Leadership in Nursing

Running head: Leadership in Nursing 1
“It is a truism that organizational culture is informed by the nature of its leadership” (Francis,
2013)
(Author’s name)
(Institutional Affiliation)

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Introduction
Health care culture can be highly influenced by its leadership. Most of the healthcare
cultures that can be affected by its leadership include failure to put patients first, acceptance of
poor standards and willingness of change, misplaced assumptions of trust, and lack of
consideration of patient’s risks(Giltinane, 2013). Leadership is complex and various individuals
understand it differently. One of the definitions of leadership is that it is a process that involves
goals identification, the motivation of other people to act, and support provision either manually
or influential in order to achieve mutually benefiting objectives(Williams, McDowell, & Kautz,
2018). Clinically, leadership has been defined as involvement in clinical care as you constantly
influence others to provide quality and safety care. Most people often confuse leadership and
management. Leadership is different from management in various aspects (Williams, et al.,
2018). First, leadership is involved in setting a direction as compared to management which
involves planning. Furthermore, leadership involves aligning individuals comparing to
management which includes staffing and organizing(Fleming & Kayser-Jones, 2013). Other than
that, leadership provides inspiration and motivation while management involves control and
solving problems.
In nursing, there are various qualities of a good leader. These include emotional
intelligence, integrity, critical thinking, respect, communication skills, and dedication to
excellence, professional socialization, mentorship, and professionalism(Wong & Giallonardo,
2013). Such characteristics have been guided using various literature and theories(Fleming &
Kayser-Jones, 2013). Such theories include trait theory, behavioral theories, and contingency
theories, situational, transactional and transformational theories. The most current leadership
theories are transactional, situational and transformational theories. This study seeks to

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demonstrate various types of current nursing leadership theories, their application in the
healthcare setting and analysis of how they have influenced healthcare culture.
Understanding Leadership Theories Nursing
Transactional Leadership Theory
This theory suggests that, by offering rewards to workers, a leader can produce positive
impacts. However, most of the transactional leaders often focus on management tasks and
usually do not identify the shared values of a team(Tyssen, Wald, & Heidenreich, 2014). The
transactional approach is usually task oriented thus it effective in emergency care like dealing
with urgent issues. This approach, however, may make nurses fail to treat patient as a whole as
they focus of single tasks that need to be done thus leading to poor healthcare culture
(Amanchukwu et al., 2015). One example of transactional leadership is autocratic leadership.
Autocratic leaders are usually power oriented, controlling and closed minded(Tyssen et al.,
2014). Their main objectives are strict adherence to the rules and obedient. Although most of the
nurses and health care providers dislike aristocratic leaders, they well worked under them. Such
leaders have been found to be effective since they determine what need to be done by creating a
good structural and cultural healthcare organization(Tyssen et al., 2014).
There are three types of transactional leaders which include contingent rewards,
exception active management and exception passive management leaders(Giltinane, 2013).
Contingent rewards offer reword where certain task are met to promote motivation, active
exceptions management involves leadership scenarios where leaders intervene into staff
behaviors before they become problematic and passive exceptions is when leaders do not
intervene into workers activities until they become problematic(Giltinane, 2013). When the

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leadership is weak, there is poor performance leading to poor quality of care and poor
organizational culture.
Situational Leadership Theory
Situational leadership involves using different leadership styles to manage various
scenarios. Healthcare organizations are constantly changing and therefore leaders are encouraged
to use different styles while dealing with different situations(West et al., 2015). Other than that,
health care organization should recognize individuals who are effective in leading particular
situations. Situational leaders in nursing have abilities to identify competencies, performances
and can commit to others(Amanchukwu et al., 2015). Situational leaders are built through the
development of good relationships and behaviors between leaders and staff. A leader usually
uses supportive behaviors to involve staff through communication and the provision of emotional
support. In order to make staff cooperate, situational leaders apply directive behaviors to create
roles for the workers(Sfantou et al., 2017). This is usually done by leaders explaining the
activities of each task and how the tasks are done. The development of skills on workers depends
on their hand working, wiliness, experience, and responsibilities.
Clinically, the nurse leader’s uses situational approach while supervising nursing students
or newly qualified nurses. This is due to the fact that situational leadership depends on workers
confidence and level of experience (Giltinane, 2013). A newly employed worker has enough
knowledge but lack personal confidence and experience. In that case, the leader will apply for a
more directive role until that nurse gains enough confidence and experience. Situational
leadership encourages leaders to recognize the complexity of the work and consider a number of
situational factors before deciding what to do(Giltinane, 2013).