You Set the Tone: A Tutorial in Nurse Leadership by Example

You Set the Tone: A Tutorial in Nurse Leadership by Example

Moxie Scrubs
4 minute read

Written by Ann McMahon, RGN, BA, MA

Before I was a seasoned nurse, I learned about nurses and the healthcare field from watching television shows such as ER. Sadly, I’ve never crossed paths with George Clooney (yet), but I have found that the stories depicted on ER felt realistic. 

One scene from the show that I have never forgotten was when the inspirational leader of the ER, Dr. Mark Greene passed the baton to his successor, Dr. John Carter, with four little words, “You set the tone Carter, you set the tone.” Those words taught me all I needed to know about leadership, especially in the nursing profession. “Setting the tone” involves acting as a prototype for others, simply by being and behaving the way you would like others to be and behave. Consequently, they will resonate with you, and follow your lead.  


Throughout my career, I have had many managers, some I considered good, some bad, and some mediocre. What sets the good managers apart from the pack is not their breadth or depth of clinical knowledge, their organizational skills, or even their years of experience. What makes a good manager is their ability to set the tone for their unit, department, or hospital. 

Leaders must embody the role. Maya Angelou said it best, “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” If a leader makes you feel respected - they will gain the respect of their nursing staff. If a leader values your opinion, you will value theirs. If managers demonstrate that they are part of the team, then their team is more likely to engage in teamwork behaviors. 

The leadership team on a unit can make or break the culture in the work environment. It doesn’t matter which specialty of nursing- if the management team is considered incompetent or promotes a negative culture, it’s unlikely the nurses on the unit will be happy and engaged. 

Patient Care

Dr. Greene’s words are a good maxim to live by. Patients can unconsciously pick up on the healthcare team’s body language and tone of voice. You can de-escalate complicated situations by remaining calm and regulating your tone. As a nurse, you’re undoubtedly aware that your confidence and knowledge about a topic can ease the anxiety of patients. Preparing patients with what to expect prior to a procedure can completely change their experience. Patients will follow your lead.

Family life

If you’re a parent, you set the tone for your family every minute of every day through daily activities such as parenting, cooking, and managing the home. Is the tone casual, authoritarian, organized, or chaotic? The kids will notice how you react to a messy bathroom or burned dinner. This is what sets the tone for your family.


How you set the tone for your own life also matters一in fact it is paramount. Do you live to work, or work to live? Do you practice self-care, take time out, and get enough rest and sleep? Are you dealing with your work stresses, or do they come home with you? Do you know and state your boundaries as an employee, or is your life driven by the needs of an institution? Make yourself a cup of tea or coffee and spend 10 minutes thinking or writing about these questions.

Dr. John Carter evolved from a bumbling novice to a noble leader who set an exemplary tone in his fictional ER. He was considered friendly, approachable, a fantastic teacher, stern when the situation required, clinically knowledgeable, and always compassionate. His successor, Archie Morris, was frankly so forgettable I had to Google him. I like to think he improved over time and set a worthy tone. I know that he tried. Every day and every shift, we try to do better.

About the Author

Ann McMahon, RGN, BA, MA is a health and wellness writer, general practice nurse, and coach at When not wearing one of her professional hats she likes to take walks in the countryside with or without one of her five children.

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