RESUMO
Purpose Nurses are a significant part of the professional workforce, but leaders may be promoted without the requisite competencies. This study aims to explore the perspectives of nurse managers about the core competencies necessary for promotion as leaders in health. Design/methodology/approach This was a mixed-methods study that targeted nurses (N= 126) who were promoted in four Caribbean countries over the past five years. A 30-item questionnaire was used for quantitative data collection and analyzed using SPSS version 25. Interviews yielded the qualitative data, which were analyzed using open coding and thematic analysis. Ethical approvals were received from ethics committees at the university and country level. Findings Most participants were female (n= 112), had 15 or more years' experience (n= 71) and an associate degree/diploma in nursing (n= 62). Leadership was the most important competency required of nurse leaders in spite of their position within the organization, followed by team building and motivation. Challenges to the transitioning into leadership positions included the prevailing culture and a lack of a systematic approach to building capacity in leadership. There was also between-group statistical significance, as determined by oneway ANOVA for delegation, motivation and leadership as core competencies based on occupations roles.