Nurse leaders often function as managers of the care team. They must maintain a continuous balance between cost-effective care and patient safety. As managers of the clinical care team, they sometimes face pushback from staff nurses.

Since nurse managers must implement and facilitate change, they sometimes must work with staff nurses who are resistant to change. Change can be a massive roadblock in nursing- many staff nurses have years of experience and are used to a particular way of delivering care. As the adage goes, "if it ain't broke, don't fix it." However, the many changes in healthcare are implemented because of evidenced-based research, which is continually changing and uncovering improved methods of care.

While change is necessary for healthcare, it can be exhausting for staff nurses. Once a workflow or treatment is learned and mastered, another one comes in to play. It can be mentally draining to change practices continuously, and staff nurses can feel (and demonstrate) resentment with leadership-including nurse leaders.

Another common theme conviction among staff nurses is that nurse leaders do not understand their work. Many times, nurse leaders are not on the "front lines" of healthcare, so decisions that are made without input from staff nurses can be frustrating to them. Sometimes they feel that workflow decisions are too idealistic for what the reality of nursing is. From a staff nurse perspective, it's difficult to know what's happening on a nursing floor when working from an office. Sometimes staff nurses feel like nurse leaders almost "sell out" to the profession, as there is a level of disengagement from bedside nursing.

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From a nurse leader perspective, working more "behind the scenes" in nursing helps facilitate change to improve patient care. They take their clinical expertise and use it to advocate for patients in the leadership arena. They also work to improve efficiency, which helps manage cost. Contrary to popular belief, increased efficiently doesn't always mean less staff. It means finding different treatments and workflows that save time and cost while maintaining patient safety.

Nursing can be a challenging and stressful career. There has historically been, and always will be friction between staff nurses and nurse leaders. It's important to recognize that every member of the healthcare team is there for patients. Patients are why they choose the path they do. Working collaboratively, communicating effectively, and sharing ideas helps reduce friction between the two roles.