Lesley Doherty, chief executive of Bolton NHS Foundation Trust, talks about how to work as a successful nurse leader
“More nurses should be managers,” says Lesley Doherty, chief executive of Bolton NHS Foundation Trust. “It would sort the NHS out if they were.”
According to Lesley Doherty, chief executive of The Royal Bolton Hospital NHS Foundation Trust, nurses make excellent managers because of the resilience and empathy they learn on the job.
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Ms Doherty started her training as a nurse in 1976, qualified in 1979, did midwifery and immediately was drawn to neonatal nursing.
“I got the neonates bug in that job,” she said. “And that was where I did most of my clinical care.”
But she was always keen to get involved in management and by the time she was 24, she was a sister. “I always wanted to find ways to increase my footprint and make the biggest difference for patients, and management was my way of doing that,” she says.
But for her, the best management training she ever did was being a Royal College of Midwives steward. “I did a two-week course at Keele University, and it was the best management and training ever. It gave me a real insight into employment law and management. It also taught me pragmatism and an ability to see both points of view.”
She also became active in the Neonatal Nurses’ Association and says that being involved in professional associations, such as unions and bodies such as this, offers huge learning opportunities in terms of management.
“At the RCM, I learnt negotiating skills and speaking on behalf of other people, and I never lost an appeal,” she says. “It also exposed me to external drivers and taught me techniques that I still use today. I didn’t learn how to read a balance sheet and about EBITDA when I was director of nursing, but when I was working for the Neonatal Nurses’ Association.
Her move into a director of nursing role was led by a belief that once more she could increase the impact of her influence. “I remember going to my regional nurse and telling her I wanted to be director of nursing. “She told me: ‘You and lots of other people.’ But I told her then I would be a director of nursing.” In 1998, she became director of nursing at Burnley.
According to Ms Doherty, it is all about taking a leap of faith in yourself for enhancing your career, and others showing that confidence in you.
“I quite often look at other people’s jobs and think I can do them, but when you get there it’s different of course. I knew nothing about waiting lists and management issues, but I knew that I could apply common sense. That’s what nurses do when they become manager’s – they often take on a troubleshooter role, learning on the job and that’s really helpful.”
Ms Doherty’s tips for people who think they fancy a management post is to ask to shadow the role they are interested in. “I’ve never been turned down when I’ve asked someone to do this. I may have to wait a while for them to fit me in, but they always say yes.”
It may seem like she has led a charmed career but there have been jobs she hasn’t been successful in getting. “I didn’t get one once after Burnley merged, but I got some of the best advice I ever received, and that was to hold my head up high, keep dignified and don’t look bitter or blame the world when something doesn’t go your way.”
Of course, she then went on to become director of nursing at Bolton Royal in 2003.
She also didn’t get the first chief executive job she applied for, and the feedback she got then was just as valuable. “I think as nurses, sometimes, we lack self belief and that lack of self confidence came through in my interview.”
“I’d done a course to see if I wanted to be a chief executive and I was surrounded by people who knew they wanted to do it. I suppose I wasn’t sure and part of that was worrying that I couldn’t do it. But it’s silly to think that – a financial director who becomes chief executive can’t gain clinical knowledge or insight, so it stands to reason that a clinician who becomes chief executive can and will learn other skills. That course taught me about the importance of putting the right team around you is how you fill those gaps.”
When she did get a chief executive post in the very trust she was working, she said that her nursing career proved very useful. “I’ve learnt to draw on my inner resources of experience and resilience when I had a sick child in front of me and I do that now as a chief executive and you find yourselves, like we are now as an organsation, in breach of our FT authorisation using all those skills to support my team to find a way through. Nurses’ backgrounds shows we can focus in adversity.”
She believes that nurses have tremendous skills and just need to be confident at deploying them in the workplace. “I met one nurse who said she couldn’t run a business unit but she ran three Slimming World groups to make extra money in her own time. That takes organisation and skill, but she didn’t realise it was a transferable skill.”
She also believes that having the ability to see things from a clinical perspective makes you a great addition to the board. “If you can’t influence the board and make them think about quality, you’re in the wrong job. You should be able to bring the clinical view even if you’re talking about finance. You have to be able to influence the agenda.”
Her final advice for aspiring leaders is to be kind to your own boss. “If you don’t like what your manager is doing, then put yourself in their shoes and think about how you’d do things differently and consider what you’d want your staff to do, and then influence that. Your manager’s success is your success.”