The First Pushback: Lessons from My Early Days in Leadership
As I’ve begun re-listening to The First 90 Days, I can’t help but laugh at myself. There’s something humbling about looking back on those early transitions into leadership—the moments that felt chaotic then but taught me the most about who I was (and wasn’t yet) as a leader.
Before I ever wore a stethoscope, I held a management title. Nothing major—just a small team, limited responsibility, and plenty of room for rookie mistakes. Fast forward a few years, and I was deep into my hospice career. I had worked my way up through the ranks and finally landed in a management role that felt both exciting and terrifying.
About a year in, everything changed.
The agency went through a drastic shift—mass turnover, new structure, and suddenly I was handed a slew of new responsibilities and direct reports. I was now not only managing a team but also filling gaps, covering cases, fielding on-calls, and doing whatever was needed to keep the wheels turning.
And right in the middle of all that—entered her.
The Nurse Who Taught Me More Than Any Leadership Book
She was an incredible nurse—skilled, respected, and loved by patients and staff alike. But she was also one of the most challenging people I had ever managed.
She was outspoken, opinionated, and often insubordinate. The kind of nurse who didn’t just push boundaries—she redefined them. To make things even more complex, she was an LPN in a world that required RNs to case manage, so her limitations within policy often clashed with her confidence in practice.
Our early interactions were… spirited, to say the least.
She had a habit of speaking her mind, and I had a habit of standing my ground. It was my first real test as a leader—to balance respect for her expertise with the accountability required for my role. I quickly realized that no one had ever told her “no.” People just went along because it was easier.
Until me.
When her annual review came around, I was tasked with giving honest feedback. It was tense, uncomfortable, and absolutely not well received. She was defensive, argumentative, and every other challenging adjective you could imagine. But I stood firm—and respectful.
And somehow, that moment changed everything.
The Turning Point
Months later, during yet another agency realignment, leadership reshuffled reporting structures. On paper, she was supposed to move to another manager. But then my boss walked into my office and said, “She’s requesting to stay under you.”
I was stunned.
I thought she despised me. But that wasn’t the truth.
She didn’t like me because I had challenged her. But she respected me because I did.
And that respect became the foundation of a working relationship I never expected to succeed.
What That Experience Taught Me About Leadership
Leadership isn’t about being liked.
It’s not about being right.
It’s about being real—and being consistent enough to earn trust even when you’re the last person someone wants to hear from.
You will lead people from all walks of life. Some you’ll instantly connect with. Others will take time. And a few will test every ounce of your patience. But in all those relationships lies an opportunity—to grow, to coach, to understand.
That nurse taught me that pushback isn’t always defiance. Sometimes it’s defense. Sometimes it’s a test to see if your words match your actions. And sometimes, it’s the very moment when respect begins to grow.
Final Thought
If I could go back and tell my younger self one thing, it would be this:
Don’t fear the tension.
Don’t avoid the uncomfortable conversations.
The people who challenge you the most may just be the ones who teach you what leadership truly is.
Because leadership isn’t about control—it’s about courage.
And sometimes, courage sounds a lot like quiet confidence in the middle of a loud conversation.
