Leadership Styles in Nursing Practice

This article discusses the different leadership styles in nursing practice and their impact on patient care outcomes. It explores autocratic, laissez-faire, transformational, and authoritarian leadership styles and their advantages and disadvantages. The article emphasizes the importance of effective leadership in ensuring positive nursing outcomes and patient satisfaction.

Leadership styles in Nursing Practice
By
Student’s Name
Course
Tutor
Institution
Date

2
Leadership styles in Nursing Practice
The application of evidence-based nursing care practices is an essential tool in managing
effective patient care outcomes in health care and ensuring high productivity towards improved
care quality on patients. Leadership perspectives in health care have been essential in
investigating and improving care approach process. Enhancing effective leadership skills is
crucial in managing patient care issues (Dickey, Dismukes & Topor, 2014). Leadership in
nursing is a critical aspect which ensures that there is a coordinated and integrated care
approach for the patient. Leadership in nursing is essential in ensuring that care is delivered to
the patients. Over recent years various studies have been conducted with regard to leadership
styles and nursing practice have incorporated these various leadership styles in their practice.
Leadership styles offer morale, improved production, and positivity in workplace settings
(Kiesewetter et al., 2013). Nurses employ a wide variety of styles into their practices and often
seek to ensure success and positive outcomes. The dynamic environment of nursing practices
has led to the usage of various styles such as autocratic, laissez-faire, transformational and
authoritarian leadership styles in practice.
Authoritarian/Autocratic Leadership is demonstrated in situations where the decisions are
made without regard to the consideration of staff input. Use of negative reinforcement is the
typical application of enforcing the rules. In this leadership, knowledge is seen as a
fundamental source of power, with critical information being withheld among nurses. Further
errors and mistakes are not often regarded as an essence. In a positive angle, this leadership
style is essential in emergency situations and chaotic encounters where there is no time for
discussion especially in emergency states (Cummings et al., 2010).
The style is essential in enforcing policies and guidelines which promote the safety and
health outcomes of the patient; however, it does not promote any form of trust, communication,
and teamwork approach in nursing care practices. The essential decision styles in this
leadership category are not often made, but rather occur as a reactionary measure. It is widely
used by inexperience nurse leaders and those who are ending their careers, as they do not offer
any significant progress to the workforce (Courtney et al., 2015).
Effective autocratic leadership styles can be effective in making quick decisions without
any consultation of other team members and ensure that nursing practices progress which
ensures that there is improved patient outcome rather than deteriorating state of the patients.

3
During emergencies and stressful patent situations, autocratic leaders tend to be more effective
and value leadership. The underlying disadvantage of this style entails a patient of abuse from
nurse leaders who have a strong personality. However, despite this, autocratic leadership in
nursing practice can tend to cultivate the rise of powerful personality types which stifle the
staffs and discourage creativity. New nurse’s graduates and registered nurses tend to react to
this leading to hampering the quality of patient care. Further, this form of leadership
discourages open communication process among subordinates and leaders which is
fundamental in nursing practice and affecting nursing outcomes on patient safety (Cummings,
Salomone & Wielgus, 2015).
Nurse leaders thus remain to be a crucial example for others either in a negative or
positive way. A nurse who engages in this type of leadership tends to make decisions and
directions on specific orders to the subordinates who discourage dissent or questions. This style
is essential in the performance of straight forward tasks and making sure that strict medical
adherences are followed in the nursing practice. Further, it is essential in emergency situations
where there is a need for a strong voice which offers a directional approach (Ortega et al.,
2018).
Laissez-faire leadership has been referred to as a ‘hands –off’ type of leadership which
guide staff management of the team. Studies have demonstrated that this type of leadership has
a negative impact on the safety of the patients and the overall satisfaction of the employee. This
form of leadership style has been regarded as an antithesis form of transformational leadership
and is often characterized by a lack of leadership. Studies and research have demonstrated a
negative perception view of this leadership style in medical fields (Yang, 2015).
Studies undertaken have demonstrated that this style is effective in offering highly
motivated and skilled staffs (Khan et al., 2015, Razzaq & Mujtaba, 2014). Other studies have
shown that laissez fair leadership style empowers employees and enhances the overall
motivation of workers in the nursing arena.
A significant impact of the nursing problem linked to this leadership style entails how
leaders are defined. It is more of definition which plays a fundamental role. In empowering the
team members, is essential for achieving an excellent process. Nurses do not require managers
to managing them. This, in essence, is a micromanagement tool in its practical aspects. Inter
linkage of micro management and employee performance is an average medium which ensures

4
proper application for this form of leadership style (Rubin, 2013).
This form of leadership tends to be a distant style where the nurses take and make
decisions which are based on strict guidelines and boundaries of their scope of service. In
nursing practices, handling patients is a priority and is a process initiated first by accomplishing
roles and process linked to patient care. Nurse exercise allows for the making of a key decision
on patient care process without any consultation to the nurse leaders supervisors. Nurses can
endeavor to undertake and provide care for patients who are sensitive to the culture of the
patent without any explicit permission request from the nurse supervisors.
A relevant example in the utilization of this style entails a nursing role in disaster
management. The use of the laissez fair leadership process is an essential tool in managing a
disaster plan. In disasters and emergency care, as a nursing leader, designating team leaders is
an essential aspect. Nurse leader guiding the team is able to offer instruction which may
entrench safety and communication process. This process allows the nursing staff to do best
with the resources they have at their disposal.
Transactional leadership allows for order and structure. They form a militia type of
command which is essential in management larger organization and ensures that rules and
regulations ate adhered to based on regulations and objectives of the organization.
Transformational leadership has often been compared to transactional leadership which
deepness on self-motivation in a structured and directed environment.
Transactional leadership, in essence, focuses on conforming on existing results on the
existing structure on the success measures based on the rewards system of the organization.
Transactional leaders in this arena have a formal position and authority of responsibility in the
organization. Further, it is essential in ensuring routine maintenance of managing individual
performance and enabling group performances. These leaders are able to set criteria for health
care staff based on previously defined criteria. More often reviews of performances are an
essential aspect in judging nurses performances. This type of nurse leaders further work and
perform best with other nurses who are efficient in their tasks and are thus are rewarded for
their exemplary performance (Webb et al., 2014).
The key benefits of this style tend to be more oriented to reward those staffs who are self-
interested and follow laid down guidelines. Further, it achieves short objective goals quickly
and rewards and penalty actions are clearly defined in the overall structure of the leadership.

5
The nursing practice of this style ensures that there is a high priority on supervision. This is an
effective process in crisis and disaster management which needs to be undertaken in high-level
detail to ensure patient safety and positive outcome. Studies undertaken have indicated that this
type of leadership style is effective in health care institutions. It enhances and reinforces
leadership in enhancing patient safety and achieving positive health care outcomes (Mullen &
Kelloway, 2011).
A classical example of this type of leadership style entails nursing care actions during
emergency situations. Nurses play a fundamental role in ensuring care is provided to the
patients. Nurse’s activity and roles during this process entail offering the best care based on
best practices among the employees who know what should be done during crisis time. This
displays how nurses are reactive to patient status.
Transformational leadership is essential in leadership and characterized by the creation of
relationships and motivation among staff members. Transformational leadership is key in
inspiring self-respect, confidence labels and entrenching loyalty in the nursing profession
among the nurses. Transformational leadership in nursing has been often regardless of the
difficult style to adopt in nursing practices. It requires a change shift in action paradigm
combined with combined professional maturity, improved and enhanced communication and a
true belief in the overall organization process and is to trust others. This style takes a longer
duration of time in the development stages (Muhashamsani, 2015).
Research has continued to showcase the need for transformational leadership in
enhancing both better nursing outcomes environment and evidence of improved care outcomes
in the nursing practice. Transformational leadership enhances greater patient safety, improved
patient outcomes and improves the motivation and satisfaction of job among the employees
(Doody & Doody, 2012).
In a study undertaken in the year 2015, published in the Nursing Administration Journal,
the implication of leadership styles and patient safety was discussed thoroughly. The key
results indicated that transformational leadership is an essential tool for the contribution of
patient safety and ensures an ample environment for achieving improved nursing outcomes
(Yoder-Wise, 2015).
Transformational nursing leaders have often been described as a professional who walks
the walk, the nurse’s words and actions are often contestations with the health care

6
organization goals. Transformation leadership style is essential for the nurse’s role in
enhancing responsibilities and to work continuously aligning their practices with the goals of
the organization. While as nurses enjoy an organizational environment which value this
leadership, there is need to enhance and enhance what is right to the patents and the overall
nursing team in ensuring that best and evidence-based practices are entrenched in the nursing
practices (Ross et al., 2014).
A key example of transformation leadership style in nursing practice is to ensure that
effective support, communication, and setting of clear goals and encouraging the nursing
colleagues in the health care practice. In hospital set up with patient care coordination, a
transformational leader allows the nurses to and staff to engage in decision making on staffing
and scheduling process. In this way providing constructive criticism and informative
suggestions is essential in these nursing practices. Further, the nursing leader is opened and
encourages the nurse sin offering complements and mentoring other nurses in the professions.
Typical characteristics of transformational leadership are to ensure that cost are contained and
adhering to appropriate staffing productivity and enhanced competency process for effective
nursing practice.
In conclusion, leadership has often been referred to as the interrelations between the
nurses which leads and the follows of the leader. Currently, there are many applied leadership
styles which play a fundamental role in enhancing the care process for the patients and
ensuring that appropriate care is enhanced for the patients. Nurses often find themselves in
critical encounters in the nursing process and depict an epic of disaster proportions. When
nurses encounter disasters in the nurse practices, laissez-faire approach style is unlikely to
enhance and mobilize support for an effective team to save lives. Further, more often,
autocratic leadership is essential in crisis management in health care practices.
Transformational leadership is essential in raising the nursing sprits for responding to disasters.
As much as laissez fair leadership is often portrayed more relevantly in the business world, it is
essential in ensuring nursing situations are managed. A lot of research has been undertaken
with regard to leadership styles in enhancing nursing outcomes. Effective leadership is a
fundamental component which is essential in ensuring effective and positive nursing outcomes.
The relationship between effective leadership and patient satisfaction leads to a reduction of
adverse effects on patients.

7
Reference
Courtney, M., Nash, R., Thornton, R., & Potgieter, E. (2015). Leading and managing in
nursing practice: Concepts, processes and challenges. Leadership & nursing—
Contemporary perspectives, 1-20.
Cummings, G. G., MacGregor, T., Davey, M., Lee, H., Wong, C. A., Lo, E., ... & Stafford, E.
(2010). Leadership styles and outcome patterns for the nursing workforce and work
environment: a systematic review. International journal of nursing studies, 47(3), 363-
385.
Cunningham, J., Salomone, J., & Wielgus, N. (2015). Project Management Leadership Style: A
Team Member Perspective. International Journal of Global Business, 8(2).
Dickey C, Dismukes R, Topor D. Creating Opportunities for Organizational Leadership
(COOL): Creating a Culture and Curriculum that Fosters Psychiatric Leadership
Development and Quality Improvement. Acad Psychiatry. 2014:1–5. doi:
10.1007/s40596-014-0082-2
Doody, O., & Doody, C. M. (2012). Transformational leadership in nursing practice. British
Journal of Nursing, 21(20), 1212-1218.
Khan, M. S., Khan, I., Qureshi, Q. A., Ismail, H. M., Rauf, H., Latif, A., & Tahir, M. (2015).
The styles of leadership: A critical review. Public Policy and Administration Research,
5(3), 87-92.
Kiesewetter, J., Schmidt-Huber, M., Netzel, J., Krohn, A. C., Angstwurm, M., & Fischer, M. R.
(2013). Training of leadership skills in medical education. GMS Zeitschrift für
medizinische Ausbildung, 30(4).
Muhashamsani, A. G. (2015). The relationship between pay satisfaction, leadership styles, and
intention to leave among local empoyees at Yamaha Electronics Manufacturing (M) Sdn.
Bhd (Doctoral dissertation, Universiti Utara Malaysia).
Mullen, J., Kelloway, E. K., & Teed, M. (2011). Inconsistent style of leadership as a predictor
of safety behaviour. Work & Stress, 25(1), 41-54.

8
Ortega, J., Hooshmand, M., Foronda, C., Padron, M., Simon, D., Waters, M., ... & Montano, N.
P. (2018). Developing nurse leaders across the Americas: evaluation of an online nursing
leadership course. Revista Panamericana de Salud Pública, 42, e152.
Ross, E. J., Fitzpatrick, J. J., Click, E. R., Krouse, H. J., & Clavelle, J. T. (2014).
Transformational leadership practices of nurse leaders in professional nursing
associations. Journal of Nursing Administration, 44(4), 201-206.
Rubin, E. N. (2013). Assessing your leadership style to achieve organizational objectives.
Global Business and Organizational Excellence, 32(6), 55-66.
Webb, A. M., Tsipis, N. E., McClellan, T. R., McNeil, M. J., Xu, M., Doty, J. P., & Taylor, D.
C. (2014). A first step toward understanding best practices in leadership training in
undergraduate medical education: a systematic review. Academic Medicine, 89(11),
1563-1570.
Yang, I. (2015). Positive effects of laissez-faire leadership: conceptual exploration. Journal of
Management Development, 34(10), 1246-1261.
Yoder-Wise, P. (2015). Leading and Managing in Nursing. (6th ed.). United States: Elsevier
Health Sciences.
Zareen, M., Razzaq, K., & Mujtaba, B. G. (2015). Impact of transactional, transformational and
laissez-faire leadership styles on motivation: A quantitative study of banking employees
in Pakistan. Public Organization Review, 15(4), 531-549.