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There are several recognized leadership styles such as bureaucratic where the leader rigidly follows rules, policies, and regulation; or participative here the leader allows the staff to participate in decision making and seek the participation of those involved. Our discussion will revolve around two forms of nursing leadership patterns, mainly transformational and transactional styles of leadership.
Transformational leaders use the feminine approach and “inspire and empower everyone with the vision of what could be possible” (Hood, 2006 as cited in Burns 2003); whereas, transactional leaders use the masculine approach and “maintain daily operations using rewards to motivate subordinates” (Hood, 2006 as cited in Burns 2003). Review of the Professional Nursing Literature Leadership styles in nursing can be evaluated by understanding the relationship between management, planning, and structure of the organization.
The leadership skills and abilities of the nurse manager are critical to the contribution of the smooth operation of inpatient units and acute care hospitals. Thus, the manager’s leadership implementation style can have significant impact on work environment and organizational commitments. If the nurse manager can positively influence the work environment and foster the staffs organizational ointment, the leader will stimulate greater achievement at the unit level while enhancing the organization’s competitive advantage (McGuire & Keenly, 2006). Nurse Managers can be transformational or transactional.
According to McGuire & Keenly (2006, p. 1 79), “In an era when nurse managers are both critical to, and responsible for retention and performance, leadership style is critical to achieve both outcomes”. Leadership styles can be learned or taught, and an effective leader is one who maintains a balance between transformational and transactional leadership style, thus meeting the needs of the followers. Employees feel more committed and loyal to the organization when they have a sense of belonging, feel more self-confident and involved and share a common sense of direction (McGuire & Keenly, 2006).
Traditionally, it has been the nurse manager’s job to plan, direct, coordinate, and control the activity and personnel on the unit. However, today’s hospitals are calling for managers who have the ability to coach and mentor staff which creates a supportive climate where individual differences are recognized, two- way communication is promoted, and effective listening skills are valued McGuire & Keenly, 2006). Healthcare leadership continues to run under a transactional style which may be the main reason why nurses are exiting the system.
Transformational leadership style which is best suited to team building, however, may be the key to reducing nursing shortage. It ignites followers with a vision and enables them to be motivated. The transformational model leads to shared governance through involvement in decision making, which can be empowering to team members. With transformational leadership ?? with no one telling followers what o do ?? they feel empowered to take on responsibility and be accountable. With the face of the workplace changing to the transformational style, it requires the use of effective and appropriate communication (Thayer, 2003).
The styles of nursing leadership and management effects work environments. A correlation has been found between healthy workplace environment and healthy patients, along with the well-being of the staff. The transformational style and participative management, has also been correlated to the patient to nurse ratio; educational level of the nurses; opportunities for learning and professional placement; reward schemes; quality of patient care; patient satisfaction; employee health and well-being programs; nurse satisfaction; and retention of nurses (Toomey, 2009).
Application of Clinical Example “Transactional leadership is a style of leadership focused on contingent rewards of followers” (McGuire & Keenly, 2006, p. 180). Goals are set, directions are given, and rewards are used to reinforce employee behaviors associated with meeting or exceeding established goals. Followers are manipulated and controlled with rewards of praise and recognition, merit raises, and promotions, which can be given or withheld according to the employee’s performance.
The outcome of such behavior is enhanced role clarity, job satisfaction and improved performance (McGuire ; Keenly, 2006). “Transformational leaders use ideals, inspiration, intellectual stimulation, and individual consideration to influence the behaviors and attitudes of others” (McGuire ; Keenly, 2006, P. 180). The leader clarifies the responsibility and accountability of the staff, and identifies and agrees on responsibility. The leader also has continuous consultation and support of the staff.
Continuous feedback and update is provided, ongoing evaluations and acknowledgments are given, and achievements are celebrated. The staff is protected and motivated, which improves quality of nursing practice. My manager employs both transformational and transactional leadership styles. Patient first is our policy at work. I can recall an incident where a patient presented to triage in active labor on a busy night and no beds were available on Labor and Delivery to admit the patient too. She was very uncomfortable with the contractions and efforts at breathing techniques and relaxation methods roved unsuccessful.
The patient refused to be medicated with intravenous medication as she had her heart set on an epidural which was not given in our triage area, and was only done on Labor and Delivery. However, my manager was made aware of the situation and a quick call to the Anesthesiologists resulted in him coming to triage to administer the epidural which made the patient very happy. Her pain controlled, she was now smiling and did not mind waiting for her bed to become available. She was given a robe with the hospital’s logo on it for her understanding of the situation by the manager.
Conclusion Although healthcare continues to run under a transactional leadership style, transformational leadership is ideal for today’s nursing society as it seeks to satisfy needs and involve both the leader and the follower in meeting those needs. It is also flexible, allowing the leader to adapt to varied situations. The leader accepts that things will change often and followers will enjoy this flexibility.