The difference between management and leadership in nursing

Advanced practice nurse and trainee coach, Anna Young, explores the difference between management and leadership in nursing and why it is important to recognise them as two different ‘hats’ that cannot always be worn at the same time

So often, we end up with titles (nurse lead, nurse manager, team lead) without any clear articulation about what these titles mean or what is expected through them.

The terms management and leadership are often conflated too, both in expectation and job description. It can be useful to start with definitions and then to extrapolate these into the real world.

The Oxford Dictionary defines management as the control and organisation of something, and of leadership as a set of characteristics, the person in charge and a position.

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Management is processes, it is governance, the day-to-day tasks that make work tick along smoothly and nicely.

Good management is having someone ensure that you get your lunch break, that you are not overwhelmed with tasks; it does your appraisal on time and listens to your ideas, concerns and expectations.

A good manager ensures that the policies and procedures are in place for workplace safety and thriving. If management is good, we often don’t notice it. If it is bad, we do!

Leadership is about people, about relationships. It is motivation, morale and communication. It requires emotional intelligence and curiosity.

A good leader is someone who has spent time getting to know their team, has built trust and understands that connection and collaboration is KEY to everything. Leadership doesn’t fear disagreement, for if the relationships have a good foundation, conflict can allow for curiosity and a new perspective on a situation.

Both management and leadership are skills which take a long time to develop and hone, and each new role we move into requires us to continue to learn and grow. Relationships too take a long time to develop and trust doesn’t happen overnight.

Often, too little time is dedicated to the foundations of relationships within teams so we can end up with barriers and hurdles to overcome due to a lack of mutual trust or understanding.

Becoming a team leader means getting to know your team, their likes and dislikes, how they prefer to receive feedback, what their motivations are and their weaknesses. Great teams also know this about their lead. This requires vulnerability – which carries its inherent risk.

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This is why leaders are called to be brave. This is the path to success in leadership, to create real influence – by knowing your team, you can speak to and treat someone as they want to be spoken to / treated – it’s these behaviours that drive change rather than values and principles. These behaviours invite people to be courageous – and also to approach you when they have failed or made a mistake.

However, leadership cannot happen in a vacuum! Having structures in place that enable leadership and teams to thrive is key. This is where management and leadership kiss.

Creating structures that support, having good processes for day-to-day tasks and the management of workload also support a team to feel valued.

Knowing that someone is escalating unsafe practice on your behalf, writing policies that have nursing competencies at their heart and is fair in the allocation of annual leave makes coming to work so much easier.

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Most senior roles ask that we are both. But we need to understand that management and leadership are two different hats and we cannot wear both hats simultaneously!

Knowing the difference between the two can help us to decide, in a given situation, which hat we need to put on, and enable us as we grow in both our management and leadership roles that we have today and aspire to in the future.

Anna Young is an advanced practice nurse in primary care, as well as South Yorkshire non-medical prescribing/independent prescribing development lead for primary care and an advanced practice training programme director for primary care at NHS England’s Regional faculty of Advancing Practice. Ms Young is also a Professional Nursing Committee member for the Royal College of Nursing.