Leadership onboarding, development, and succession planning is something I’ve cared deeply about for a long time. My original Master’s capstone was focused on this exact topic, and I spent years working closely with leaders across healthcare and academic settings. What I saw again and again was this: when new leaders are set up to succeed, everything around them improves. But when they’re not, the costs ripple far beyond the individual.

The Myth of the Natural Leader

Many organizations promote high performers into leadership roles simply because they excel at their current jobs. They are problem solvers. They care deeply. They want to help.

But leadership is not just the next rung on a ladder. It’s a different job entirely, with its own skill set, expectations, and emotional demands. We often assume people will “figure it out” once they get there. We hope their commitment will be enough. Though the majority who step into leadership are wildly intelligent, capable, and driven, there are aspects of leading in complex organizations that no one could possibly just ‘know’.

This sets new leaders up to survive, not thrive. And once someone starts in survival mode, it’s very difficult to shift out of it.

(is Freja digging for answers or hiding from overwhelm? Both common for a new leader!)

The Reality of Unprepared Leaders

New leaders often step into roles without the tools they need to lead effectively. They’re navigating system complexities, team dynamics, performance issues, and organizational politics, all while trying to onboard themselves.

They don’t yet know how to give effective feedback, how to manage up and down, how to prioritize under pressure, or how to set boundaries. They are immediately caught in the noise, and that noise becomes their new normal.

Instead of stepping into the visionary, people-centered leadership they imagined, they learn to cope. Their optimism turns into exhaustion. Their compassion turns into frustration. Eventually, they burn out or leave entirely.

This is how we lose our most caring, driven people.

I once facilitated a workshop for a group of clinical leaders, each of whom had between 50 and 200 direct reports. These leaders rarely had a chance to connect with one another in an open or safe space, even though they were doing similar work across the system.

During the session, the conversation organically shifted into a vulnerable reflection. Every single one of them admitted they had felt completely overwhelmed and underprepared from day one. While they were confident in the technical aspects of the work, no one had prepared them for how little of that they would be doing. Instead, they found themselves consumed with people management, system breakdowns, and performance issues.

The word “bamboozled” resonated with many of them to describe how they ended up in the role. But here’s what struck me: once they had the space to connect honestly, the tone shifted and they quickly moved from commiserating to collaborating. They started building solutions together. The skill, care, and intelligence were never the issue; what they lacked was time, tools, and autonomy.

The Cost to Organizations

When leadership onboarding is overlooked or treated like a formality, organizations suffer:

– Quality of work or care decreases as efficiency declines.
– Turnover increases due to misaligned expectations and burnout.
– Innovation slows because no one has capacity to think strategically.
– Organizational culture erodes when leadership becomes reactive instead of intentional.

These impacts are often brushed aside as personal shortcomings and a new leader is ushered in. In reality, they are structural failures and the pattern will repeat.

Why This Work Matters

I’ve had the privilege of supporting some of the most fiercely compassionate and intelligent leaders in healthcare. Many stepped into their roles because they couldn’t bear to watch their teams struggle. They wanted to help, to do better, to be the change.

But they weren’t given the support they needed to carry that responsibility well.

If I could do one thing with my career, it would be to design meaningful, sustainable systems to onboard, support, and grow leaders. Because when we invest in our leaders, we invest in everyone they influence and support.

Leadership onboarding is not a luxury. It’s not a checklist. It’s a long-term strategy for organizational health and sustainability.

Up Next In this Series:

This is the first in a four-part series exploring how we can better support and grow leadership capacity across organizations.

– Part 2: How to Support a New Leader Through Onboarding
– Part 3: How to Onboard Yourself as a New Leader
– Part 4: Rethinking Succession Planning

Throughout the series, I’ll draw on a blend of personal experience and practical frameworks, including LEADS in a Caring Environment, McKinsey’s Influence Model, and The Leadership Pipeline. These models offer a structured way to think about leadership growth while staying grounded in real-world challenges.

Whether you are a new leader, someone supporting one, or responsible for shaping leadership development across your organization, I hope this series helps you see what’s possible when we choose to invest in our people: intentionally, consistently, and with care.

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• Making Strategy Human: Finding meaning in the metrics
• Leader Succession Planning
• Learning From Both Sides of the Classroom
• Morning Thoughts