Choosing Leadership

The typical career progression for a clinical nurse often follows one of two pathways: education or leadership. For nurses who aspire to become an Associate Nurse Unit Manager (ANUM), it’s reasonable to assume that many might also envision becoming a Nurse Unit Manager (NUM) one day.

I took the leadership pathway. As an ANUM, I often envisioned the kind of leader I wanted to become and the impact I could have on my team. I was determined to transform the workplace culture and dedicated myself to creating a positive working environment. My goal was to inspire the unmotivated and enable the bright stars. While I knew it would be a challenging and lengthy journey, my passion for building strong, meaningful relationships with the staff remained my top priority. I felt I could accomplish this as an ANUM - not a NUM!

The Dilemma

ANUMs know precisely what’s involved in the NUM role daily. So, what is it about the NUM role that feels daunting or undesirable to the ANUM group? In my experience, there wasn’t enough support for ANUMs looking to transition into a NUM role, and certain elements of the NUM role made the progression from ANUM to NUM, quite frankly, undesirable!

NUMs are the “leaders” of the team; however, through no fault of their own, they are forced down the rabbit hole of numbers, meetings, and no breaks.

Addressing these issues through mentorship, leadership support, and cultural shifts in upper management can reduce the stigma surrounding NUM roles and create a stronger, more sustainable leadership pipeline within the organisation.

Unpacking the Hesitation

There are many reasons why an ANUM may hesitate to apply for a NUM position. I have outlined a few of the most common reasons below, which are often brought up immediately when engaging with the ANUM group.

1. Pressure of Reporting

Reporting data, such as hours per bed day and quality indicators, is a key aspect of the NUM role. NUMs must present daily key performance metrics to the executive team, often facing immediate questions if results fall short of expectations. They must provide on-the-spot explanations, adding to the pressure of the role. NUMs lining up in the executive suite to deliver their reports quickly and concisely felt like taking a number at a deli counter.

The process often feels overwhelming and discouraging, leaving ANUMs hesitant to step into these roles. Here's why:

While last-minute help with running reports can sometimes be found, what’s missing is proper orientation and time to learn the system. As a new NUM, there’s often no consistent guidance on navigating administrative tasks, leaving you to figure it out alone. Balancing this with clinical responsibilities feels impossible, and I often defaulted to the familiar clinical work, pushing administrative tasks into unpaid after-hours.

This constant cycle of working back late, falling behind, and feeling anxious became overwhelming. Meanwhile, the team expected me to be present on the floor, adding to the pressure.

2. Unpaid Overtime

NUMs often work beyond their paid hours, starting early, finishing late, and frequently missing lunch breaks. In contrast, ANUMs are compensated for every hour they work and can typically hand over their duties and leave on time. ANUMs often earn more than NUMs due to penalty rates and additional income from extra shifts, which are not available to NUMs on a fixed salary.

3. Fear of Clinical Disconnect

ANUMs are often regarded as the backbone of their units, acting as the "glue" holding the unit together and supporting the NUM and the clinical team. They filter and manage information and rosters and provide clinical support and expertise, making the role fulfilling and highly valued. However, this deep connection to the team creates a fear of losing clinical involvement, as many ANUMs believe moving into a NUM role will remove them from the hands-on work they cherish.

Time to Break the Cycle

A structured mentorship and leadership support program can bridge the gap between clinical and administrative responsibilities and encourage ANUMs to pursue leadership positions like the NUM role and beyond. This program can alleviate the challenges that deter ANUMs from taking the next step in their careers by providing hands-on guidance, practical training, and ongoing support whilst maintaining a healthy presence in the clinical space.

Mentorship programs build confidence and offer a safety net for ANUMs, enabling them to tackle the challenges of upper nurse management that await and feel a sense of empowerment and readiness for the role.

Mentor on Call

When I stepped into the acting NUM role, I quickly searched for guidance and support. It reminded me of being a graduate nurse again, looking for a "mother hen" to turn to. Fortunately, I identified a go-to person—a NUM who led maternity services—who provided reassurance and support when I needed it most.

This experience highlighted the importance of a dedicated program supporting ANUMs transitioning into NUM roles. Such a program could allow leaders to focus on truly leading rather than just managing tasks.

After all, no one remembers a NUM for the reports they filed or completed tasks. What resonates with staff is the kind of person the NUM was, the culture they cultivated, and the legacy they left behind, if any. Supporting ANUMs to step into leadership confidently ensures that legacy is worth remembering.

Leading with Heart

For me, leadership wasn’t just about managing a team at work, it was about ensuring people were genuinely happy to be there. I wanted my team to feel heard, supported, and valued. That meant doing the little things that made a big difference in their personal lives. I ensured everyone got their breaks, accommodated shift changes whenever possible, and motivated my team to perform at their best. A wise manager once told me:

I took those words to heart and adopted that philosophy to the best of my ability. By prioritising my team’s well-being, I saw firsthand how a supported and happy workforce could thrive.

Conclusion

The legacy of a NUM should not be measured by the reports they’ve submitted or the breaks they’ve skipped but by the positive impact they’ve made on their teams, the emerging leaders aspiring to become NUMs, and the culture they’ve created. Doing so can create a stronger, more sustainable healthcare leadership pipeline where ANUMs aspire to and thrive in NUM roles.

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