First 90 Days: Don't Panic, It's Just Your Dream Job

You did it! After years of hard work, countless prayers, and maybe a few sleepless nights wondering if you were ready, you've landed your dream leadership position. Now you're sitting at your new desk, staring at your imposing calendar, and fighting the urge to hide under said desk. First things first: breathe. As someone who's navigated multiple leadership transitions across healthcare organizations, I'm here to tell you that those butterflies in your stomach? They're actually your friends.

Remember: God Doesn't Call the Qualified, He Qualifies the Called

Before we dive into the practical strategies, let's address the elephant in the room – that nagging voice wondering if you're really ready for this. Here's the truth: leadership isn't about knowing everything; it's about being willing to learn everything. When I stepped into my first executive role, my prayer journal looked like a mix between a strategic plan and a desperate plea for wisdom. Spoiler alert: Both were exactly what I needed.

Your First 90 Days: A Roadmap (Not a Race)

Days 1-30: The Listening Tour

Stop, Look, and Listen: Your first month isn't about making waves; it's about understanding the waters. Schedule one-on-ones with your team members, peers, and key stakeholders. Yes, all of them. Your calendar will hate you, but your future self will thank you.
Document Everything: Keep a journal of observations, insights, and questions. Pattern recognition is your new superpower.
Quick Wins vs. Quick Fixes: Resist the urge to change everything immediately. However, if you spot small, easily fixable issues that cause daily frustration, addressing them can build early credibility.

Pro Tip: I once kept a "quick win" list on my office whiteboard. My team started adding their own suggestions, turning it into an impromptu collaboration tool. Sometimes the best management strategies happen by accident!

Days 31-60: Finding Your Rhythm

Establish Your Communication Style: Be clear about your expectations, but also about your values. When I transitioned to one role, I started each meeting with a brief "why we're here" moment, connecting our daily work to our mission of serving others.
Build Your Support Network: Find mentors, both within and outside your organization. And yes, it's okay to have a "leadership support group" where you can safely admit you're not sure what you're doing sometimes.
Start Shaping Your Vision: By now, patterns should be emerging. What's working? What isn't? Where can you add unique value?

Reality Check: Remember that time I tried to implement a new reporting system in week six? Let's just say there's a reason this section isn't called "Completely Revolutionize Everything."

Days 61-90: Finding Your Stride

Strategic Priority Setting: You've listened, learned, and likely identified several areas needing attention. Now it's time to prioritize and create an action plan.
Team Empowerment: Start delegating more significantly. Your role is to remove obstacles and provide resources, not to do everything yourself.
Measure and Celebrate Progress: Set clear metrics for success, but don't forget to celebrate small wins along the way.

The Hidden Curriculum: What They Don't Tell You

1. Emotional Intelligence is Your Secret Weapon

Your technical skills got you here, but your emotional intelligence will help you succeed. Learn to read the room, understand subtext, and navigate office dynamics. And yes, sometimes this means pretending not to notice when someone brings the same issue to three different meetings hoping for a different answer.

2. Culture is Everything

You can have the best strategies and plans, but if they don't align with your organization's culture, they won't stick. Take time to understand the cultural dynamics at play. When I joined HealthCatalyst, I spent considerable time understanding how their data-driven culture could be balanced with the human element of healthcare.

3. Self-Care Isn't Selfish

Schedule time for reflection, exercise, and family. Your team needs you at your best, not your most burned out. I learned this lesson the hard way during my transition to my first VP role – turns out running on coffee and determination isn't actually a sustainable leadership strategy.

Common Pitfalls to Avoid

The Superhero Complex: You don't have to save everything yourself. In fact, trying to do so will probably make things worse.
Analysis Paralysis: Yes, gather data. No, don't wait for perfect information before making decisions.
Forgetting Your Roots: Just because you're in leadership doesn't mean you stop being a nurse, technician, or whatever got you here.
Neglecting Prayer and Reflection: In the rush of new responsibilities, don't forget to maintain your spiritual center.

Moving Forward with Grace

Remember, leadership is a journey, not a destination. There will be days when you feel like you're conquering the world, and days when you wonder if your predecessor would notice if you snuck their nameplate back onto the door. Both are normal.

The key is to approach each day with humility, grace, and a willingness to learn. Keep your mission front and center, your team close, and your sense of humor closer. And when in doubt, remember that even Moses probably had moments where he wondered if he should have stuck with shepherding.

Final Thoughts

Your first 90 days are just the beginning of your leadership journey. Focus on building relationships, understanding your environment, and setting a foundation for long-term success. And remember, that knot in your stomach? It means you care. Use it as fuel for growth, not fear.

Leadership is a privilege, a responsibility, and sometimes a wild adventure. Embrace it all, and don't forget to document the journey – someone else will need your wisdom someday.

About the Author:

Sarah Roberts, DNP, MSN, MBA, RN, NE-BC, OMC, is a dynamic healthcare executive with extensive experience in clinical operations, telehealth, and healthcare analytics. Currently serving as Senior Vice President of Clinic Practice Operations at HealthCatalyst, she brings a wealth of experience in leading large-scale healthcare initiatives and fostering innovation in patient care. Sarah combines her clinical expertise with business acumen to drive organizational success while maintaining a focus on compassionate, patient-centered care. When she's not transforming healthcare operations, you might find her mentoring the next generation of nurse leaders or contributing to various nursing advisory boards. She firmly believes that effective healthcare leadership requires both data-driven decision-making and a heart for service.