Recent public remarks questioning whether nurses can lead major health institutions have sparked justified outrage across Kenya’s healthcare sector. Yet beyond the indignation lies a more uncomfortable question: if nurses form the backbone of care delivery, why are so few occupying top leadership roles?
This is not a question of capability. It is a question of preparation, perception, and deliberate investment in leadership development especially through structured management and leadership skills development.
Kenya’s history offers compelling evidence that nurses can and do lead at the highest levels. Take Dr Mary Nandili, Director of Nursing Services at the Ministry of Health, who oversees national nursing policy and workforce governance. Or Prof Eunice Ndirangu, Chair of the Nursing Council of Kenya and Dean at Aga Khan University’s School of Nursing, shaping both regulation and academic leadership.
Globally, Kenyan nurses such as Eunice Muringo Kiereini rose to become the first African president of the International Council of Nurses decades ago.
Even at operational levels, leaders like Mary Akai Supat, who manages critical departments and teams in county hospitals, demonstrate that nurses already handle complex leadership responsibilities daily.
The evidence is clear, and the issue is not whether nurses can lead. They already do. The real barrier lies in an invisible ceiling, and how leadership is cultivated or neglected within the profession.
Nursing in Kenya has historically evolved within a structured, hierarchical model. Training emphasises clinical excellence, discipline, and responsiveness. These are essential competencies but they are not sufficient for executive leadership.
When a nurse is promoted, the shift is abrupt. One day they are delivering patient care; the next, they are expected to manage budgets and resources, lead multidisciplinary teams. navigate policy and politics and make strategic decisions under pressure.
Yet these skills are rarely part of formal training. Research on Kenyan hospitals shows that leadership at middle levels is often shaped more by context and experience than by structured development.
The result is a highly competent nurses placed in leadership roles they were never prepared for , seems set up to struggle, and sometimes unfairly labelled ineffective.
Then there is a perception gap. This gap feeds a broader perception challenge. When nurses are not visibly occupying strategic roles, outdated stereotypes persist that they are ‘support staff’ rather than decision-makers.
This perception is reinforced when policymakers overlook professional expertise, leading to recurring tensions around remuneration, recognition, and workforce migration.
Ironically, healthcare systems depend on nurses for continuity, patient experience, and operational stability yet exclude them from the very leadership spaces where these issues are addressed.
If Kenya is to unlock the full leadership potential of its nursing workforce, one intervention stands out; structured, intentional leadership skills development.
Coupled with coaching it translates knowledge into leadership behaviour, which can develop into better self-awareness and emotional intelligence critical for managing teams and patients, decision-making and critical thinking essential for leadership in complex health systems.
Communication and influence to engage doctors, administrators, and policymakers effectively, Strategic thinking to move from task execution to system-level impact, performance management and ability to work under pressure, build resilience and manage their mental wellbeing.
Globally, health systems that integrate leadership coaching into clinical careers are seeing stronger outcomes not just in management, but in patient care, staff retention, and innovation.
In Kenya, initiatives to strengthen nursing and midwifery leadership are already emerging, recognising that technical competence must be complemented by leadership capability.
Another constraint is awareness. Nursing careers today extend far beyond hospital wards into research, public health, policy, education, mental wellness, aviation, correctional services, and global health organisations. Yet many nurses remain confined to traditional pathways.
Breaking into these spaces requires more than qualifications. It demands career clarity, confidence to take risks, ability to articulate impact not just tasks.
This is where leadership skills coaching again becomes critical helping nurses reposition themselves as leaders, not just practitioners.
Closing the leadership gap is not the responsibility of nurses alone, but a shared responsibility.
Healthcare institutions must embed leadership development into career pathways, identify and groom high-potential nurses early, avoid promoting individuals without preparing them for leadership role, and blaming them when they fumble.
Sometimes it seems intentional.
Professional bodies and regulators should also integrate leadership and coaching into curricula and advocate for nurse representation in policy and governance decision making bodies.
Nurses themselves must intentionally take ownership of their career growth, pursue continuous learning beyond clinical skills and step out of comfort zones and into leadership spaces, or opportunities that stretch them. Only those affected by the glass -ceiling can break the glass, and real or perceived impostor syndrome.
Kenya’s healthcare challenges from workforce shortages, lack of basic working resources , low remuneration, delayed salaries to system inefficiencies require leaders who understand care at its most human level. Nurses bring that perspective.
They are closest to patients. They understand the system’s strengths and failures intimately. They operate daily at the intersection of care, coordination, and crisis.
The question is no longer whether nurses can lead. It is whether Kenya is willing to invest deliberately and consistently in preparing them to do so. And yes, a Nurse can lead a healthcare institution, and a CS or PS of health need not be a clinician.
Leadership skills training and coaching may well be the bridge between effective and leadership roles for Nurses.