According to Sullivan and Decker (1997) transactional leadership is a traditional, goal oriented type of leadership based on the social exchange theory. Work is exchanged for rewards in order to maintain the status quo and implement company policy and procedures. This leadership is essentially based on economics. The leader and followers both benefit socially and economically by exchanging performance for rewards. This exchange continues until one of the parties views the exchange as nonofficial to them. An example of this would be monetary incentives to pick up extra shifts when staff challenged.
This exchange meets the financial needs of the follower and the leader is successful in keeping the facility adequately staffed. This type of social exchange breeds dependence and satisfies self interests of those involved. It is predictable and routine. It does not put the interest of the patient or client in the forefront. Murphy (2010) contends that our first nursing leader, Florence Nightingale was a transactional leader and that her traditions set the foundation for such leadership style in nursing for decades.
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During her time, this type of leadership as termed autocratic and was eventually replaced with the term transactional. Therefore authoritarians and transactional leaders have the same qualities. The matriarchal and hierarchal control that Nightingale implemented during her time went on to dominated the nursing field for decades. Many nurses still cling to this type of leadership which can be effective only in crisis situations. Unfortunately, in the healthcare profession, new nurses are often promoted quickly without much experience or education on leadership styles.
In the attempt to be successful and out of fear of failing they will become directive and authoritarian to accomplish their personal driven goals. This facilitates transactional leadership which has proven to be obsolete and ineffective in improving quality patient outcomes and motivating the workforce. Transformational leadership moves people beyond basic transactions and motivates them to revolutionized change for a common goal. It is not based on maintaining the status quo but instead inspires followers to envision what could be possible and then encourages them to work toward that goal.
This leadership supports empowerment of the front line staff to anticipate and prepare for true changes or trends in healthcare. Everyone works together for a common shared vision and not for individual or personal gains. The effective transformational leader in the nursing profession will inspire others to become leaders and promote shared governance. They place value on teamwork and collaboration between all members of the organization. Unity is a core value to them. The transformational leader is successful at ” creating a community within the organization. ” (Hood, 201 0, p 460).
People who belong to a community take pride and ownership of that community and focus on continuous quality improvement in their community. A sense of belonging elevates an individual to seek higher standards and promotes positivist in the workplace. Kermit (2008) summarizes that educated workers want to make a difference and contribute to a humanitarian cause and not just be delegated to perform their technical skill. If they do not feel that they make a difference then they will eventually feel exploited which leads to negativity and turnover in the organization.
Organizations with transformational leaders tend to have greater staff retention and reports of reduced stress in the workplace. In a longitudinal study published in The Journal of Advanced Nursing, Miner and Noise (2009) concluded that transformational leadership styles reduced stress in the workplace and contributed to better sleep habits of the employees. Application of Clinical Example Transformational leadership will guide the current metamorphosis that is taking place in the nations skilled nursing facilities.
Long term care for elders is transitioning from the skilled nursing facilities to community based settings such as assisted living facilities, retirement communities, home health and adult day are facilities. This leaves the traditional nursing home faced with the changing needs of health care in our society. It is forecasted that skilled nursing facilities will become the transitional acute care centers for rehabilitation as hospitals are now discharging complex patients earlier than before to satisfy Homo’s and financial restraints.
The ma and pa nursing home of the past will have to succumb to this drastic change in order to survive financially. This transition must be led by transformational leadership in order to be successful. A study in 008 by Nelson et all on the effects of transformational leadership in long term care, determined that this leadership facilitated a higher job satisfaction amongst long term care workers and a sense of well being.
The employees who dedicate their lives to altercate will need to have a higher sense of job satisfaction and personal well being to endure the task of the drastic culture change that will take place in their profession. They will need to buy into this process and make it their own in order for it to be successful. They will need strong visionary leaders to tide them through the process with a shared vision. Many of the geriatric health care providers have been in their field for years and may feel like they cannot meet the growing demands of acute care.
They will need to be empowered to embrace the change that is headed their way. Through transformational leadership they will unite and work toward a common goal of resident centered care through this transition. Those facilities with transactional leadership have a much less chance of surviving this change on the horizon for long term care. In fact, transactional, authoritative leadership could be stateroom as health care providers would most likely rebel against a change that they have no control over and is forced upon them by a leaders who do not share common ground with their followers.
Conclusion Transactional leadership supports a task oriented work force based on a the social exchange theory. The outcome is business as usual without a sense of purpose. Transformational leadership encourages a community of unique professionals working toward a shared vision for the greater good of the organization. The result of this type of leadership is higher job satisfaction and reflections ownership which then facilitates better patient outcomes.
Providing transformational leadership in the changing field of long term care will facilitate a smoother transition for the workers and keep them focused on positive client outcomes.