Leadership Theories in Practice in Nursing

Leadership Theories in Practice in Nursing Discussion – Week 4
            This paper will make reference to three formal leadership theories namely health-promoting, transformational, and transactional leadership theories. Health-promoting leadership aims at indirectly supporting the health of employees by creating healthy working conditions. Such working conditions are those that reduce the risk of stress and burnout (Jimenez et al., 2017). Transformational leadership is mainly concerned with the creation of motivation and relationships among employees Leadership Theories in Practice in Nursing. Transformational leaders inspire employee respect, confidence and loyalty (Sfantou et al., 2017). As for transactional leadership, the focus is on results. There is conformity to the organizational structure and success is measured based on the organization’s system of penalties and rewards (Asiri et al., 2016).

            The article by Jimenez et al (2017) documents a study that sought to determine the impact of health-promoting leadership on the working environment. The study established that health-promoting leadership can be defined as the capability and dedication of a leader to create the right working conditions for the organization’s employees. According to the study, such conditions constitute increased access to resources as a result of which the risk of the employees experiencing stress and burnout is reduced (Jimenez et al., 2017) Leadership Theories in Practice in Nursing. In the study explained in the article by Sfantou et al (2017), the author’s aim was to establish the impact of leadership style on the quality of care provided in healthcare settings. The researchers narrowed down to two leadership styles namely transformational and transactional leadership styles. They found that effective leadership is associated with a high-quality work environment that ultimately produces positive patient outcomes that serve as a motivation for the employees to do more. Transformational leadership was particularly linked to lower patient mortality. The study by Asiri et al (2016) was focused on determining the relationship between leadership styles and empowerment and the organizational commitment that nurses show in an acute healthcare setting. The study evaluated transactional and transformational leadership styles. The finding was that the nurse managers did not display the right level of transformational leadership behaviors and this negatively affected the nurses’ commitment to the organization. The transactional leadership style was, however, employed appropriately and this was associated with a higher commitment. Leadership Theories in Practice in Nursing


From the above resources, it is clear that leadership behaviors are extremely important in the healthcare setting where the safety of patients has to be upheld. One key insight is that in accordance to health-promoting leadership theory, leaders should ensure that employees have adequate access to resources as a way of cushioning them from stress and burnout. Stress and burnout leave nurses unable to appropriately attend to the need of patients, thereby compromising patient safety. A second insight is that a leadership theory or style, no matter how good it is, has to be adopted fully for it to produce the desired results. This can be seen in that whereas transformational leadership was associated with lower patient mortality in Sfantou et al (2017)’s study, inadequate transformational leadership behaviors resulted in a lower commitment to the organization in Asiri et al (2016)’s study.

I have seen the use of health-promoting leadership behaviors at my workplace. I work in a very busy inner-city Emergency Room/Trauma Center. This means that the flow of patients is high and the staff often has to attend to many patients within a short time; or fast enough to stabilize them. The patient acuity is very high, and it is imperative that we as a team, have the necessary resources in order to provide the most effective patient-centered care. To do this, it is extremely important that we have access to all required resources. For instance, our nurse manager arrives very early in the morning and secures all resources that are required on a typical day. It is a skill she has mastered over the years and we are almost always assured that we will get what we need when we need it. This approach has been extremely effective in ensuring that we do not move around looking for equipment and other resources thereby wasting precious time and opportunity to save the lives of our patients. Transformational leadership is also evident in the organization. Every end of the week, the nurse managers debrief the nursing staff, during which we reflect on accomplishments on the unit, as well as identifying opportunities for improvement. Any problematic issues, including those that interfere with the staff relationships such as the failure of one nurse to cooperate, are addressed therein. Doing this over time has produced staff that is highly cooperative and motivated to work together towards common outstanding results. Although I prefer a transformational form of leadership, I have adapted to be able to follow a transactional leadership style. Leadership Theories in Practice in Nursing.



Asirir, A., Rohrer, W., Al-Surimi, K., Da’ar, O. & Ahmed, A. (2016). The association of leadership styles and empowerment with nurses’ organizational                                 commitment in an acute         health care setting: a cross-sectional study. BMC Nursing, 15:38

Jimenez, P., Bregenzer, A., Kallus, W., Fruhwirth, B. & Wagner-Hartl, V. (2017). Enhancing      Resources at the Workplace with Health-Promoting Leadership.                   International Journal of        Environmental and Public Health, 14(10):1264

Sfantou, D., Laliotis, A., Patelarou, A., Sifaki-Pistolla, D., Matalliotakis, M. & Patelarou, E.        (2017). Importance of Leadership Style towards Quality of Care                    Measures in Healthcare        Settings: A Systematic Review. Healthcare (Basel), 5(4):73

Discussion 1: Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations. Leadership Theories in Practice in Nursing

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

  • Review the Resources and examine the leadership theories and behaviors introduced.
  • Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
  • Reflect on the leadership behaviors presented in the three resources that you selected for review.

By Day 3 of Week 4

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

By Day 6 of Week 4

Respond to at least two of your colleagues on two different days by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described Leadership Theories in Practice in Nursing

Great discussion, True to your statement, health-promoting leadership aims at indirectly supporting the health of employees by creating healthy working conditions and transformational leadership as defined is a general set of behaviors applicable across various settings where the leader wishes to inspire, motivate, and present a value-based vision that inspires action.

Effective leadership has been identified as crucial to positive patient/client outcomes across all clinical settings and strong leadership is critical for an organization if the vision of a transformed healthcare system is to be realized.

Transformational leaders are leaders that are equipped with effective leadership style, be it democratic or autocratic or a combination of other styles and should not just be present at the highest level of nursing. Rather, transformational leaders should be present at every level of the organization to inspire future leaders, empower the staff and share in the decision making. Leadership Theories in Practice in Nursing

The nursing leadership should set the standard for a transformational leadership and develops a well-articulated philosophy, professional practice model, strategic and quality plans in leading the nursing services.

In addition, nursing leaders must be knowledgeable and competent to be able to support the move for change to meet the current trends of the organization and to improve staff’s performance and satisfaction as well as ensure positive patients’ outcomes. Great post!

I also agree that transformational leaders are focus driven and work to make things happen in a timely and seamless manner- creating and enacting mandates are frequent measures of transformational leaders; however, it is important to note that even when a leader has a clear vision, lasting leadership occurs when people “follow you not because they must but because they want to” (Armstrong, 2018, p140).  Everyone likes to be encouraged and to work in a collaborative environment, creating a more effective work environment through heightened morale, team building, and a desire to come together for the good of the unit. Leadership Theories in Practice in Nursing

Reading of how your department operates is how the department I work in used to operate- and it is a good reminder that these places do exist. The leadership within your department echoes what Marshall and Brome (2017) describes as critical to leadership through “leadership development, coaching, and mentoring,” as all critical to developing transformational leadership (p. 164).  Within our department, we had an amazing leader; however, when she moved on to a higher role within the organization, there was a vacancy in her position for a long time, and now there doesn’t seem to be cohesion, I am the only nurse left with more than ten years’ experience, we can’t seem to keep nurses in the department, and there is no sense of teamwork. Leadership Theories in Practice in Nursing

Our former director, was always available for questions, she actively worked on the floor, and wasn’t just an administrator (though I understand sometimes this isn’t possible). Nevertheless, through her involvement with the staff, even the small things such as celebrating birthdays, milestones in years of service, etc., she was able to create an atmosphere of a true work family and everyone wanted to work in the department. She demonstrated true leadership through being goal-driven, supportive, and through recognizing the value of teamwork, feedback, collaboration, and making decisions effectively, efficiently, and collaboratively when appropriate (Marshall and Broome, 2017). Leadership Theories in Practice in Nursing




Armstrong, Lori, DNPc, MSN, R.N., N.E.A.B.C. (2018). CNE describes inseparable linkbetween nursing care and patient outcomes. Biomedical Instrumentation & Technology,         52(2), 140-142. Retrieved from                                                                                                                                                    http://ezproxy.gardner-webb.edu/login?url=https://search-proqust-com.ezproxy.gardner-webb.edu/docview/2018965296?accountid=11041

Marshall, E., and. Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nded). New York, NY: Springer.(pp.145-170) Leadership Theories in Practice in Nursing. 

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