Nurse managers across health and social care settings are reporting growing anxiety about fulfilling core leadership responsibilities such as addressing performance concerns, challenging unsafe practice, or making difficult operational decisions (Norman et al, 2025; Gruebling et al, 2025; Royal College of Nursing, 2025).

Many describe feeling increasingly vulnerable to grievances, accusations of bullying, or potential legal consequences, even when acting within organisational policy and in the interests of patient safety – something which is only compounded by inconsistent and conflicting HR advice, often in the most difficult cases.

This perceived personal risk can lead to hesitation, avoidance, and inconsistent management, which may undermine team functioning, morale, and care standards.

At the same time, staff must have confidence that concerns about bullying, discrimination, or unfair treatment will be taken seriously. Robust, transparent processes for reporting and investigating such issues remain essential for a safe and respectful workplace. Managerial authority has the potential to feel intimidating, and some difficult conversations could be being handled without sufficient psychological safety or trauma‑informed practice (Royal College of Nursing, no date).

A balanced approach recognises that both perspectives hold legitimacy. Nurse managers need clear guidance, fair processes, and organisational support to lead confidently and compassionately. Staff need assurance that they can speak up without fear.

References

Gruebling N, Seymour B, Darling T and Ray J (2025) Priorities for Nurse Managers, Nurse Leader, 23(4), 102421. doi: 10.1016/j.mnl.2025.03.005.

Norman K, Lewis A and Carter L (2025) The role of the nurse leader in facilitating effective support and communication to raise concerns, British Journal of Nursing, 34(3), pp. 154-158. doi: 10.12968/bjon.2024.0170.

Royal College of Nursing (2025) RCN warns of workforce shortages causing nightmares and panic attacks. Available at: rcn.org.uk/news-and-events/news/uk-rcn-warns-of-workforce-shortages-causing-nightmares-and-panic-attacks-171125 (Accessed 7 April 2026).

Royal College of Nursing (no date) Psychological Safety. Available at: rcn.org.uk/About-us/Equity-diversity-and-inclusion/Taking-time-to-talk/Important-concepts-to-understand/Psychological-safety (Accessed 7 April 2026).

Further Reading

Department of Health and Social Care (2024) Leading the NHS: proposals to regulate NHS managers. Available at: gov.uk/government/consultations/leading-the-nhs-proposals-to-regulate-nhs-managers (Accessed 7 April 2026).

Nursing and Midwifery Council (2024) Good leadership means better care. Available at: nmc.org.uk/standards/guidance/good-leadership-means-better-care (Accessed 7 April 2026).

Quinn B (2024) How to manage being bullied as a nurse leader, Nursing Management, 31(6), pp. 17-21. doi: 10.7748/nm.2024.e2129.

Royal College of Nursing (2026) Bullying and harassment: Advice Guide. Available at: rcn.org.uk/get-help/rcn-advice/bullying-and-harassment (Accessed 7 April 2026).

Royal College of Nursing (2026) Grievance: Advice Guide. Available at: rcn.org.uk/get-help/rcn-advice/grievance (Accessed 7 April 2026).

Royal College of Nursing (2026) Raising Concerns Toolkit. Available at: rcn.org.uk/employment-and-pay/raising-concerns/raising-concerns-toolkit (Accessed 7 April 2026).

Royal College of Nursing (2025) Nursing Workforce Standards. Available at: shbn.org.uk/wp-content/uploads/2021/05/RCN-Nursing-Workforce-Standards.pdf (Accessed 7 April 2026).

Royal College of Nursing (2025) Working in understaffed services is making nurses sick. Available at: rcn.org.uk/magazines/News/Working-in-understaffed-services-is-making-nurses-sick (Accessed 7 April 2026).

Royal College of Nursing (2024) How to tackle workplace bullying. Available at: rcn.org.uk/magazines/Advice/2024/Apr/How-to-tackle-workplace-bullying (Accessed 7 April 2026).

Somerton K (2025) Fostering psychological safety as part of effective nurse leadership, Nursing Standard, 40(12), pp. 68-73. doi: 10.7748/ns.2025.e12486.

Trivedi S S (2026) Nurse at centre of "witch-hunt" describes six-year NMC case ordeal. Available at: rcni.com/nursing-standard/newsroom/news/nurse-centre-of-witch-hunt-describes-six-year-nmc-case-ordeal-221761 (Accessed 7 April 2026).