Leadership Without a Title: The Power of Influence, Mentorship, and Showing Up

Leadership is often associated with titles, positions, and recognition. We tend to think of leaders as the individuals at the head of an organization, directing teams, making decisions, and shaping policy. Yet some of the most influential leaders I have encountered throughout my career have never held a formal leadership position.

They were the people who recognized potential in others, challenged conventional thinking, advocated for change, and stepped forward when something needed to be done.

Over the years, I have come to believe that leadership is not necessarily about the position you hold. It is about the influence you have, the standards you uphold, and the opportunities you create for those who follow.

Finding My Voice Through Clinical Practice

As a Certified Registered Nurse Anesthesiologist (CRNA), I have spent my career in a profession that requires independent judgment, clinical expertise, and the ability to make critical decisions under pressure.

Anesthesia is an extraordinary combination of science, technical skill, and human connection. Patients place an enormous amount of trust in us, often during some of their most vulnerable moments. That responsibility demands more than clinical competence. It requires accountability, confidence, and an unwavering commitment to patient safety.

Working in independent clinical practice has reinforced something I believe applies to women in every profession: expertise and confidence must develop together.

There is a difference between possessing the knowledge necessary to make a decision and having the confidence to stand behind it. Developing that confidence requires preparation, experience, and a willingness to accept responsibility for the outcome.

For women, particularly those working in environments where their expertise may be underestimated, learning to trust their professional judgment can be one of the most important steps toward becoming influential leaders.

Confidence, however, should never be confused with having all the answers. Some of the strongest professionals I know are also the first to acknowledge what they do not know. They ask questions, seek additional perspectives, and recognize that continued learning is essential to excellence.

Mentorship Is an Investment in the Future

One of the most rewarding aspects of my career has been the opportunity to educate and mentor future healthcare professionals.

As a doctoral-level nurse anesthesiology educator, I have become increasingly interested in how we prepare students not simply to pass examinations, but to think critically, make decisions, and navigate the uncertainty inherent in clinical practice.

I often tell students, in one form or another, that knowing the correct answer is only part of the equation. Understanding why it is correct, recognizing when circumstances change, and having the judgment to respond appropriately are what ultimately distinguish a knowledgeable student from a capable clinician.

This philosophy has influenced my approach to education. I incorporate simulation, experiential learning, and unconventional teaching methods designed to encourage students to engage with information rather than passively receive it.

Learning should challenge people. It should occasionally make them uncomfortable. Most importantly, it should help them discover that they are capable of more than they initially believed.

Mentorship extends beyond the classroom. Whether I am working with doctoral students, supporting emerging professionals, or introducing high school students to careers in healthcare, I recognize the importance of helping others see possibilities they may not have considered.

Sometimes influence begins with something remarkably simple: taking the time to tell someone, "I think you could be really good at this."

We may never fully appreciate how much those moments matter.

The Importance of Professional Advocacy

Leadership also means recognizing that our responsibilities extend beyond our individual workplaces.

My involvement in professional organizations, including the American Association of Nurse Anesthesiology (AANA) and the Minnesota Association of Nurse Anesthetists (MANA), has provided opportunities to contribute to conversations about clinical practice, professional advocacy, education, and the future of nurse anesthesiology.

These experiences have reinforced my belief that professional progress does not happen automatically. It requires people who are willing to participate, ask difficult questions, challenge outdated assumptions, and contribute their time and expertise.

Nurse anesthesiology has a remarkable history, shaped in significant part by women who demonstrated extraordinary clinical skill and determination long before the profession received the recognition it deserved.

Their contributions remind us that professional advancement is rarely the result of a single individual or achievement. It is the cumulative effect of generations of practitioners who refused to accept that the status quo represented the limit of what was possible.

Today, we have both the opportunity and the responsibility to continue that work.

Advocacy does not always involve standing at a podium or participating in legislative discussions. Sometimes it means mentoring a colleague, improving a clinical process, raising a patient safety concern, or helping others understand the value of our profession.

Each of those actions contributes to meaningful change.

Making Room for Innovation

I have never believed that doing something a particular way for years is, by itself, a compelling reason to continue doing it that way.

That perspective has shaped much of my work in education.

Traditional teaching methods certainly have value, but healthcare is constantly evolving. The ways we prepare future clinicians should evolve as well.

I am particularly passionate about creating learning experiences that bridge the gap between classroom knowledge and clinical application. Through simulation, interactive exercises, and creative approaches to complex material, I want students to develop not only a deeper understanding of anatomy and physiology, but also the ability to apply that knowledge when it matters.

Innovation requires a willingness to experiment. Not every idea will work as intended, and that is part of the process.

I believe effective leaders create environments where people feel comfortable asking questions, exploring new approaches, and learning from mistakes.

The goal should never be innovation simply for the sake of doing something different. The goal is to make something better.

Redefining Success and Influence

As my career has evolved, so has my definition of professional success.

Early in our careers, it is natural to focus on accomplishments: earning degrees, developing expertise, achieving professional milestones, and establishing ourselves within our chosen fields.

Those achievements matter. They represent years of dedication, sacrifice, and hard work.

But over time, I have found that the most meaningful measure of success is not simply what we accomplish for ourselves. It is what we make possible for others.

Did we encourage someone to pursue an opportunity they might otherwise have dismissed? Did we help a student develop the confidence to make a difficult decision? Did we advocate for an improvement that made our workplace or profession stronger?

Did we leave something better than we found it?

For women navigating demanding careers, leadership responsibilities, and personal commitments, it can be tempting to measure success against someone else's expectations. Yet there is no single path to becoming an influential professional.

Some women will lead large organizations. Others will build businesses, advance research, educate future generations, or transform the culture of their workplaces.

Each of these contributions has value.

What matters is the willingness to recognize our own capabilities and use them with purpose.

The Legacy We Create

I have been fortunate to learn from exceptional clinicians, educators, mentors, and colleagues throughout my career. Their influence has shaped not only the professional I have become, but also the kind of educator and leader I aspire to be.

The greatest way I can honor those contributions is to extend the same encouragement, opportunities, and support to others.

I want my students to become clinicians who are more knowledgeable, more capable, and more confident than they were when they entered my classroom. I want the professionals I mentor to recognize their potential and pursue opportunities that challenge them. And I want to contribute to a profession that continues to advance through education, collaboration, and advocacy.

Ultimately, influence is not measured solely by the number of people who know your name or the titles that appear after it.

It is measured by the difference you make.

Leadership begins when we recognize that we have something valuable to contribute and decide to act on it.

And sometimes, the most powerful thing a leader can do is simply show up, share what they know, and help someone else discover what they are capable of becoming.

About the Author

Rachel Edgerton, DNAP, CRNA, APRN, CHSE, FAANA, is a nurse anesthesiologist, doctoral-level nurse anesthesiology educator, and healthcare simulation specialist based in Minnesota. She serves on the faculty of Saint Mary's University of Minnesota, where she focuses on regional anesthesia education, clinical reasoning, and innovative approaches to experiential learning. She is a Fellow of the American Association of Nurse Anesthesiology, serves on the AANA Practice Committee, and is Co-Chair of the Minnesota Association of Nurse Anesthetists Communications Committee. Her professional interests include independent clinical practice, patient safety, simulation-based education, mentorship, and advancing the nurse anesthesiology profession.