizational culture and practices that fail to support and equitably reward effective leadership.

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Emotional intelligence and leadership success

For purposes of this article, we make the assumption that every nurse leader wants to be successful and begins a new leadership role with that intent. However, without understanding the risks of derailment and ways to ensure leadership success, nurse leaders may find themselves stumbling and even failing. With the encouragement and support of their managers and other leaders in the organization, as well as sufficient resources, nurse leaders can proactively maximize the likelihood of success and reduce the risk of leadership missteps or failure.

We propose Goleman's19 EI framework to help nurse leaders develop or reinforce the competencies needed for successful leadership. Goleman's19 conceptualization of EI, building on Salovey and Mayer's work,7 posits that leadership success, like success in the workplace at any level, requires competencies in 4 domains: self-awareness, self-management, social awareness, and relationship management. Failure to attend to 1 or more of these puts leaders at risk for derailment. Table 1 outlines the components of Goleman's19 4 domains of EI.

Table 1

Table 1

Defining emotional intelligence as a critical ingredient for effective leadership, Goleman19 notes that there is no single quality that assures one is emotionally intelligent or has a high emotional quotient. Rather, EI is a set of learned competencies across the 4 domains. Note the emphasis on the word “learned,” as this suggests that leaders who lack or are weak in some competencies can develop them through commitment and practice. Goleman19 emphasizes that emotional intelligence must begin with self-awareness or self-insight, the ability to reflect on and accurately appraise one's own strengths and weaknesses. Such self-appraisal requires leaders to have personal insight about their own emotions and behaviors, seek feedback from others, take the feedback to heart, and commit to addressing areas of weakness in service of becoming more effective leaders.

Too often, derailed leaders fail to be open to acknowledging the importance of self-awareness. Instead, arrogance, overconfidence, and the belief they already know all they need to know (and know what's best for the organization) blind leaders to their own hubris and can eventually compromise their effectiveness while also damaging morale and even the organization itself.1,2,10,11 News headlines are replete with examples of failed leadership across a range of sectors: public sector institutions including government, corporations, nonprofits, professional associations, the media, and the entertainment industry. Certainly, the health care industry is no exception. These stories of leadership derailment offer important object lessons for those wishing to learn from, and avoid, similar fates.

Hewertson20 also emphasizes the importance of self-awareness as foundational to effective leadership but defines it as personal mastery. In addition to personal mastery, she asserts that 3 other types of mastery are essential to leadership success: interpersonal, team, and culture and systems. Each of these requires the competencies associated with emotional intelligence. The elements of these parallel Goleman's19 EI domains, although Hewertson20 also notes the importance of a leader's values, ability to articulate a vision, effectiveness in managing up, being accountable, holding others accountable, and having leadership courage.

Like Goleman, Hewertson20 views emotional intelligence as an essential ingredient for leadership success. Specifically, she defines knowledge and technical expertise as threshold competencies, and asserts that emotional intelligence is the differentiating factor for success. In fact, she asserts that emotional intelligence is “twice as important as IQ and technical expertise combined,” noting that “90 percent of the difference between outstanding and average leaders is linked to EI” (p. 27).

Parr reinforces the importance of emotional intelligence:

Intrapersonal qualities, such as self-awareness and integrity, are particularly important because insight of their own errors can prevent overconfidence, a common problem of derailed leaders. Social skills and empathy are necessary for building relationships with colleagues and key stakeholders. The ability to navigate and understand the business realm is critical for decision-making. All these skills...relate to the importance of leadership skills: the ability to effectively staff, direct, and motivate others.13(p2)

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Assuring early leadership success

Impressions created early in a new leadership role can make the difference between success and failure. Watkins21 operationalizes the competencies needed for leadership success in the first 90 days of moving into a leadership role or advancing to one at a higher level. He emphasizes the importance of getting it right in this timeframe, suggesting that leadership derailment can almost always be traced to problems that developed during the first few months in the role.

Watkins21 identifies common traps that leaders fall into during this early period:

  • Continuing to do the same things that led to success in previous roles and failing to develop the competencies required for success in the new role.
  • Trying too hard to put one's own imprimatur on the organization by making decisions or implementing change before getting to know the organization.
  • Setting unrealistic expectations of oneself or others or failing to establish clear and reasonable goals.
  • Trying to do too much too soon, creating multiple initiatives without clear purpose or direction in the hope that a few will be successful instead of focusing on a limited number of key initiatives.
  • Having all the answers to the organization's problems and not taking time to get to know others' perspectives and enlist their help with potential solutions.
  • Focusing too much on the technical parts of the organization and not enough on relationships and organizational culture.
  • Spending too much time managing up and not paying sufficient attention to direct reports, peers, and other key stakeholder relationships.

Nurse leaders who fall into one or more of these traps risk early derailment from which it may be difficult to rebound. Or, if they do not derail, they often fail to reach their full potential, depriving both themselves and their organizations of key opportunities for further success.

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Best practices for preventing self-imposed derailment

The Chally Group14 surveyed organizations that make talent management a priority and found they employed several strategies to proactively support leadership success and prevent derailment. The top 5 strategies included (1) setting clear expectations of performance, (2) goal-setting and identifying measures of success, (3) assessments of leadership effectiveness, (4) constructive feedback, and (5) mentoring and coaching.

One of the most useful tools to assess leadership effectiveness is 360-degree assessment, a structured process in which leaders seek and receive input from others who work with them—supervisor, direct reports, peers, other key individuals.14 Typically, with the exception of the leader's supervisor, individual responses to a standard set of leadership competencies are anonymous and grouped by rater category to give the leader a composite picture of strengths and weaknesses. This feedback provides the basis for a leadership development plan across the 4 domains of emotional intelligence or mastery. To enhance the likelihood of success, new leaders should proactively seek and take advantage of leadership development opportunities, beginning with 360-degree feedback. The latter is most helpful when administered after a new leader has been in the role for several months, especially to provide early feedback after those first 90 days, giving the leader an opportunity to adjust behavior.

Leaders who welcome and use feedback about their strengths and who commit to addressing their weaknesses through leadership development opportunities are positioning themselves and their organizations for leadership success. Such opportunities may include ongoing constructive feedback, continuing leadership development (learning resources, conferences, formal leadership development programs), mentoring, and executive coaching.

Further, nurse leaders who are committed to developing others in their organization can engage consultants to bring leadership development opportunities to the leadership team. These may include a focus on such topics as self-awareness (employing various assessments tools), executive presence, developing and leading through others, team building, or other leadership topics of value to the team and the organization. Sponsoring others to participate in formal leadership development programs offered by the organization or others can also build leadership strengths, which, in turn, contribute to the success of individual leaders and the organization as a whole. Risks of self-imposed derailment and opportunities for preventing or mitigating them are summarized in Table 2.

Table 2

Table 2

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Other- or situation-imposed derailment: Risks and opportunities

As noted earlier, derailment threats or occurrences can result from situations imposed by others or by situations that are beyond the individual nurse leader's control. While nurse leaders may not be able to control or influence circumstances they may face, they can control how they respond to changes and challenges in their leadership career, despite the source. When derailment threatens or occurs, regardless of cause, self-insight and personal strengths can be key to thriving in spite of this. Further, the nurse leader's reputation, social and political capital within the organization, strong social supports, and professional networks can cushion or mitigate the impact. Finally, the ability to personally cope with adversity and rebound with resourcefulness, resilience, and integrity will often determine whether nurse leaders allow the situation to derail their leadership career permanently, or see it as a temporary setback instead, exerting the will and optimism to look for, or create, new leadership opportunities.5

Risks of other- or situational-imposed derailment and opportunities for preventing or rebounding from them are summarized in Table 3.

Table 3

Table 3

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As nurse leaders reflect on how they want to lead, it is critical they understand the pitfalls and opportunities associated with leadership missteps that can lead to career derailment. Armed with the knowledge presented in this article, nurse leaders can equip themselves to recognize potential career stallers and stoppers in both their own leadership and those that surround them. They can then take steps to avert or correct them.

Nurse leaders should also be alert to derailment risks or situations they have witnessed and be attentive to those imposed by others or by work or life situations. They should consider what can be done to reduce the risks that are within their control. Such awareness can help prevent or mitigate risks that potentially threaten leadership effectiveness.

Having a strong sense of self, as well as the will and commitment to be an effective leader, is key to any nurse leader's success. As nurse leaders contemplate their own roles, behaviors, and emotional intelligence, our hope is that they will leverage the tools and tips offered in this article, thereby improving their leadership effectiveness with their direct reports and team members, as well as across their organizations. Nurse leaders can adopt key strategies outlined here as best practices to improve their leadership strengths, address areas for further development, and be purposeful in setting goals for a successful leadership journey.

The challenge of leadership is to be strong, but not rude; be kind, but not weak; be bold but not bully; be thoughtful, but not lazy; be humble but not timid; be proud but not arrogant; have humor, but without folly.

Jim Rohn22

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career derailment; emotional intelligence; leadership; leadership failure

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