The First 90 Days: Your Blueprint for New Nursing Leadership Success

When you step into a new nursing leadership role, the clock starts ticking immediately. Research consistently shows that leaders establish their reputation within the first 90 days—and here's the truth: it's far easier to build credibility from the start than to rebuild it later.

After over 30 years in nursing, I've learned that those initial three months aren't just important—they're everything. Let me walk you through a strategic approach that will set you up for long-term success.

Why These 90 Days Are Critical

Think of your first 90 days as a critical window of credibility. Your team is watching, stakeholders are evaluating, and you're forming the foundation of every relationship that will define your leadership. This isn't about making a splash with dramatic changes—it's about investing time wisely in understanding your new environment before you reshape it.

Weeks 1-2: Lead with Your Ears, Not Your Mouth

Your first mission is simple but powerful: listen more than you speak.

I call this the "Listening Tour," and it's non-negotiable. Before you change a single policy or process, you need to understand the landscape you're working with. Schedule individual conversations with every staff member, key stakeholders including physicians and other department managers, and if possible, connect with the previous manager or a trusted mentor who knows the unit's history.

Questions that build trust:

• "Tell me about your role and what you need to be successful"

• "What's working well on this unit?"

• "If you could change one thing, what would it be?"

• "What should I know about the culture here?"

• "How can I best support you?"

These aren't just pleasantries—they're intelligence gathering. You're learning the spoken and unspoken rules, identifying champions and resisters, and most importantly, showing your team that their voices matter.

Month 1: Demonstrate Competence with Quick Wins

By the end of your first month, identify two or three small problems you can solve relatively quickly. These quick wins demonstrate both your competence and your commitment to making things better.

Some examples that work well: fixing a broken supply ordering process, implementing daily huddles to improve communication, addressing a persistent staff complaint that's been ignored, or recognizing excellent performance that's gone unnoticed.

The key here is choosing wins that are visible, achievable, and meaningful to your staff. You're not trying to revolutionize everything at once—you're proving you can deliver on what you promise.

Month 2: Build Your Leadership Coalition

Every successful unit has key players who make things happen, whether or not they have formal titles. Your job in month two is to identify and cultivate relationships with these essential people.

Look for:

• The Informal Leader – respected by peers, influences opinions

• The Veteran – knows every unwritten rule and historical context

• The Innovator – always thinking of better ways to do things

• The Connector – facilitates relationships across teams

At the same time, stay alert to warning signs: staff who undermine decisions, cliques creating division, time-wasting processes, and communication breakdowns between shifts. You don't need to fix everything immediately, but you need to know where the fault lines are.

Month 3: Lay Your Foundation

By the end of 90 days, you should have accomplished several critical objectives. You've established trust with key team members, identified major challenges and opportunities, created initial improvement plans, and begun implementing your authentic leadership style.

This is when you present your six-month vision to the staff, establish regular meeting rhythms and communication channels, and launch your first significant process improvements. You've moved from observer to active leader, and your team should feel confident in the direction you're setting.

Your 90-Day Action Plan

Weeks 1-2:

• Introduce yourself personally to every team member

• Schedule stakeholder meetings

• Review policies, procedures, and performance data

• Observe operations across all shifts

Month 1:

• Complete your listening tour

• Implement at least one quick win

• Establish regular communication patterns

• Master your unit's budget and key metrics

Month 2:

• Conduct one-on-one meetings with each staff member

• Strengthen physician partnerships

• Address urgent performance or culture concerns

• Prioritize unit improvement areas

Month 3:

• Share your vision with the team

• Solidify communication channels and meeting schedules

• Launch process improvements

• Complete initial staff evaluations or check-ins

Mapping Your Stakeholders

Create a visual representation of everyone who influences your unit's success. Your inner circle includes direct reports and daily partners. Your influence circle encompasses key physicians, fellow managers, and support staff. Your information circle reaches administration, quality teams, and educators. Understanding these relationships helps you navigate the political landscape and build the alliances you need.

Reflection Questions to Guide You

Throughout these 90 days, regularly ask yourself:

• How am I balancing approachability with authority?

• What assumptions have proven incorrect, and what have I learned?

• Who are my key allies, and how can I strengthen those partnerships?

The Bottom Line

Your first 90 days aren't about having all the answers—they're about asking the right questions, building authentic relationships, and demonstrating through small wins that you're the leader your team needs. Take this time seriously, invest it wisely, and you'll establish a foundation of credibility that will serve you throughout your entire leadership journey.

Remember: you don't get a second chance to make a first impression, but with the right approach, your first impression can launch years of successful, fulfilling leadership.

Are you a new nursing leader preparing for your first 90 days? What challenges are you facing in this transition? For more tips get my free eBook- The Nurse Manager Success Blueprint.