A leader’s job is to provide the resources and support needed by the team to get the job done. You then need to get out of the way, and let them work and develop. I seldom have engaged in close, direct supervision. I make sure the resources are there, available to the team, and then I let them work.

I have been blessed to work with some great staff in many ORs over the years, and most have responded well to my style. Sometimes I have been disappointed when things didn’t turn out as expected, but, on balance, it has been a productive strategy.

Many years ago, I was introduced to McGregor’s Theory X and Theory Y of leadership and supervision. In the 1960s, social psychologist Douglas McGregor developed two contrasting theories that explained how managers’ beliefs about what motivated their employees affected their management style. Theory X was authoritarian, and Theory Y was participative.

If you believe your employees dislike their work and have little motivation, you are most likely an authoritarian (X)leader. This approach is very hands-on and usually involves micromanaging your employees’ work to ensure it is done properly.

If you believe that your employees take pride in their work and see it as a challenge, you are more likely to adopt a participative management style (Y). Managers who use this approach trust their employees to take ownership of their work and do it effectively by themselves.

 I am a Theory Y sort of leader. I believe people want to do a good job when they come to work. I believe that, as their leader, I should provide the resources and set the work conditions to allow people to do their best work.

I lean toward a consultative style, especially when working with CCI. It is much different than leading an OR, so my style has changed. I always favored a collegial, consultative approach in the many years I spent in ORs, but it has become more focused in recent years.

My leadership style has been influenced by my life experiences. I am a veteran with enlisted service in the Army and service as an officer in the Navy Nurse Corps. I enlisted at 17 years old during the Vietnam War era and entered military service shortly after graduating high school. Later in life, I graduated from nursing school, which was funded in part by my GI Bill benefits, and became an officer in the Navy.

The Navy Nurse Corps places a premium on leadership development, and that is where my leadership style was forged. I was fortunate to serve with some superb leaders like Captain Patricia Bannow at Naval Hospital Groton, Connecticut, and Naval Medical Center Portsmouth, Virginia. I learned a lot from Captain Bannow and other Navy leaders.

My leadership style also has been heavily influenced by my academic experience. I was blessed to receive an excellent pre-licensure education at a Diploma school, The Toledo Hospital School of Nursing. The military then facilitated additional education with graduate school work at East Carolina University, and then the many years of doctoral work.

I am now adjunct faculty and work with pre-licensure students at Edgewood College in Madison, Wisconsin, and with graduate students and doctoral candidates at other universities.

The interaction with faculty and administrators has provided useful experiences and helped to shape me as a leader. In addition, my academic experience has been helpful in working with other credentialing bodies and diverse certification organizations.

Leading and managing in the OR is a distinct skill set. When I first began managing ORs, my mentor shared resources she used in her career.

At that time, the career path for those who aspired to a leadership role was not well defined. We still operated under the belief that OR leaders, who were almost always nurses, had to pay their dues over many years and establish their perioperative skills first.

For many perioperative nurses, that meant years of gradual progression up through the ranks until someone died or retired, and then the new leader was picked from the best, most experienced clinicians. Many organizations now devote resources to develop nurses early in their careers for leadership and management roles.

We have become much more systematic about this, and recognize that ongoing professional development and advanced educational degrees are a part of that development course. Many perioperative nurse leaders combine a BSN with an MBA.

If you want to be a perioperative leader, just set your course, do the hard work and educational preparation, and go for it. The resources are out there, and we know what degrees and certifications will be useful and productive on this path.

The ability to recognize and own up to mistakes is an important part of a leader’s success. I have been humbled many times, and I have learned hard lessons from those experiences.

In my last role as a perioperative nurse leader, I came to the realization that I had to develop more flexibility and be open to more ideas and innovative solutions from my team. I had a great team of developing leaders who helped me reach that epiphany. It was a good experience for me in that I got to learn my blind spots. I was fortunate to have a good team from which to learn those lessons.

In the Navy, the role of a Nurse Corps officer is to develop your subordinates; you are evaluated on how well you do that. We had a saying that still serves me well: “Your legacy is not what you have accomplished but, rather, what is accomplished by those you have led and mentored.”

I am very proud to say that I worked with some superb nurses when I was in the Navy Nurse Corps. I encouraged them, shared what I could, and made sure they had quality evaluations that accurately reflected their work.

Some of those nurses have gone on to senior leadership roles far exceeding anything I ever accomplished. That is a great thing.

I think there are two big myths that were present in the OR when I started, and they still persist today.

The first is that new nurses cannot come directly into the OR upon graduation. We still have this notion that nurses must build their skills with 2 years of med-surg experience before they can become perioperative nurses. I know of no research-based evidence that supports that belief. In fact, much of what we know about how nurses learn and acquire skills runs counter to that assumption.

Perioperative nursing requires a unique set of complex skills, and the best way to sharpen and refine those skills is to do the work of perioperative nursing. There is very little research in this area, but I know of no study that supports the need or benefit of med-surg experience before coming to the OR.

The second myth is that to be a leader or manager in the OR, you must first develop your skills as a perioperative clinician.

CCI has studied the work performed by both perioperative nurses and OR leaders. These are two distinct and very different roles, and there are few common tasks between them.

It is entirely possible that a nurse may perform well in a leadership role in the OR and not have the best clinical skills. It is also possible that experts in clinical perioperative care may not make the best leaders. To move a superb clinician away from patient care may have unintended negative consequences as you drain your much-needed clinical experience.

 In respect to hiring, we are amidst some of the most challenging times I have ever experienced in my nearly 40 years in the OR. Our staffing challenges encompass both perioperative nurses and surgical techs.

Nursing students are our future, and we have a vested interest in developing them. The current hiring issues show the need to devote more time and resources to students, and all of us have a role in fostering a positive learning experience for them.

The CCI nurses teach a pre-licensure course at Edgewood College in Madison, Wisconsin. We are now working with our third cohort, and the class has been very well received in the region.

We continue to expand our clinical sites, and many of our students are now in perioperative nursing orientation.

Any OR could be a clinical site for students. Any clinical experience is an opportunity to make a favorable impression on a student who may one day become a perioperative nurse.

My last thought here is for the nurse leaders at the far end of their careers. That now includes me as I ponder what comes after my work at CCI.

My advice is to pay it forward and contribute whatever small part you can to the future of perioperative nursing. It may be continued volunteer work, giving presentations to high school students with an interest in nursing, or serving as adjunct faculty.

Nurses with many years of perioperative experience may no longer wish to work full time, but I believe they still have much to contribute.