FACES OF CRITICAL CARE
Rebecca Reily
Nurse Unit Manager
“Leadership isn’t about having all the answers, but about how you show up for people”
What has been the biggest shift for you moving from bedside nursing into ICU leadership?
The biggest shift has been moving from having somewhat control over a single patient’s care to holding responsibility for the bigger picture. At the bedside, you’re deeply focused on one or two patients: in leadership, you’re constantly balancing the needs of the whole unit, including patients, staff, flow, and safety. You don’t always get the immediate satisfaction of “fixing” something yourself. Instead, your impact comes through supporting others, making decisions with incomplete information, and trusting your team. That shift took some adjustments, but it’s also where you can make the greatest difference.
What does leadership look like on a challenging day in ICU?
On a challenging day, leadership is about being visible, calm, and decisive. It’s checking in with staff who look overwhelmed, stepping in when needed, and balancing ever changing priorities’ even when everything feels urgent. It’s also about creating a sense of psychological safety. A priority for me is making sure people feel supported to speak up, ask for help, or say “this isn’t safe.” Sometimes leadership is very practical, like reallocating resources or troubleshooting flow, and other times it’s simply supporting someone through a tough moment.
What do you think ICU nurses need most right now to feel supported at work?
More than anything, ICU nurses need to feel seen, heard, and valued. That means adequate staffing and resources, flexibility, and being genuinely listened to and involved in decisions that affect their work. Recognition matters, both formal and informal, and so does having access to development opportunities and a clear sense of career progression. Just as importantly, nurses need space to debrief and process the emotional load that comes with critical care. Support isn’t just about fixing problems; it’s about consistently showing that people matter.
Was there a moment in your career that shaped the way you lead today?
Rather than a single moment, it’s been a collection of experiences, both positive and challenging, that have shaped how I lead. Working in high-pressure environments, including global health settings, showed me the importance of adaptability, cultural awareness, and teamwork. I’ve also learned a lot from leaders I’ve worked with, both the ones I’ve tried to emulate and the ones who showed me what I would do differently. Those experiences have reinforced that leadership isn’t about having all the answers, but about how you show up for people, especially in difficult moments, and that transparency builds trust and goes a long way.
How do you look after yourself while leading in such a high-pressure environment?
It’s something I have to be intentional about. For me, it’s about creating clear boundaries between work and home, staying active, and making time for my family. Having young kids forces a bit of perspective and helps me switch off from work. I also rely on strong peer support, people I can debrief with who understand the realities of ICU.