Leadership Roles in Nursing Profession: A Literature Review

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Contents
INTRODUCTION........................................................................................................................1
DISCUSSION..............................................................................................................................1
REFERENCES............................................................................................................................. 5

INTRODUCTION
Leadership in nursing is considered as an important element and aspect that enables the
nurses to lead the care planning and develop future practice. This assignment is based on
identifying the importance of leadership roles in the nursing profession and the review of
literature on this. Out of a variety of literature present on the chosen topic four relevant and
highly authentic articles are chosen to provide evidence for the argument. This paper will be
able to present reliable information supporting the claim that leadership in nursing is an
important criterion and is also associated with the competent practice. The critical evaluation
and appraisal of the articles reviewed will be done to make sure that the information provided
is credible and authentic in nature. This will also help in better understanding of the concepts
and will provide implications for the future clinical practice. This paper will highlight the
importance of evidence-based practice as the literature review of reliable literature on the
chosen topic will exemplify the importance of evidence-based practice in nursing.

DISCUSSION
Scully (2015), in the article "Leadership in nursing: The importance of recognising inherent
values and attributes to secure a positive future for the profession" examined the importance
of leadership roles in the nursing profession and the values that are inherited for a better
leadership process. Nursing is a dynamic profession that presents different challenges and
opportunities for the individual. The author stated that in today’s contemporary health and
social care field the identification of a competent nurse leader is a common challenge faced
by the sector. The paper aimed at correctly focusing on and highlighting the requirement of
identifying the proper nurse leaders to provide positivism for the profession. Leadership in
nursing is usually interchangeably used with the term management as it is considered that
leadership in nursing can only be done by the management professional but this concept is
wrong, as dissociation of the leadership from management is essential. Leadership in nursing
not only involves the management of the nurses and team members but it also involves
supporting the clinical colleagues, purposefully enlisting the willing and enthusiastic
colleagues, inspiring and transforming themselves and their followers as well as summing up
the management roles.
There is a variety of leadership theories highlighting or supporting the definitions provided
since ages. The “great man” leadership theory was widely used theory in past that explained
how the leadership qualities are inherited and leaders are born in particular families with
particular specific traits. Thou the theory originated in the mid-19 century the expansion to
this theory were provided from the personal trait theory. Recent theories on leadership
incorporating both situational and personalized views explain how efficient leadership
includes personal traits of a leader, situation a hand and the qualities of the follower.
Leadership is stated as not a blurred planning or disorganized view but it involves the vision,
communication of the vision, planning for the implementation, and serving for the source of

energy for the team. Therefore it can better understand as “bringing order to chaos”. In 1978
Burns, described two main models of leadership that are even widely followed today as
transformational and transactional leadership. Transformational leadership depends on the
leaders creating a team of followers by motivating them to perform beyond their capabilities
with the view of a shared goal and followers are motivated to achieve higher order needs that
are called as transformation. Transformational leadership inspires its followers to perform
beyond basics, with competence, altering and elevating their potential, shaping their
excellence and ensuring better patient care on their own. This kind of leadership is highly
recommended for nursing practice. Whereas transactional leadership involves the benefit of
both leaders ad follower in return of the goals achieved. Some of the recommendations that
the article provided for a future nurse leader are, enrollment of the capable nurses for nursing
leadership courses that are present in Australia, the strategy by Australian government
regarding “Emerging Nurse Leaders” that enables identification of competent and potential
nurse leaders for future (MacPhee et al., 2012). There is a need for local and in workplace
strategies for training and development of nurse leadership and mentoring programmes that
support this view. Along with the identification of future competent nurse leaders there
should be a system of not fostering the people who are leaders but cannot lead effectively.
Joseph & Huber (2015), in their article “Clinical leadership development and education for
nurses: prospects and opportunities” aimed at highlighting the clinical leadership
development and education opportunities present for nurse leadership roles in Australia. The
article identifies that complexity, chaos, rate of changes, safety and quality issues are some of
the aspects why a proficient leadership is essential in the nursing profession. The article
focused on how to educate the current nursing workforce for the roles that do not have
adequate jobs like training the Registered Nurses to shift from the traditional model and apply

integrated nursing to their practice. Smolowitz et al studied the role of registered nurses in
primary care and found that the chronic care delivery, preventive care and practice operations
were three sectors where the registered nurse clinical leadership and interprofessional
leadership was required and was lacking. Leadership is defined as the process to lead people
in order to accomplish set goals. Some concepts related to good leadership are an influence,
communication, group process, goal attainment and motivation. Clinical leadership in nursing
is defined as the process of influencing the point of care and improvement in both
organizational aspects and individualized care in order to attain the quality and safety of the
care outcomes. The clinical leadership roles are referred to as educating, training and getting
the nurses ready to lead in every level of care. Some of the leadership roles include Care
coordinator role, clinical nurse leader, and advanced practice registered nurse. The advanced
education for clinical leadership in nursing can be achieved by innovation and
interdependence. Health care is directing continuously to outpatient and community care that
requires better team working and supervision (Frankel., 2019). It is recommended that the
clinical nurses and advanced RN will require crossing boundaries and innovate to be able to
promote better quality care. Curriculum innovation is also highly recommended for better and
potential production of nurse leaders. High definition and understanding of partnership
working are to be set. Also, the production and formation of a high functioning team with
highly skilled and trained individuals will allow this vision to be real.
Roche et al (2015), aimed at examining the elements of leadership linked to the intention to
leave in the public care hospitals. It is seen that nurse leaving the workplace is a major issue
that is faced by hospitals and management. The major cause of this turnover is identified as
nurse management and leadership qualities. The role of the nurse unit manager is important
in managing the retention of nurses especially due to their influence on stability and quality
of the work environment provided. The study used primary data collection method to collect

the information from 62 medical, surgical and mixed units across eleven public care centres
in three states of Australia. Total of 1673 nurses participated in the interview and was
evaluated for their perceptions regarding the issue. The results identified that the role f unit
manager was a very important factor that influenced the will of the nurse to whether to leave
or remain in the work environment. The nurse’s appreciated human skills and connection
more than managerial qualities. They also agreed that the leader’s connection to their
concerns, clarity, participation and encouragement was an appreciable and major factor that
helped them to retain their work. The study found that the role of nurse unit managers was
major in the retention of nurses and workforce in hospitals. The results indicate some of the
leadership skills the nurses supervising the unit should adopt for better outcomes. The results
show that nurse managers should be adequate in performing duties towards managing unit
management and finances, they should also possess human skills. The skills of leaders
including conflict resolution, communication and collaborative working and decision making
are highly considered. The nurses fund the leaders with compassion, understanding to their
needs, and engaging more with them to be more helpful in leading rather than another type of
leaders. Previously the leaders were selected without any perception to skills on the basis of
experience and seniority but now the changes have perceived and the leaders require set
attributes and skills to be potential and competent in their roles. Some recommendation for
selection of an appropriate leader includes the selection on the basis of education, skills,
attributes and support provided. The education programmes for these candidates should not
only focus on management skills but also incorporate effective leadership roles and skills that
are essential in nursing. Majority of developing countries and developed nations have
adopted curriculum changes that include effective leadership training to the nurses to adapt
and perform effective leadership roles for future practice. There are some basic limitations to
this research that includes that the study was not intended to repeat the analysis with

regressed organizational and environmental outcomes into leaving the jobs. The evaluation
was based on leadership aspects and their role in nursing. The research did not explore the
strength of the factors but just provided a correlation of job satisfaction with leadership roles.
The response rate of the study was 44.4% and participation was not completely voluntary but
this does not limit the generalizability of the findings.
Dyess et al (2016), in their study “Growing Nurse Leaders: Their Perspectives on Nursing
Leadership and Today’s Practice Environment”, examined the importance of the
development of future nurse leaders. This article was based on perceptions extracted of
postgraduate nurses prior to their initiation of coursework. The method used in the research
was using generation Y nurses in a focus group. The development of appropriate leaders in
nursing is found to be a great challenge in today’s health care. Effective nurse leadership
planning is essential for a new era. There will be a shortage of around 67000 nurse manager
till 2020. The candidates in their 10 years of initial practice undergo promise phase where
they work on enhancing their abilities to be a competent leader by gaining knowledge and
skills. The study included 44 student nurses who participated in focus groups. The results
identified three major themes including “idealistic expectations of the leaders”, “leading in a
challenging practice environment” and “cautious but optimistic outlook about their own
leadership and future.” It was seen that the future generation does not get the opportunity to
get skilled for the role of leaders. Staff nurses have limited opportunity to observe their
leaders and get acquainted with future opportunities. The study found that once the nurses
initiate working with their leaders their perception regarding the roles and challenges faced
by their leader changes. Also, it was identified that the nurses without formal training or
understanding decide not to become a leader based on their observation of what is going on in
the work environment. Also, it was concluded that the future of nursing leadership is at risk if
these potential leaders would not come forward to fill in the roles. The study has certain

limitations including the geographical restriction of the research where only one area of
nurses were evaluated for their perceptions. The results are not applicable for generalization
for other areas and with time. Yet the results are helpful in explaining how a lack in
communication and understanding of the leadership roles in nursing is present in health care.
The study recommended that with the retirement of many leaders in nursing there is a new
scope for opportunities for new leaders but this scope is not identified by the modern
generation nurses. Nurse’s perceptions regarding directing their future practice for leadership
roles are influenced through the job satisfaction and current work environment. The growing
future nurse leaders are a quest and require planning and action (Scott, & Miles., 2013).
There is a need for current leaders to identify this perception that their workload and attitude
is presenting on emerging leaders. They should be able to work in order to promote training
and guidance to these emerging leaders for future practices.

REFERENCES
Dyess, M. S., Sherman, O. R., Pratt, B. A., & Chiang-Hanisko, L. (2016). Growing nurse
leaders: Their perspectives on nursing leadership and today’s practice environment. OJ Nurs.
Frankel, A., & PGCMS, R. (2019). What leadership styles should senior nurses
develop?. Mental health, 12, 50.
Joseph, M. L., & Huber, D. L. (2015). Clinical leadership development and education for
nurses: prospects and opportunities. Journal of healthcare leadership, 7, 55.
MacPhee, M., Skelton‐Green, J., Bouthillette, F., & Suryaprakash, N. (2012). An
empowerment framework for nursing leadership development: supporting evidence. Journal
of Advanced Nursing, 68(1), 159-169.
Roche, M. R., Duffield, C. M., Dimitrelis, S., & Frew, B. (2015). Leadership skills for
nursing unit managers to decrease the intention to leave.
Scott, E. S., & Miles, J. (2013). Advancing leadership capacity in nursing. Nursing
administration quarterly, 37(1), 77-82.
Scully, N. J. (2015). Leadership in nursing: The importance of recognising inherent values
and attributes to secure a positive future for the profession. Collegian, 22(4), 439-444.