What to Do When You’re Thrust into the Role and the Pressure Starts to Build
You’re good at your job. Your clinical skills are solid. You’ve built a reputation as someone who gets things done. Then one day, you’re asked to lead.
At first, it feels like an honor. But it doesn’t take long before the weight sets in. People start turning to you for direction, decisions, and solutions. You want to help, but suddenly you’re juggling team dynamics, patient outcomes, and a mountain of expectations you weren’t exactly trained for.
Dr. Ian J. Alexander understands that pressure. In Thrust into Leadership, he speaks directly to people who never set out to be leaders but found themselves in the role anyway. His book offers clarity and guidance to those facing the very real challenges of leading small teams in high-stakes healthcare settings.
Here’s what Dr. Alexander wants new leaders to know when the job feels like more than they bargained for.
- You Don’t Need to Know Everything
There’s this quiet pressure in medicine to always look like you’re in control. That pressure doubles when you become a leader. Everyone expects answers, quick decisions, and perfect composure.
But here’s the truth. Nobody has it all figured out. Dr. Alexander points out that being honest about what you don’t know can actually strengthen your team’s trust in you. When leaders admit uncertainty and ask for help, they invite collaboration. It shows confidence, not weakness. It builds credibility and encourages a culture of openness.
You’re not failing your team by asking questions.
- Stop Trying to Do Everything Yourself
Most doctors and allied health professionals are used to working hard and handling things independently. That mindset often gets them noticed and promoted. But once you’re in a leadership role, doing everything yourself just doesn’t work.
Dr. Alexander illustrates this with a fictional example of Solo Hero, a leader who refuses to delegate and ends up overworked and isolated. In contrast, Heavenly Patience trusts her team, shares responsibility, and creates space for others to grow. Her team thrives because she believes in them.
Delegation is not about passing off tasks. It’s about giving people the opportunity to learn, contribute, and lead. When you stop trying to carry it all, you give your team room to shine.
- Conflict Is Inevitable. How You Handle It Matters.
Frustration in healthcare is common. Delays, policy changes, missing equipment, and communication breakdowns are part of the job. The key, Dr. Alexander says, is not whether you feel frustrated, but how you express it.
Yelling, blaming, or making passive-aggressive comments can feel like a release in the moment, but they almost always cause more harm than good. Instead, take a pause. Give yourself a chance to breathe. Then approach the situation with a calm, problem-solving mindset.
If there’s a serious issue that needs to be addressed, do it privately. Focus on the behavior, not the person. Be specific, respectful, and solution-focused. People won’t remember every word you said, but they will remember how you made them feel.
- Burnout Can Sneak Up on You
Leadership adds emotional weight. You’re carrying not only your own stress, but also your team’s needs and expectations. Over time, that load can wear you down.
Dr. Alexander doesn’t sugarcoat it. Burnout is real, and it can happen even to those who love their job. Leaders need to take care of themselves too. That might mean setting boundaries, taking time off, or having honest conversations about workload and support.
If you find yourself constantly tired, detached, or asking, “Why am I doing this?”—those are signs to take seriously. Leadership is a marathon, not a sprint. Protect your energy and well-being so you can lead with clarity and compassion.
- Trust is Built Through Small Moments
Earning your team’s trust doesn’t come from having a title. It comes from the way you show up consistently. Dr. Alexander encourages leaders to learn names, say thank you often, and give credit where it’s due.
A kind word in the hallway. Public praise for a job well done. Listening without interrupting. These things add up. They create a culture where people feel valued and safe to speak up.
Trust takes time to build, but it starts with intentional daily choices. Be the kind of leader people can count on, even when times are tough.
- Uncertainty Is Part of the Job
Sometimes the hardest part of leading is not knowing what’s coming next. Plans change, systems fail, or unexpected problems arise. You may not always have control, but you can still offer stability.
Dr. Alexander’s advice is to communicate often, even if your message is simple. Let your team know what you do know. Be transparent about what’s uncertain. Just hearing, “We’re figuring this out together,” can help your team feel more secure.
You don’t have to be the hero in every situation. You just have to be present and willing to work through it with your team.
Leadership challenges aren’t something you conquer once and move on from. They show up again and again in different forms. What Dr. Ian J. Alexander offers is not a quick fix, but a mindset. His book reminds us that great leaders aren’t perfect—they’re intentional, self-aware, and committed to learning.
Whether you’re new to leadership or just trying to do it better, the tools in Thrust into Leadership are practical, encouraging, and grounded in real experience. At the end of the day, leadership in healthcare is about people. If you care, if you listen, and if you stay open to growth, you’re already on the right path.
