The Nurse Executive: Rules of Negotiation
Nurses are often expected to lead teams, manage complex systems, and advocate for patients and teams—without ever being taught how to negotiate. Unlike their colleagues in business, medicine, or administration, most nurse leaders have never received formal training in negotiation strategy. Yet it’s one of the most powerful skills we can bring to the table.
Whether you’re negotiating your salary, project resources, department scope, or organizational priorities, knowing how to negotiate—strategically and ethically—can reshape your influence and impact.
Below are the top rules I’ve taught to nurse executives, grounded in evidence and real-world leadership.
1. Everything is Negotiable
If it matters to you, it’s worth a conversation. Don’t assume boundaries are fixed just because no one has questioned them before.
Tip: Practice this strategy by attempting to negotiate something that you would not necessarily bargain over. Focus on how it feels. Negotiation can be very uncomfortable for some - this will help you prepare..
2. Never Accept the First Offer
The first offer is almost never the best offer—it’s a starting point, not a final one. Practice pausing before responding. Buy yourself time and set a counter-anchor if needed.
Tip: To ease into this just ask: “is that negotiable?”
3. Give Reasons for your POV
Justification gives power. It creates a shared rationale, not just a demand. Use data, values, and strategic framing—not emotion alone.
Example: “Based on the scope of the initiative and the expected outcomes, I believe this is a reasonable level of support.”
4. Know Your Goal
Before any negotiation, be clear on your ideal outcome. If you don’t know what you want, you’ll end up accepting whatever the other person offers.
Tip: No one needs to know your goal but you, but knowing it can help you stay level-headed and focused.
5. Know Your Anchor
Anchoring is the first number or position mentioned—it frames the rest of the conversation. If you can control the anchor, you shape the negotiation.
Experienced negotiators will assume that you are anchoring higher (or lower depending on the specifics) than your goal —and they will do the same. If you don’t anchor some distance from your goal, you can lose value in the negotiation.
6. Know Your Walkaway
What are you willing to walk away from? Know your floor—emotionally, ethically, and practically.
This is incredibly difficult in an emotional negotiation. Test your walkaway BEFORE you enter the negotiation. Ask yourself, “Will I really end the negotiation if I don’t at least get those terms?”
7. Know Your BATNA
BATNA = Best Alternative To a Negotiated Agreement.
What will you do if the negotiation fails? A strong BATNA gives you leverage. A weak or undefined BATNA leaves you exposed.
Tip: BEFORE entering the negotiation, think through what you will be left with if the negotiation fails. Are you willing to accept this outcome? If not, you may need to adjust your walkaway.
8. Be Aware of Time Constraints
Urgency often benefits the party who’s better prepared. Don’t let artificial deadlines pressure you into quick agreement unless it’s strategically advantageous.
Tip: Understand your own time constraints, as well as those of your negotiating partner. If they are more sensitive to time than you are, you have an advantage. The reverse is also true, so you may not want to let your negotiating partner know if you have a time constraint..
9. Relationships Are Paramount
You’re not just negotiating the deal—you’re negotiating the relationship. Preserve trust. Approach the conversation as a long-term investment, not a one-time win.
Most negotiations are conducted between people who have an ongoing relationship. Consider if there will be damage to your relationship if you push too hard.
10. Final Thoughts
Negotiation isn’t about being aggressive—it’s about being clear, strategic, and intentional. As nurse leaders, we advocate for patients every day. Learning to advocate for ourselves—and our teams—with equal skill is not just professional development. It’s survival.
