Nurse Managers (NM) are crucial to the success of any hospital department. NMs are chosen around a misconception that nurses with expert clinical skills are prepared to lead effectively and this couldn’t be further from the truth. Studies indicate that NMs are often the least prepared to handle the challenges of their roles. Unstructured leadership development for NMs fails to offer experiences that assist them in developing the competencies of successful leadership and can result in role transition problems, lead to dissatisfaction for new NMs, as well as their unit staff. This, in turn, could negatively affect patient care quality, service, and safety. Foreground: Upon reviewing the current NM orientation at a healthcare organization in Houston, Texas, the nursing leaders of the organization agreed that the current NM orientation training did not provide the management and leadership training curriculum necessary for NMs to be effective leaders. In addition, when measured, mean scores from the Nurse Manager Skills Inventory (NMSI) pre-course knowledge assessment indicated a gap in knowledge in a pilot NM group.