A leadership pipeline hiding in plain sight
Healthcare does not have a leadership shortage. It has a recognition problem.
Across Australia, nurses represent one of the most experienced, adaptable, and system-aware workforces in healthcare. Yet despite this, many remain underutilised when it comes to leadership and business roles.
Lisa Lucas, founder and CEO of The Hive Nursing Development, believes the issue is not capability, but recognition.
“Healthcare creates really great clinicians, but it doesn’t support them to become leaders. It’s a sink or swim system. If you’re a great clinician, you might get promoted into a management role, but you’re not given the training or support to succeed.”
Skills built at the bedside
The capabilities developed in nursing extend far beyond clinical care. Nurses are trained to make decisions under pressure, manage competing priorities, and navigate complex human situations in real time. These are not just clinical skills; they are core leadership capabilities.
In most industries, that would be recognised as leadership.
I think nurses are looking for a way to use their skills to do something different,” Lisa says.
“We’re adaptive, proactive, great critical thinkers, and quite innovative because we have to make things work when they’re not working.”
These are the same attributes organisations spend years trying to build in leadership teams. Yet in healthcare, they are often confined to clinical environments rather than developed into broader leadership capability.
A system that fails to develop its own leaders
The gap becomes most visible at the point of progression.
Lisa describes a system where progression often comes without preparation. Without guidance in areas such as financial management, team leadership, and organisational strategy, many nurses are left to navigate leadership roles alone.
Often, without support.
The jump between roles can be huge, especially moving into senior positions, and there’s nothing really bridging that gap. They’re missing out on incredible leaders.”
The result is not just burnout, but lost opportunity. The gap is not a lack of capability, but a lack of structured support to turn clinical expertise into leadership capability.
From clinical expertise to leadership in practice
As traditional pathways fall short, many nurses are creating their own. Instead of waiting for structured progression, they are moving into leadership and business, building services, practices, and new models of care that draw directly on their clinical experience.
In doing so, they are not leaving healthcare, they are reshaping it.
In many cases, this includes building businesses, private practices, and new service models that operate outside traditional healthcare structures.
“There’s a small portion who are redesigning their careers,” Lisa says.
A lot of nurses get stuck in the mindset that this is what nursing has to look like, and if they don’t fit that, they think they need to leave altogether. Many don’t want to stop being nurses because it becomes part of your identity.”
What has changed is the visibility of alternative pathways.
“Ten years ago, that wasn’t really a pathway people considered. Now nurses are seeing that they don’t need to retrain completely, they can build on what they already have and step into something new.”
Lisa has seen this shift play out directly in her work with nurses navigating their next step. In one case, a nurse who initially doubted her ability to progress went on to become a nurse practitioner after receiving the right guidance and support. In another, a midwife transitioned from working within someone else’s private practice to establishing her own, creating a model of care that better aligned with how she wanted to support new mothers.
These are not isolated outcomes, but examples of what becomes possible when clinical experience is paired with the right direction and support.
Unlocking leadership through support
Lisa’s experience highlights a clear gap and a clear opportunity. If support is what enabled her to progress, its absence is what is holding others back.
That’s the difference.
When I looked deeper, I realised the difference was the support I had, the mentors and people I could turn to for guidance.”
Without that structure, many nurses are left to navigate their careers alone, often leading to disengagement or leaving the profession altogether. Lisa has seen this pattern repeatedly, with capable nurses stepping away rather than moving into leadership roles.
The implication for healthcare leaders is straightforward. Mentorship, structured development, and clearer pathways are not optional extras, they are essential to retaining talent and building leadership capability from within.
What healthcare is at risk of losing
The implications extend beyond individual careers. Because this is not just about workforce.
When nurses are not supported to grow into leadership roles, healthcare systems lose more than workforce capacity. They lose deep clinical insight, operational understanding, and the ability to develop leaders from within.
“That means healthcare loses people with years of experience and deep understanding of patient care.”
At the same time, retention continues to decline.
We’re also seeing the length of time nurses stay in the profession decreasing. If you can’t retain nurses long enough, you can’t develop future leaders. If we don’t support nurses, we’re going to see a continued decline in the workforce.”
From underutilised to essential
The conversation around nursing often focuses on shortages. But the more pressing issue may be how the profession is being used.
Healthcare does not lack leadership potential. It is failing to fully recognise and develop it.
Nurses are not just a critical part of the system. They are one of its most underutilised leadership assets.
The question is no longer whether nurses can lead.
It’s whether healthcare is willing to invest in them.
Source:
The Hive Nursing Development, Nurses Growing Nurses. https://www.thehivedevelopment.com.au/
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