Leadership in nursing PDF

LEADERSHIP IN NURSING 1
LEADERSHIP IN NURSING ACCORDING TO VARIOUS THEORIES
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INTRODUCTION
Nursing is an important priority sector in the healthcare system; this is because nurses are
involved with the primary care of the patients spending the most time with their patients. This is
important because they should be involved in the policy-making and leadership of the healthcare
institutions(Finkelman,2012). This paper will focus on leadership and management in nursing
and various theories that cover these topics. It will also focus on a literature review regarding a
specific theory in leadership and how the leadership and management affect the role of the nurse,
impact for patients and healthcare systems. Leadership is a complex issue as it involves diverse
aspects of the healthcare system. Various theories have been developed in an attempt to define
leadership. According to Lewin,Lippitt&White(1939), autocratic leadership involves leaders
who don’t consult other parties during decisionmaking, democratic leadership involve other
parties in decisionmaking although the final say is theirs while Laissez-faire leadership
decisionmaking lies with the involved parties. Another theory is by Likert(1967) participative
leadership where the leader involves the parties in decisionmaking and ensures everyone is
involved and there is maximum cooperation. Likert also established the authoritative leadership
where the leader uses threats and intimidation to achieve the set goals.
Transformational leadership is a theory coined by Bass and Riggio(2006) which emphasizes that
leadership is creating a positive environment while at the same time motivating the workers to
achieve the best outcomes. Situational leadership states that before a leader makes decisions he
considers the availability of resources, motivation, confidence level and the emotional support of
the workers(Hersey and Blanchard,1969). Various theories of leadership use different
approaches and they have various applications in nursing. Management is the ability to utilize
resources in an institution to ensure the smooth running of the operations. Leadership and

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management work hand in hand to ensure the success of various divisions in an organization
(Tomey,2009). Follet (2003) described management as working together with employees rather
than above the employees. Cooperation with the employees yields better results rather than
working without involving them. Fayol (1916) described the theory of management as having
various aspects and principles including planning, organization, command, coordination and
control. Gulick (1937) further elaborates the principles of management to include reporting and
budgeting.
Leadership and management play an important role in nursing as the healthcare institutions look
up to nurses as leaders and managers at various posts such as nurse practitioners, clinical nurse
specialists and in charges in the ward. Nursing is a dynamic profession and involves various
policies at the individual level, hospital, community, government and international levels. The
nurse is required to have leadership skills to make rational decisions and consult with other key
stakeholders (Scully,2015). A leader and a manager are expected to be compassionate while
dealing with the subordinates, assertive and able to handle conflict without taking sides. Good
skills ensure growth in the nursing profession and easier cooperation at the employee level.
Setting goals with the other parties, involving them in decision making, resolving conflict and
finding amicable solutions while providing the resources and motivation sums up a good nurse
leader and manager.
Transformational leadership theory by Avolio is the theory of management that I will criticize in
my paper. This theory comprises of four aspects which involve identifying diverse needs of the
nurses and patients in this case nursing leadership. The second aspect is the leader provides
motivation that inspires the entire team to achieve the set objectives and goals. The leader
involves the team during problem and they make contributions to finding a solution known as

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intellectual stimulation. Idealized influence refers to transformational leaders acting as the role
models whom the rest of the team looks up to. Doody&Doody (2013) states that transformational
leadership is a flexible type that is applicable to the nursing field considering the long
mismanagement. The role of the nurse under this type of leadership changes drastically to
making rational decisions and approaching leaders when faced with challenges.
CHOICE OF TRANSFORMATIONAL LEADERSHIP IN NURSING
Transformational leadership involves working together with the employees to ensure that the
goals and objectives set are met while ensuring their welfare is met.According to Robbins and
Davidhizar (2007) transformational leaders in nursing have been associated with increased
patient satisfaction. Choosing this type of leadership considers the key players involved in the
health care system mainly the managers, the nurses & other health care workers and the patients.
It has been proven that transformational leadership has the ability to equip nurses with skills to
make decisions while providing primary care. They are also involved in making health policies
which affect the healthcare sector. This type of leadership has maximum benefits and outcome
success measures rely on the patient satisfaction.
LITERATURE REVIEW ON TRANSFORMATIONAL LEADERSHIP IN NURSING
Nurse managers at various positions such as nurse practitioners practice leadership which
requires various skills such as honesty and respect towards other nurses and patients. In my
organization, transformational leadership plays an important role in promoting teamwork and
collaboration between the nurses and the providing care to the patients. The nurse leaders utilize
the transformational leadership which emphasizes on individual consideration of the needs of the