After years as a front-line registered nurse, the nurse author became a registered manager to drive systemic change. Registered managers are not required to have a nursing background, yet he argues the role demands more than admin skills; it requires clinical leadership, complex decision-making, knowledge of safeguarding and ethical oversight. Nurses already have these essential skills and values, but many do not see themselves as managers. The author explains how nursing and leadership skills go hand in hand in the role, and urges more nurses to step up as the sector needs clinically grounded, values-driven leaders to improve services and boost care.