Workshop: The leadership shift—From managing tasks to leading with influence

Editor's Note

Perioperative leaders move the needle when they trade task management for system-level thinking and influence, posited Ivelisse Vicente, MS, RN, NEA-BC, CNOR, RNFA, assistant director of nursing for ambulatory services and DNP student at Old Dominion University, and Nick Rizzo, MS-HSA, RN, CNOR, assistant director of nursing for the operating room at Strong Memorial Hospital, University of Rochester and adjunct professor at Rochester Institute of Technology, at this OR Manager Conference pre-conference workshop. At their institutions, the scale alone demands it, they said.

They started by distinguishing managing from leading. Managers ensure policy, compliance, and daily flow. Leaders set direction and motivate execution over 3 to 5 years, for instance. Vicente described the identity jolt when she moved into assistant director: she had to stop “step[ping] into anybody’s job” and instead “trust the great leaders that [she] had” under her, while she focused on standardization and safety across sites, she said.

Strategic thinking showed up in practical moves. Rizzo said he urges teams to anticipate case complexity, specialty items, vendor needs, and multi-service setups; to plan for high census and equipment downtime; and to use focused huddles with the right people for the right purpose. Simple workflows beat serial phone calls. Red-teaming asks “what could go wrong here,” with a designated contrarian to fight groupthink. A modified Three Horizons view helps leaders act on Now, Next, and Future, while SWOT keeps attention on what is controllable, he explained.

Delegation is a growth engine when done deliberately, they explained, outlining the following: assess the work, assign to the best-fit person, align on outcomes, and account through feedback. They covered the Five Rights of Delegation, including: right task, circumstance, person, direction, and supervision. Leaders match tasks to interests, set SMART goals, and recognize wins to build momentum, they said.

Tackling the sometimes nebulous concept of executive presence, they called it a learned skill, not a trait. Vicente highlighted three pillars: gravitas, communication, and appearance. Gravitas shows up as “grace under fire,” authenticity, emotional intelligence, and business savvy. Communication requires concise, confident delivery and storytelling that connects. Appearance should align to audience and context. Leaders can grow presence by asking for feedback on how their style lands and by learning organizational etiquette and culture.

And trust fuels performance, sustaining every other aspect of leadership growth, they said, urging attendees to create buy-in by treating team members as partners, fostering belonging, simplifying work through small wins, and honoring wellness and flexibility. Conflict, they noted, is inevitable but can strengthen teams when handled with transparency and respect. Drawing from Lencioni’s model, they emphasized being open about personal gaps, surfacing quiet problems, and allowing candid debate without personal attacks. “Accountability grows in those scratchy conversations handled professionally,” they said.

Ultimately, the workshop challenged perioperative leaders to elevate from managing to leading by thinking strategically, delegating with purpose, cultivating executive presence, communicating with impact, and building trust that drives lasting results.