Nursing Clinical Leadership

This paper evaluates the concepts of nursing clinical leadership, including transformational leadership, emotional intelligence, situational leadership, and servant leadership. It discusses their relevance to the development of leadership skills in the nursing profession and provides recommendations for effective usage. The limitations of each theory are also explored.

Running head: NURSING CLINICAL LEADERSHIP
NURSING CLINICAL LEADERSHIP
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Introduction
The nursing profession at present, seeks nurses to function beyond merely the alleviation
of disease symptoms in patients, and focus upon maintaining optimum organizational
environments and workforce functioning in the clinical scenario. Clinical leadership is a major
responsibility outlining clinical nursing duties and involves usage of clinical nursing experiences
by nurses to delegate and lead the clinical staff towards fulfillment of positive patient outcomes
and organizational principles. Hence, the following paper will aim to evaluate clinical leadership
concepts in nursing, their limitations, recommendations and relevance to development of
leadership skills in the nursing profession, as discussed in four peer reviewed, scholarly studies.
These include: discussion of transformational nursing leadership by Fischer (2016), usage of
emotional intelligence by Crowne et al., (2017), utilization of a person centered situational
leadership framework by Lynch et al., (2018) and the administration of a servant style of clinical
leadership by Saven and Munro (2017).
Nursing Leadership Theory
For the optimum execution of skills of clinical leadership and workforce manage among
staff working in healthcare organizations, the usage of clinical nursing leadership theories is of
utmost importance (Démeh & Rosengren, 2015). The selected four articles discussed relevant
aspects of clinical nursing leadership theories which potential nurse leaders can utilize for quality
nursing professional practice. Fischer (2016) , with the aid of concept analysis, explores the
relevant aspects of transformational leadership in clinical leadership. The usage of
transformational nursing leadership encompasses administration of skills of empowerment by
nurses to motivate subordinates to achieve their highest potential, leading to increased

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occupational satisfaction and subordinate autonomy (Weng et al., 2015). The clinical leadership
theory explored extensively by Crowne et al., (2017), comprises the usage of emotional
intelligence by nurse leaders which involves exhibiting adequate awareness on one’s own and
other’s emotions and learning to reflect and regulate the same especially during times of
adversity. The article by Lynch et al., (2018), focuses upon the clinical leadership style of person
centered situational leadership which is characterized by the nurse leader, actively taking into
consideration, the personalized needs of the patients and using the same to direct and delegate
workforce duties for appropriately managing the unique clinical situation. Likewise, Savel and
Munro (2017), in their paper, extensively evaluated the theoretical concepts of servant
leadership, which involves the nurse leader to direct clinical leadership actions based on the
prioritizing the unique needs of the patient first, followed by considering the needs of the
subordinate and novice clinical staff.
Issues and Problems
According to Fischer (2016), transformational leadership in nursing is characterized by
nurse leaders leading and delegating clinical duties as per the unique competencies possessed by
each workforce member and using the same to inspire staff to achieve positive outcomes beyong
expectations. However, Fischer (2016) notes that a key issue pertaining to the usage of
transformational leadership by nurse leaders is the lack of an established definition and loose
discussion of competencies which otherwise makes it difficult to educate novice nurses on
acquiring values of the same. Hence, reform in the healthcare organization characterized by the
prevalence of educational nursing framework teaching the same, will be useful for administration
of transformational clinical leadership (Masood & Afsar, 2017). Likewise, in their evaluation of
the effectiveness of a leadership framework administering emotional intelligence, authors

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Crowne et al., (2017) discussed the issue of lack of emotional awareness among nurses
especially required for understanding emotional needs and establishing therapeutic relationships
with patients. Indeed, healthcare organizations, especially nursing homes, rely their functioning
on maintenance of cordial nurse-patient relationships and understanding of patient’s emotions for
quality functioning, which can be administered by nurse leaders through usage of emotional
intelligence (Carragher & Gormley, 2017). Likewise, authors Lynch et al., (2018), postulated
the importance of administering a situational, person-centered leadership considering the
prevalence of issues of using a controlled clinical management framework, which often does not
take into account the patient’s problems of boredom, loneliness and helplessness especially in
nursing care homes catering to older adults. Likewise, through discussion of a servant
leadership, Savel and Munro (2017), highlights the issues and problems associated with a
standard autocratic leadership framework, which is traditionally used in the healthcare
organization. These issues include, lack of consideration of the patient’s as well as the staff’s
needs as well as absence of a two way form of communication where clinical staff can voice
their concerns (Chicca, Frank & Hagy, 2018).
Nursing Leadership Development
The administration of a transformational leadership style, as discussed by Fischer (2016)
is of relevance to nursing leadership development since it provides guidelines on staff
empowerment and motivation hence resulting in increased job satisfaction. Hence, potential
nurse leaders can improve upon their future clinical leadership skills by following
transformational leadership principles such as working with staff using principles of
collaboration and empowerment, providing opportunities for staff to learn and develop from their
experiences, engagement in evidence based practice for improved clinical professional practice

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and encouraging clinical staff to use skills of reflection and communication for improvement of
clinical decision–making and clinical problem solving (Herman, Gish & Rosenblum, 2015).
Similarly, the relevance of the usage of emotional intelligence in nursing clinical leadership,
discussed by Crowne et al., (2017) is associated with it provision of evidenced based information
which can guide nurse leaders to respect and consider the emotions, attitudes and behaviors of
the staff especially in the management of clinical emergencies and conflicts as well as regulating
one’s own emotions for professional improvement. As researched by Lynch et al., (2018), the
usage of clinical leadership theoretical frameworks of situational person centered leadership is of
relevance to leadership development in clinical nurse leaders since it paves the way for nurses to
focus on the personalized needs of the patients, especially in elderly care settings, such as patient
emotions, needs, opinions and preferences and delegating staff’s tasks for fulfillment of the
same. Lastly, as researched by Savel and Munro (2017), the usage of servant style leadership
frameworks is of relevance for future leadership improvement by nurse leaders since it
encourages nurses to primarily prioritize and act in accordance to the needs of patients and
novice staff members and allow them the opportunity to voice their concerns resulting in positive
patient and staff relationships as well as administration of feelings of meaningfulness and
optimism among these stakeholders.
Limitations
Despite the fact that each clinical nursing leadership theory poses its own set of benefits
in the improvement of clinical nursing leadership and healthcare staff management, limitations
are prevalent in each theoretical aspect discussed in the four selected papers. It is worthwhile to
mention that transformational leadership style, as discussed by Fischer (2016) highlights the
importance of empowering the staff and increasing their potential to achieve exceptional clinical

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outcomes. However, a key limitation pertaining to the usage of the same is the lack of
established standards of competencies and principles of transformational leadership which makes
it difficult for academic organizations and healthcare institutes to teach potential nurses as well
as guide nurse leaders on appropriate usage of the same (Kovner & Brewer, 2016). Similar
limitations associated with emotional intelligence can be found in the article by Crowne et al.,
(2017) considering the lack of prevalence of established standards or guidelines on usage of the
same across organizations. Indeed, emotional intelligence has been continued to be used merely
as a suggestion for clinical practice improvement in nursing, and the lack of certified
competencies on the same, raise difficulties on uniform usage of such a leadership style across
various nursing and healthcare environments (Fujino et al., 2015). The article by Lynch et al.,
(2018), elaborates on the benefits of situational person centered leadership in the improvement of
therapeutic relationships and achievement of patient satisfaction. The limitations of a situational
leadership is associated with its difficulty to appropriate manage clinical emergencies
considering lack of feasibility in terms of time (Rokstad et al., 2015). Similarly, despite the
positive effects on patient outcomes, leadership aspects of person centered care may be used
inappropriately since it often provided greater authority for patient’s to administer their
decisions, even it if goes against evidence based practice and hence, nursing autonomy (Røen et
al., 2018). Further, a number of limitations have been identified in the aspects of servant
leadership usage by nurses, as discussed by Savel and Munro (2017). Servant leadership style
may undergo misuse by placing undue emphasis on the opinions of novice or junior members of
the clinical staff, which not only leaves little scope for consideration of the integrity of the nurse
leader but also defeats the purpose and importance of experiences and tenured professional
qualities in advanced nurse leaders (Gunnarsdóttir et al., 2018).

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Recommendations
The following four articles also present key recommendations on effective usage of the
identified theories of clinical nursing leadership. As researched by Fischer (2016), due to the lack
of definitive principles of transformational leadership, it is recommended that academic institutes
and healthcare organizations must execute a healthcare reform and modify nursing curriculum to
include standards and competency guideline of the same. These can include standards of
evidence based practice and guidelines on skills of interpersonal communication, collaborative
and motivational functioning of nurse leaders while managing staff (Seo, Son & Jung, 2015).
Taking insights from the study by Crowne et al., (2017), it is recommended that organizational
management of hospitals and care home establish frameworks of emotional intelligence usage in
conflict management and nursing recruitment due to absence of the same and importance of
maintaining positive therapeutic relationships. Considering the research by Lynch et al., (2018),
it is recommended that nurse leaders adhere to principles of situational person centered
leadership to ensure patient satisfaction and patient perceptions of meaningfulness and security,
with however, not at the expense of nursing autonomy. Lastly, as researched by the article by
Savel and Munro (2017), it is recommended that the nursing leaders administer a servant based
leadership style and allows room for consideration of the unique needs of junior staff in the
clinical workforce which will result in motivation of the staff to work in collaboration with the
nurse and hence, ensure job satisfaction and improved healthcare quality.
Conclusion
Hence, it can be concluded, that for the usage of effective nursing leadership skills,
clinical nurse leaders must consider the usage of varied clinical nursing leadership theories. In
this paper, with the aid of four peer reviewed., scholarly articles, the clinical leadership theories

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of transformational leadership, emotional intelligence, situational leadership, person centered
relationship and servant leadership have been explored extensively. While each theory is relevant
for clinical nursing leadership improvement, clinical leaders must also take into account the
limitations of each and utilize multiple theories in ensuring effective clinical functioning. To
conclude the need of the hour is for healthcare organizations to administer standards of
leadership training and competency teaching to ensure uniformity in leadership administration
across nurses.

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