Report: Critical Analysis of Clinical Leadership in Nursing (NURS 300)

This report provides a critical analysis of four journal articles focusing on clinical leadership in nursing. The articles explore various leadership styles, including transformational, participative, transactional, situational, and autocratic leadership, and discuss their suitability in different scenarios. The report highlights the benefits and drawbacks of each style, identifies barriers to effective clinical leadership, and recommends strategies for improvement. The analysis covers the importance of clinical leadership in healthcare settings, emphasizing the need for flexibility in leadership approaches and the integration of different leadership theories to achieve organizational goals. The report underscores the significance of building leadership skills among nurses and other healthcare professionals to improve the quality of care. It also examines the limitations of the studies and suggests areas for further research in the field of clinical leadership.

Introduction
Clinical leadership in nursing is essential to build and sustain an efficient and committed nursing
workforce which aims to work towards the vision of the organization. In recent times, several
leadership theories, styles, models and frameworks of clinical leadership have emerged which
can be adopted by the nurse leaders. Different concepts have different benefits and drawbacks.
Literature has classified clinical leadership as an evolving concept which requires further
research to gain a better understanding. In this report four articles are identified on the topic of
clinical leadership. Each article focuses on different aspects of clinical leadership concept. These
articles will be critically analyzed to build an understanding of the concept.
Discussion
First article
The first journal article that will be discussed in the assignment is titled “Transformational
Leadership In Nursing” (Renjith, Renu, & George, 2015). The article outlines the changing
scenario of nursing workforce and highlights the need of appropriate nurse leaders to bring the
change. The conception of leadership has also changed with advent of several theories and
models of leadership. The article focuses particularly, on one leadership style which is adopted
by many nurse leaders, which is transformational leadership. Article defines the transformational
leadership as “a process by which leaders raise the aspirations and motivations of others to
higher levels by appealing to higher ideals and values”. The efficient usage of the
transformational leadership will lead to a performance that surpasses the expectations of the
health organization. It is frequently termed as the “additive effect” of transformational
leadership. Apart from discussing the efficiency of the transformational leadership style, the
article also criticizes the style. Impression management is utilized in this style of leadership and
thereby at certain occasions, it can result in self- promotion of the leaders. Moreover, it is
challenging to teach this style as it is a mixture of several leadership theories and styles. The
style has the risk that the subordinates may be the target of manipulation of the leaders and might
face loss instead of gain.

Findings of first article
Article reveals that transformational leadership facilitates the nurse leaders to execute change
efficiently and is a vital means to build a competent nursing staff. Transformational change
facilitates the nurse leaders to execute change successfully. Through transformational leadership,
leaders converge the personal goal with the goal of the organization. The leader and subordinates
work towards the vision of the organization therefore, change is seldom met with resistance
(Northouse, 2013).
Recommendations of first article
The article recommends implementation of transformational leadership style in healthcare sector.
The article rationalizes the implication by giving certain reasonings. Firstly, healthcare sector is
ever-changing and hence it is vital for the leaders to use a leadership style that facilitate the
subordinate nurses in adapting the changes and strive towards the organizational goal
(Hutchinson & Jackson, 2013b). Transformational leadership is regarded as an appropriate
leadership style to accomplish this. When nurse leaders embrace transformational leadership
nurses at each level in the healthcare facility sense that they are heard and their feedbacks are
valued. Secondly, considering the shortage of nursing workforce, recruitment and retention of
nurses is essential. Transformational leadership is a suitable option to train the new nurses. When
new nurses are mentored under transformational leadership, they build trust and dedication to the
healthcare facility. Nurse leader can instill professional values like teamwork and responsibility
in them, so that they are transformation into an efficient team player. It will result in
improvement in satisfaction of the workforce and decreased staff turnover.
Limitations of first article
However, the article has certain limitations as it does not compare the transformational
leadership style with any other leadership theory.
Second article
Theory
The second journal article that will be discussed in the assignment is titled “Leadership theory in
clinical practice” (Jie-HuiXu, 2017). In spite of the broad acknowledgement of the significance

of the efficient clinical leadership with regards to patient outcomes, the barriers for leaders in
clinical leadership are extensive. The article mentions a scenario in which various leadership
theories can be applied which indicates that it is not possible to solve an issue with a single
leadership theory. Like, transformational leaders motivate others with their vision and partner
with their team to share common values. Participative leadership is a managerial style that calls
for input from nurses on every decision. Transactional leadership is founded on liable rewards
and can have a optimistic impact on nurses’ satisfaction and functioning. Other commonly used
leadership style by the nurse leaders are situational leadership and autocratic leadership. The
article suggests that various leadership theories must be integrated in clinical application in
current complex health settings.
Findings of second article
Article identifies these barriers, which include poor incentives, confidence deficit, clinician
cynicism, and ineffective flow of communication, weak planning and training for leadership
roles, curriculum shortages and health professional courses, experience as participants in
inadequately built clinical leadership programs, insufficient resourcing of development
programs, the lack of vision and high level dedication, ineffectual interdisciplinary partnerships,
role conflict, resistance to change, and ineffective teamwork.
Recommendations of second article
So, article recommends integration of recognised leadership styles is for nurse leaders in
healthcare facilities as different leadership styles and theories are appropriate to nursing
practice. Nurse leaders must recognize the benefits and drawbacks of all the theories.
Limitations of second article
The article only applies two leadership styles in the presented scenario and draws comparison to
derive conclusions.
Third article
Theory

The third journal article that will be discussed in the assignment is titled “The importance of
clinical leadership in the hospital setting” (Daly, Jackson, Mannix, Davidson, & Hutchinson,
2014). The discursive paper discusses clinical leadership in health care, mentions published
definitions of clinical leadership, conduct a literature search to define the attributes and traits
needed to be an effective nurse leader. The article also discusses the facilitators and barriers to
effective clinical leadership in the hospital sector. In many areas of the developed world,
contemporary hospital care is confronted by workforce challenges, changing service user
expectations and demands, fiscal constraints, increasing demands for access to care, a mandate to
improve patient centered care, and issues related to levels of quality and safety of health care
(MacPhee, Chang, Lee, & Spiri, 2013).
Findings of third article
The article establishes that efficient governance is critical to efforts in maximizing the efficient
management of service in the healthcare facilities. The significance of efficient clinical
leadership in assuring a high-quality health care system that persistently delivers safe and
competent care is found repeatedly in the literature and in multiple government documents.
Current inquiries, directives, and reports have encouraged the participation of clinicians and
clinical leadership as essential in accomplishing and maintaining improvement in quality of care
and patient safety.
Recommendations of third article
Article recommends development of future strategies which must be aimed at addressing the
identified barriers in order to improve the quality of murse leadership in hospital care. Effective
clinical leadership is related to optimum hospital performance. It is allied to an array of hospital
functions and is a vital element of the health care sector. Building skills of clinical leadership
among the nurses and other professionals in healthcare sector is of crucial significance.
Limitations of third article
Many of the references used in the articles are outdated.
Fourth article

Theory
The fourth journal article that will be discussed in the assignment is titled “Attributes of clinical
leadership in contemporary nursing: an integrative review” (Mannix, Wilkes, & Daly, 2013). The
article is an integrative review which was conducted to identify the current interpretations of
defining characteristics of contemporary clinical nursing leadership.
Findings of the fourth article
The article identifies that the concept of clinical leadership does not have a standard definition
and is not very well understood. Efficient clinical leadership is delivered as the fundamental to
beneficial, operative and assisting work environments for all the health professionals including
nurses. The article revealed that clinical leadership characteristics had a clinical focus, a team
focus or a personal attributes focus; attributes essential for sustaining enabling workplaces and
form the capability and resilience of nursing workforce.
Limitations of the fourth article
The article has limitations. Only two keywords 'clinical leadership' and 'nursing' were used for
searching the literature. The number of studies included in the integrative review were small
(only 10).
Recommendations of the fourth article
Therefore, the article recommends the need for more research in the domain of clinical
leadership.
Conclusion
The report establishes that all the four chosen articles identify the importance of clinical
leadership in nursing practice. Articles mentioned different types of leadership styles such as
transformation, participative, transactional, situational and autocratic and the scenarios in which
they are best suited. However, it is also established that no specific leadership style is
appropriate for every situation. The professionals holding leadership roles in the nursing practice
must be flexible in their leadership styles. Application of various leadership styles to different

situations is found to be most effective, and therefore all the leaders should understand when to
demonstrate a specific approach to accomplish the organization's vision. Articles also identify
barriers in implementing effective clinical leadership and recommend development of future
strategies which can address these barriers.
References
Daly, J., Jackson, D., Mannix, J., Davidson, P. M., & Hutchinson, M. (2014). The importance of
clinical leadership in the hospital setting. Journal of Healthcare Leadership, 6, 75-83.
Hutchinson, & Jackson. (2013b). Transformational leadership in nursing: towards a more critical
interpretation. Nurs Inq, 20(1), 11-22.
Jie-HuiXu. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4), 155-
157.
MacPhee, M., Chang, L., Lee, D., & Spiri, W. (2013). Global health care leadership
development: trends to consider. J Healthc Leader, 21-29.
Mannix, Wilkes, & Daly. (2013). Attributes of clinical leadership in contemporary nursing: an
integrative review. Contemp Nurse, 45(1), 10-21.
Northouse, P. G. (2013). Leadership: Theory and Practice. Los Angeles: Sage Publications.
Renjith, V., Renu, & George, A. (2015). Transformational Leadership In Nursing. International
Journal of Scientific Research and Management Studies, 2(2), 112-118.