8 | Nursing in Practice | Winter 2022
As well as poor employment conditions preventing nurses from achieving their full potential , confidence can also be an issue when it comes to seeking out and securing senior roles . ‘ So-called imposter syndrome is a barrier to nurse leadership ,’ says Ms Bostock .
‘ And yet there are nurses who may lack confidence , but with training would make excellent leaders .’
The path to leadership In terms of training and leadership opportunities , the NHS Leadership Academy , the RCN and the Queen ’ s Nursing Institute ( QNI ) all run leadership programmes offering learning and support , including ways to build confidence ( see Resources ). And despite barriers to gaining a ‘ place at the table ’, PCNs still represent a golden opportunity for nurses to step into leadership positions . ‘ I see more female GPNs moving into leadership positions since PCNs started to develop ,’ says Mrs Fenton .
But much more needs to be done to ensure more nurses achieve their full potential . A good start would be giving GPNs the same pay and conditions as their NHS colleagues , nurses say . ‘ Overall , the majority of nurses who work in general practice would like to see Agenda for Change terms and conditions applied to them ,’ says QNI chief executive Dr Crystal Oldman .
Better treatment of women in nursing would lead to better retention , recruitment and more opportunities to progress . Julie Belton has been a GPN and ANP , and is now a strategic and operational director at Cuckoo Lane Healthcare , a nurse-led general practice in west London . She is also a PCN network director , and one of the directors on a GP federation board , where she is the only female and only nurse . ‘ Nurses need to feel valued ,’ she says . ‘ It ’ s not necessarily about money , it ’ s about feeling part of a team and having a sense of purpose . Nurses want to feel they ’ re doing a good job – they need training , support and a sense of belonging .’
Nurses need ‘ a good career structure , to feel supported and not overwhelmed with work , and have time to do research and attend courses ’, Ms Phillips says . ‘ And they should not have to beg for that support – it should be part and parcel of their terms and conditions .’
To boost female leadership in nursing , and specifically in primary care , Ms Baldwin calls for ‘ opportunities early on in nurses ’ careers to develop leadership skills , such as being given ownership of different projects .
Dr Oldman says the importance of networking should ‘ never be underestimated ’. ‘ What you do with networking is you listen a lot , and find somebody who shares your values and also challenges you to think differently – somebody who has “ walked the walk ”, been a leader , and recognises the importance of growing the next generation of leaders .’
Having nurse role models and mentors , and shadowing nurses in leadership roles can also inspire and help with career progression . ‘ It ’ s great peer support , helps you to meet other leaders , and you can learn from their knowledge and experience ,’ says Ms Bostock .
Such support also helps to boost confidence and address imposter syndrome . ‘ You need that voice to help you say , yes I can do this ,’ she says .
Ms Belton believes that in order to progress their careers , ‘ nurses need to take risks , get out of their comfort zone , be assertive , do their homework and make calculated decisions ’.
When carving out a career path it ’ s important to be proactive . Mrs Fenton says : ‘ I have always pushed for career development , sold my case as to why I should be invested in , and made sure people can see the benefits .’
Case study
Steph Lawrence is executive director of nursing and allied health professionals , Leeds Community Healthcare and Leeds GP Confederation , and national professional advisor for community services within CQC ‘ I trained as a nurse in the 1980s , then worked in A & E , community , became an advanced practitioner , and started taking on more leadership roles . I ’ ve taken leadership courses to develop my knowledge , and they are also great for networking and meeting inspiring nurse leaders .
‘ You need to have confidence in your abilities . You can spend a lot of time experiencing imposter syndrome , thinking you ’ re not good enough . You also need to be kind , compassionate , and to seize opportunities that come your way .
‘ The picture of whether there are enough female nurses making decisions at different levels , such as PCN level , is variable . A lot of leadership within primary care is still very much medical leadership . It ’ s difficult for primary care nurses to take on leadership roles , as they are usually employed by GP partners , and are too busy getting on with their job to put their head above the parapet .
‘ We ’ ve got work to do to raise the profile of nursing , particularly in primary care . These nurses don ’ t get the same opportunities as those in secondary care , such as leadership training and development . We urgently need a national directive on terms and conditions for primary care . If the employment model was changed there would be more opportunities for these nurses to take on leadership roles . This would lead to better recruitment and retention .
‘ Nurses looking at taking on leadership roles should think about how they can – at every opportunity – influence and raise the profile of community and practice nursing . Don ’ t be afraid to seize opportunities . And get rid of that “ imposter ” on your shoulder .’
You need to be tenacious and use your knowledge and skills to identify what needs to be done Carole Phillips
Case study
And Ms Bostock , who put herself forward for her PCN role says : ‘ If nurses aren ’ t at the table , sometimes you have to invite yourself to the table . So be bold and believe that you can do a leadership role . You can always start small , and work your way up .’
Ms Bradley says nurses ‘ need to speak up , and ask to be included ’ in decision making . Being a nurse leader doesn ’ t mean having to influence people on a massive scale , she says . ‘ If one or two people are influenced by you , that ’ s leadership .
‘ If we all did our bit to raise our own profile then we would see how worthwhile and valuable we are .’
Ruth Oshikanlu is a nurse entrepreneur based in London , and author of Tune in to Your Baby ‘ I was a nurse , midwife and health visitor in the NHS for about 14 years . I left the NHS in 2008 in order to grow and develop .
‘ I completed a coaching programme and several leadership programmes , including some run by the RCN and the QNI , which have been pivotal to my growth and development as a leader , and have helped me to become braver .
‘ In 2010 , I founded Goal Mind , a coaching consultancy to help individuals improve their performance at work . I ’ m also a trustee for a charity , guest lecturer for several universities , and write for several professional journals . I believe in authentic leadership – engaging people and including them as part of any change .
‘ One of the reasons why women nurses don ’ t aspire to be leaders is that they are still working in a “ know your place ” culture . If you hear this long enough , you believe it . Most men have a quicker route to the top than women : they are supported to rise , and that ’ s what ’ s happening in nursing .
‘ We need more role models in nursing . If you see people like you at the leadership table then you think , I can do this too .
‘ Nurses also need coaching and mentoring – they need support to thrive . And nurse leaders need to bring others with them . The more people they bring to the leadership table , the more support they will have .
‘ Nurses are not good at asking for support , but it ’ s so important that they do . They need to ask people to mentor them . Because people do want to help .’