Leadership in Nursing: Transformational Approach, Case Study Analysis

This report analyzes transformational leadership within the context of registered nursing, focusing on its impact across several key areas of practice. The paper begins with an introduction to leadership in nursing, highlighting the importance of effective leadership approaches in achieving positive healthcare outcomes. It then provides an overview of transformational leadership, discussing its core components such as idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration. The report explores the impact of transformational leadership on communication, teamwork, delegation and management of care, scope of practice, documentation, and opportunities for newly graduated nurses. The report emphasizes the role of emotional intelligence in these areas. The second part of the assignment is based on Gibb's reflective cycle, analyzing a clinical experience involving communication. The report concludes by emphasizing the importance of transformational leadership in fostering a positive work environment and improving patient care outcomes. The paper utilizes relevant scholarly literature to support its arguments.

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PART A: Leadership Approach
Introduction
Different definitions of leadership exist based on the discipline being addressed.
However, regardless of the diverse ideas about leadership, it is clear that it plays a critical in
influencing the outcomes of a process or activity in an organization. In nursing, leadership
defines the process of achieving effective healthcare outcomes (Çetin et al. 2912; Orgambídez-
Ramos and de Almeida 2017). Healthcare managers and other practitioners are required to
adhere to effective leadership practices to enhance patient experiences, safety, and care
outcomes. However, it is important to understand the impact of different leadership approaches
on key aspects in healthcare (; Roberts-Turner et al. 2014; Zydziunaite and Suominen 2014).
Good leadership in nursing practice defines the nature of care delegation process, documentation,
communication, opportunities for newly graduated practitioners, the scope of practice, teamwork
approaches, professional relationships, and scope of practice. This paper evaluates the impact
transformational leadership approach on key areas of healthcare practice in nursing.
Overview of the Leadership Approach: Transformational Leadership
In recent years, studies on this leadership approach or skill have intensified since it is
becoming a key consideration among managers and organizational leaders. The transformational
leadership concept could be traced back to the 1970s when scholars became concerned with how
leaders inspired change among members by imparting resilience and effectiveness among their
followers (Giltinance, 2013). Transformational leadership is all about how leaders influence their
members to adapt to the system in place while at the same time developing resilience at

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workplace for their wellbeing and performance (Sechudi and Olivier, 2017; Thompson, 2012).
When a leader is considered to be transformational, it implies that they are able to understand
their scope of practice, the environment of operation, and the people they engage with on a daily
basis. Transformational leaders focus on idealized influence founded on moral and ethical
principles, which is essential in nursing. Another essential component of transformational
leadership is inspirational motivation. Inspirational motivation entails the capacity of a leader to
motivate followers to adhere to workplace principles and performance (Sechudi and Olivier,
2017). On the other hand, transformational leadership also focuses on creativity and overcoming
challenge. Through intellectual stimulation, transformational leaders are able to encourage their
followers to be creative, innovative, and critical. Moreover, transformational leadership fosters
individualized consideration as part of the fundamental principles that guide this approach,
which entails the process of encouraging members to overcome the challenges and develop
resilience skills while focusing on the needs of the people or organizations they serve
(Thompson, 2012). It is important to also note that transformational leadership also focused on
the quality of work-life to improve the experience of the flowers both at workplace and at home.
In nursing, transformational skills influence all other healthcare practices. Scholarly
literature shows that transformational leaders assist nurses to cope up with the dynamic nature of
the healthcare sector and the changing consumer needs and expectations. The first stage of care
delivery is patient assessment and diagnosis followed by treatment and post-treatment care.
However, nurses work in partnership with other healthcare professionals to implement education
programs and prevention interventions. All these activities and roles require a clear
understanding of how to impact the desired success (Gibson and Petrosko 2014). Nurses interact
with other professionals, patients, and their families. Through necessary support from leaders,

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the practitioners are able to use their emotions to meet the set milestones and enhance their
personal experiences (Lin et al. 2015). In most cases nurses find themselves in positions where
they are required to give hope to people around. Being aware of their environment and how to
behave emanates from the ability to understand one’s weaknesses and strengths (Thompson,
2012). At the same time, nurses are constantly required to stay in control based on the critical
nature of the roles they play. Such a goal is only achieved when there is a transformational leader
who inspires, motivates, and supports the followers to achieve the expected healthcare leadership
milestones as depicted in nursing standards (Nursing and Midwifery Board of Australia, 2016).
Therefore, continuous improvement in healthcare depends on the nature of leadership approach
and skills among the leaders.
Impact of Emotional Intelligence in Nursing Leadership
Impact on Communication
Communication is a vital component in nursing practice. Each nurse is expected to
portray a high level of communication expertise paying attention to how they could influence the
feelings of other people. Through communication, nurses share the requirement of their duties,
patient information, diagnostic and treatment details, and their personal experiences. When
handling patients, nurses are expected to adhere to professional guidelines of communication.
The same is true when they are interacting with one another in the workplace (Johnson and
Webber 2015). Transformational leadership ensures that the communication between nurses and
patients as well as amongst practitioners is based on comprehensive listening, reflection, and
appropriate responding skills. Nurses who receive support from transformational leaders are able
to engage in constructive communication with a positive attitude towards criticism (Edmunds,
2014). Nurses who lack the proper support and guideline are constantly associated with passive

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and aggressive communication approaches that negatively impact the process of delivering
quality care to consumers in line with the nursing standards. Being extremely critical and not
listening to others affects the ability of nurses to learn from other practitioners. Effective
communication improves healthcare outcomes by paying attention to patients’ needs.
Impact on Teamwork and Professional Relationship
Emotional intelligence, teamwork, and interpersonal professional relationship are
interrelated. Leaders are required to understand how they could tap from the synergistic power of
teamwork and build on professional relationships to enhance organizational goals. Nurses need
the support of transformational leaders to be able to understand how diversity is teamwork
should be used for the benefit of each practitioner and patient (Lin, MacLennan, Hunt, and Cox,
2015). Teamwork is associated with roles and responsibilities executed by each member but
cumulatively lead to the achievement of the primary goals. Nurses who work under
transformational leaders are able to recognize the efforts and inputs of other people while at the
same time striving to improve one another (Mudallal, Othman, and Al Hassan, 2017). Patients’
needs are diverse and sometimes complex; however, working in a team guarantees the desired
outcomes. In this case, practitioners are required to embrace the process of creating highly
transformational teams where the accomplishment and diversity of each member are
acknowledged. Moreover, transformational leadership also ensures that individual attitudes,
perceptions, and beliefs do not interfere with professional relationships or teamwork objectives
in line with healthcare practice and quality improvement in care delivery (Ross, Fitzpatrick,
Click, Krouse, and Clavelle, 2014).

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Impact on Delegation and Management of Care
Delegation and management of care is a regular activity in nursing. Nursing leadership is
supposed to be focused on effective delegation of care roles and duties and the subsequent
management of assigned roles. The nature of healthcare outcomes depends on the level of
systematic allocation of duties across different departments (Leggat and Balding 2013).
Transformational leadership enables nursing leaders to prioritize issues to be given first attention
and enough resources. In most cases, the delegation of duties focus on availability and skill set;
however, there is more to the allocation of specific roles such as teamwork considerations and
supervisory needs. Transformational leadership, as one of the effective approaches, ensures that
nurses focus on effective scheduling of tasks based on strengths of each member (Ross,
Fitzpatrick, Click, Krouse, and Clavelle, 2014; Wong, Cummings, and Ducharme, 2013). Such a
move guarantees that each shift is balanced in terms of skill set, resilience, and experience.
Attending to the needs of patients during care interventions depends on the extent to which nurse
leaders are able to understand the fundamentals of delegation and management of care. Failure to
consider how each role influence other related programs could impede the process of achieving a
high level of patient safety, proper reduction of nursing burnout, and progressive professional
development both in short-term and long-term.
Impact on Scope of Practice
The scope of nursing practice entails a range of dimensions characterizing the roles and
responsibilities of registered nurses. It is the responsibility of nurses to address the needs of
patients through the promotion of health, protection of people and their communities, health
restoration, and implementation of preventive and rehabilitative programs. It implies therefore
that leadership plays a key role in ensuring that the activities associated with scope of practice in

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nursing are successfully and effectively undertaken. It requires the intervention of
transformational leaders to determine the best way to meet the needs of people while maintaining
professional and personal resilience (Ross, Fitzpatrick, Click, Krouse, and Clavelle, 2014; Wong,
Cummings, and Ducharme, 2013). Nursing leadership that fosters self-awareness, empathy,
social skills, and self-regulation will ensure that practice knowledge is utilized establish an
environment that supports holistic care. The process of promoting self-reliance and self-care
among clients during care management needs a lot of patience and empathy; therefore, leaders
are required to support nurses to achieve a high level of resilience for them to overcome the
challenges they face. Healthcare consumers are partners in care, which implies that their needs,
decisions, and expectations should equally be professionally incorporated when planning and
implementing care interventions (Higgins, E.A., 2015; Enwereuzor, Ugwu, and Eze, 2018).
Working with clients in a positive way to improve wellbeing needs a high level of resilience and
commitment especially during preventive, rehabilitation, and palliative programs.
Impact on Documentation
One of the responsibilities of nurses is to create quality healthcare systems by considering
the needs of populations. The outcomes of such systems are used to define policy frameworks
and care programs in line with nursing standards. A strategy that is used to create a robust system
is the documentation process and practices. Nurses encounter challenges associated with poor
documentation; however, through the support of transformational leaders, they are able to
consider the best approaches to restructure and improve the internal process to guarantee
sustainable patients’ data management program (Lavoie-Tremblay, Fernet, Lavigne, and Austin,
2016).

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Impact on Emerging Leadership Opportunities for Newly Graduated Nurses
Newly graduated nurses require leadership to nurture and support for them to be able to
take up roles in healthcare. When ambitious newly graduated nurses are aspiring to be leaders,
they face a backlash from experienced nurses, which affects their level of motivation. It is
important for nursing leadership to offer opportunities for growth and development. Such a move
requires a high level of transformational capacity among leaders in order to understand their
goals and offer encouragement in terms of opportunities for practice (Lavoie-Tremblay, Fernet,
Lavigne, and Austin, 2016; Gabel, 2013;). Empathy and other social skills among experienced
nurses could assist newly graduated professionals to develop and plan for career growth towards
a healthcare leadership profession. The desire to see other people achieving their lifelong goals is
part of transformational leadership.
Conclusion
In conclusion, transformational leadership is a key approach that each nurse or any other
healthcare practitioner should have to improve care outcomes. Since leadership is a multifaceted
concept, it equally influences different elements in healthcare practice. Nurses require
transformational leadership support to foster a culture of positive communication with patients
and other professionals. At the same time, they will understand the best way to solve
documentation challenges and improve efficient patient data management. Through effective
leadership that pays attention to self-awareness, nurses will be able to execute mandates relating
to their scope of practice with limited interpersonal problems. Moreover, teamwork and
professional relationship is healthcare practice could be enhanced through leadership that is
based on transformational abilities as a primary skill. On the other hand, there are leadership

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opportunities in practice for newly graduated nurses who have embraced self-awareness, which
implies that they have the ability to influence other people towards achieving healthcare goals.
PART B: Gibb’s Reflection Cycle: Communication
Reflection on practice encounters is important because it provides insights that could be
used to improve care delivery and professionalism in healthcare (Sharp 2018; Coutt, 2014). The
use of Gibb’s Reflection Cycle provides a framework for practitioners to evaluate what happened
in terms of feelings, outcomes, and lessons learned in order to set a baseline for future actions.
This refection examines a case that I experienced regarding the impact of emotional intelligence
in nursing practice.
Helen, not her real name, was admitted to the hospital after being diagnosed with acute
diabetes. She was undergoing treatment within the facility to monitor how she was recovering
with medication. However, on one occasion when I arrived at the ward for a normal routine
check-up, Helen did not respond to my greeting and did not want to talk to me. I later learned
that one of the nurses had confronted her earlier about her habit of hiding the medication she was
supposed to be taking, which explained how her results were not consistent. This was something
Helen shared with me because of the close relationship we established from the time she was
admitted.
I felt I did not live up to the trust we had established since I shared this information with
other practitioners in charge of the ward. I expected that we will all come up with a strategy to
help Helen; however, one of the nurses confronted her before other patients. She felt betrayed by
my actions, which explains why she did want to talk to me anymore. When patients feel betrayed
by nurses they develop negative attitudes (Markin, 2014).

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Based on this scenario, the relationship between me and Helen led to the discovery of her
tricks to avoid taking medication, which was a good move towards eliminating barriers impeding
her recovery. However, I shared the information with other practitioners to see how we could
help her change this negative behavior. Nevertheless, the action by one of the nurses to confront
her was not appropriate. This is an example of a situation where a practitioner failed to depict
strong emotional intelligence. Nurses should find the best way to approach such issues without
causing any problems (Gelso, 2014).
Therapeutic professional relationships with patients as well as proper control of emotions
among nurses enhance treatment outcomes (Gelso, 2014). Such relationships are built on trust,
confidentiality, empathy, and mutual interests. I believe effective emotional intelligence could be
used to improve patient outcomes and experience during the care period. When patients work
together with nurses they improve the process of establishing patient-centered care plans in line
with the underpinning diagnoses.
I have gained important practice lessons from this incident. In the future, I will consider
the best way to help a patient while at the same time controlling my emotions. While I expected
the other nurses to consider a positive attitude while handling the issue, it was my responsibility
to remind them the essence of emotional self-awareness and how it is important to maintain
emotional control without compromising on care guidelines. I will strive to use my experience to
assist patients to overcome negative behaviors that directly impact treatment outcomes because it
will improve patient experiences (Wampold, and Budge, 2012). When my efforts fail, that is
when I will bring on board other professionals to assist the patient.
In conclusion, nurses are required to develop emotional self-awareness and self-
regulation skills when handling issues relating to patient care to create an environment that

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supports positive experiences. When patients trust healthcare practitioners, they could work in
collaboration to improve care outcomes. Treatment interventions play a significant role in
recovery; however, emotional stability based on the mutual and professional relationship
between nurses and patients also positively impact recovery process and enhanced the
achievement of patient-centered care.

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