Leadership in Nursing

Leadership in Nursing. Definitions, Theories, and Styles of Leadership Developing future nurse leaders is one of the greatest challenges faced by the nursing profession (Mahoney, 2001). Powerful leadership skills are needed by all nurses—those providing direct care to those in top management positions. Anyone who is looked to as an authority (e. g. , a nurse taking care of a patient) or who is responsible for giving assistance to others is considered a leader (Mahoney, 2001). A clinical nursing leader is one who is involved in direct patient care and who continuously improves care by influencing others (Cook, 2001).

Leadership is not merely a series of skills or tasks; rather, it is an attitude that informs behavior (Cook, 2001). In addition, good leadership is consistent superior performance with long term benefit to all involved. Leaders are not merely those who control others, but they act as visionaries who help employees to plan, lead, control, and organize their activities (Jooste, 2004). You can get expert help with your essays right now.

Find out more… Leadership has been defined many ways in the literature. However, several features are common to most definitions of leadership.

For example, leadership is a process, involves influence, usually occurs in a group setting, involves the attainment of a goal, and leadership exists at all levels (Faugier & Woolnough, 2002). There are several recognized leadership styles. Autocratic leaders set an end goal without allowing others to participate in the decision-making process (Faugier & Woolnough, 2002). Bureaucratic leadership occurs when a leader rigidly adheres to rules, regulations, and policies.

Participative leaders allow staff to participate in decision-making and actively seek out the participation of those involved.

This type of leadership allows team members to feel more committed to the goals they were involved with formulating (Faugier & Woolnough, 2002). Laissez faire leadership leaves employees to their own devices in meeting goals, and is a highly risky form of leadership. A more effective form of leadership may be situational leadership. This is where the leader switches between the above styles depending upon the situation at hand and upon the competence of the followers (Faugier & Woolnough, 2002). There is a difference between theory and style of leadership.

According to Moiden (2002), theory represents reality, while style of leadership is the various ways one can implement a theory of leadership—the way in which something is said or done. Organizations should aim for a leadership style that allows for high levels of work performance, with few disruptions, in a wide variety of situational circumstances, in an efficient manner (Moiden, 2002). Similarly, there is a difference between management and leadership. Managers plan, organize and control, while leaders communicate vision, motivate, inspire and empower in order to create organizational change (Faugier & Woolnough, 2002).

Transactional versus Translational Leadership Outhwaite (2003) cites definitions of transactional and transformational leadership as posited by Bass in 1990. Transactional leadership involves the skills required in the effective day to day running of a team. However, transformational leadership involves how an integrated team works together and the innovativeness of their approach to the work (Outhwaite, 2003). For example, a leader can empower team members by allowing individuals to lead certain aspects of a project based on their areas of expertise. This will encourage the development of individual leadership skills.

In addition, leaders should explore barriers and identify conflicts when they arise, and then work collaboratively with the team to resolve these (Outhwaite, 2003). Furthermore, the leader should remain a part of the team, sharing in the work, thus remaining close to operations and being able to understand the employee’s perspective (Outhwaite, 2003). Transactional leadership focuses on providing day-to-day care, while transformational leadership is more focused on processes that motivate followers to perform to their full potential by influencing change and providing a sense of direction (Cook, 2001).

The ability of a leader to articulate a shared vision is an important aspect of transformational leadership (Faugier & Woolnough, 2002). Transactional leadership is most concerned with managing predictability and order, while transformational leaders recognize the importance of challenging the status quo (Faugier & Woolnough, 2002). One group of authors described the use of transformational leadership by Magnet hospitals (De Geest, Claessens, Longerich, & Schubert, 2003). This leadership style allows for instilling faith and respect, treating of employees as individuals, innovation in problem solving, transmission of alues and ethical principles, and provision of challenging goals while communicating a vision for the future (De Geest, et al. , 2003). Transformational leadership is especially well-suited to today’s fast-changing health care environment where adaptation is extremely important. The author cites findings that this leadership style is positively associated with higher employee satisfaction and better performance. These, in turn, correlate positively with higher patient satisfaction (De Geest, et al. , 2003). One way to facilitate change using transformational leadership involves the use of action learning (De Geest, et al. 2003). Leaders use directive, supportive, democratic, and enabling methods to implement and sustain change. The effects of such leadership will radiate to better outcomes for both nurses and patients. Transformational leadership focuses on the interpersonal processes between leaders and followers and is encouraged by empowerment (Hyett, 2003). Empowered nurses are able to believe in their own ability to create and adapt to change. When using a team approach to leadership, it is important to set boundaries, goals, accountability, and supports for team members (Hyett, 2003).

Transformational leadership is seen as empowering, but the nurse manager must balance the use of power in a democratic fashion to avoid the appearance of abuse of power (Welford, 2002). Respect and trust of staff by the leader is essential. Clinical or Shared Governance Clinical governance is a new way of working in which National Health Service (NHS) organizations are accountable for continuous quality improvement, safeguarding standards of care, and creating an environment for clinical excellence (Moiden, 2002).

Requirements of several recent UK government policies require that new forms of leadership better reflecting the diversity of the workforce and the community be developed (Scott & Caress, 2005). Leadership needs to be strengthened and needs to involve all staff in clinical leadership. Shared governance is one method of allowing for this. This form of leadership empowers all staff for decision making processes, and allows staff to work together to develop multi-professional care (Scott & Caress, 2005).

Shared governance is a decentralized style of management in which all team members have responsibility and managers are facilitative, rather than using a hierarchical management style where managers are controlling and staff are not involved in decision-making (Scott & Caress, 2005). Scott and Caress (2005) contend that this type of leadership will lead to increased morale and job satisfaction, increased motivation and staff contribution, encouragement of creativity, and increased sense of worth.

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