Leadership in nursing practice : Nursing made Incredibly Easy (2022)

What do nursing and leadership have in common? Caring and compassion. Leaders do more than organize, direct, delegate, and have vision; they use interpersonal skills to help others achieve their highest potential. A recurrent theme in the literature is that leadership involves influencing the attitudes, beliefs, behaviors, and feelings of other people. This results in a feeling of being genuinely valued and respected—a basic way to achieve self-actualization and establish a trusting culture. Leadership is the foundation that brings an organization's mission and vision to fruition (see What leaders do).

Keep in mind that leadership and management skills are different. Whereas managers are adept at controlling processes, making decisions, and coordinating resources, leaders empower others, inspire innovation, and challenge traditional practices. Leadership is about relationship-building; it facilitates management. However, these skill sets need to overlap to ensure safe, quality care (see Comparison of leadership and management statements).

As a nurse who may not be in a formal leadership position, how can you be a leader in your clinical area? By cultivating a positive leadership style, considering techniques such as leadership by walking around (LBWA) and mentorship, and continuing your education, nurses in every role and at all levels can be effective leaders.

Sure got style!

There are several different leadership styles: servant, transformational, democratic, authoritarian or autocratic, and laissez-faire. Let's take a closer look.

Servant

Servant leadership occurs when an individual influences others by developing relationships and team member skills. Servant leaders value diverse opinions, cultivate a culture of trust, have excellent listening skills, think long-term, and respond to the needs of individuals and groups with humility.

Transformational

Transformational leadership creates valuable and positive change in individuals and social systems with the end goal of developing followers into leaders. Transformational leaders display three general characteristics: 1) individualized consideration—the degree to which the leader focuses on each follower's needs; 2) intellectual stimulation—the degree to which the leader changes assumptions, challenges the status quo, and takes risks; and 3) inspiration motivation—he or she “walks the talk.” In other words, transformational leaders are role models for the change process.

Democratic

Democratic leadership fosters a participative and teamwork approach to problem solving. It's the democratic leader's responsibility to validate the importance of each team member's input and derive themes from the totality of the team's work. For example, a democratic leader may say, “We've had a good brainstorming session and these are the important points I'm hearing from the team.” The democratic leader embraces a spirit of collegiality so that everyone on the team feels valued in the problem-solving process. Effective communication techniques, especially listening skills, are important tools that the democratic leader uses.

Authoritarian/autocratic

Authoritarian or autocratic leadership is demonstrated when a person makes every decision without considering input from others. Negative reinforcement and punishment are often common with this leadership approach. The focus may be on blame rather than continuous improvement of imperfect processes. However, this leadership style is often effective during a crisis or emergency when a decision must be made immediately.

Laissez-faire

Conversely, the laissez-faire leader provides little or no direction or supervision. Generally weak at supporting the mission and vision of the organization, this type of leader doesn't usually address problem areas or empower others to celebrate their successes or identify areas for improvement. Laissez-faire leaders let things happen rather than make things happen.

The change process is best accomplished using the servant, transformational, and democratic leadership approaches. These three styles often result in people who are motivated through inspiration. When clinical nurses say that they want to be just like their supervisor, it's a strong indication that the supervisor puts people first and is a transformational leader.

Walk this way

LBWA is a powerful and simple strategy to ensure that your nursing team feels valued and outcomes are achieved. Remember that your nursing colleagues may see you as a leader even though you may not necessarily be in a position of authority. The idea is to get out and see how things actually work, visiting with people and gaining insight into who's doing what. To operationalize this strategy, the sole goal of LBWA is meeting with people rather than taking care of business issues.

For example, as you move from one person or group of people to the next, ask questions or make comments, such as the following: “How was your weekend?” “How's it going today?” “How was your son's high school graduation?” “Have you and your spouse made those cruise reservations yet?” “I saw your daughter's engagement announcement in the newspaper.” Make sure you're alone when you walk around, your sincerity shines through with a smile and good listening skills, and you involve everyone. Don't circumnavigate anyone.

One strategy while visiting with someone is to ask them “May I have a seat?” and then share a story or situation about yourself unrelated to work. Take time to share your aspirations. When you share something about yourself, people feel needed, valued, and important. Be funny and use humor as appropriate. People will see that you're real and down to earth. On occasion, plan to walk around when you know people are engaging in specific activities of which they're proud. Show up during the activity and acknowledge the team's excellent work, expressing how proud you are of them. You'll find that managing people and processes is more effective when you use the LBWA method.

The value of mentorship

Simply stated, mentoring (or coaching) is a dynamic process of building supportive relationships to enhance professional growth and maximize individual potential (see Developing future nurse leaders). Mentorship is a means of sharing your knowledge, skills, attitudes, and behaviors with another nurse. The mentoring process may be as simple as providing words of encouragement. What are the qualities of a mentor and what do mentors do?

  1. Mentors have self-knowledge. They understand their roles within an organizational context and have the courage to identify ways to improve nursing practice. Mentors aren't afraid to acknowledge their weaknesses. They also understand the importance of celebrating their own strengths and the strengths of their mentoree and other nursing colleagues.
  2. Mentors have strategic vision. They have the ability to connect the essence of nursing practice—compassion and caring for people—to evidence-based approaches to continuously improve the quality of patient care. Having strategic vision involves being a risk-taker by “thinking outside of the box” and having an interprofessional methodology to achieving organizational goals. In short, mentors are successful change agents.
  3. Mentors are effective communicators. They're skilled in verbal and nonverbal communication skills, providing clear and articulate guidance and responding in ways that show respect. Calm and relaxed in countenance and body language, they're good listeners who give the mentoree time to process before speaking and indicate that they understand what he or she is communicating. Additionally, mentors aren't afraid to indicate that they're wrong and offer an apology.
  4. Mentors are supportive and encouraging. Effective mentors are patient, kind, and motivate the mentoree to problem solve. They're approachable, available, and trustworthy. They may use humor and have fun in the journey with their mentoree, but they always demonstrate genuine compassion.

Building the future

In order to advance nursing as a profession, we must continue our formal education. Patient outcomes are more likely to be achieved at a higher level as we further our education and experience.

(Video) Leadership in Nursing

In 2013, the Robert Wood Johnson Foundation released The Case for Academic Progression, which states that patients, employers, and the nursing profession benefit when nurses advance their education. In 2014, the American Association of Colleges of Nursing released a position statement titled The Impact of Education on Nursing Practice, strongly encouraging nurses to progress their education in support of the Institute of Medicine's 2010 Future of Nursing report call to increase the number of baccalaureate-prepared RNs to 80% by 2020. In 2015, the American Nurses Association and the Organization for Associate Degree Nursing released a joint position statement titled Academic Progression to Meet the Needs of the Registered Nurse, the Health Care Consumer, and the U.S. Health Care System that recommends seamless pathways in educational mobility for the RN pursuing advanced education.

Nurse leaders should develop an action plan for career mobility. The nursing education career ladder allows an individual to stay at one level or advance one step at a time to a higher level of education. For example, a practical/vocational nurse can set his or her initial goal to earn an associate degree in nursing to become an RN, with an eventual goal of earning a doctoral degree in nursing, such as the doctor of nursing practice. Nurses who wish to pursue an executive, academic, or NP role will need to earn at least a master's degree in nursing; however, doctoral degrees are becoming more of a standard in these roles. Don't forget the value of other graduate degrees, such as in education and interprofessional studies, as you evaluate your career goals.

Leaders also need to consider earning certifications in a nursing specialty area. And as a nurse leader, you'll need to continue enhancing your leadership abilities by attending conferences and workshops that have a nursing and interprofessional focus.

Celebrating nurses

There's a need for leadership at all levels of nursing practice. Although our roles may be different according to educational preparation and experience, we all have one common goal: to provide safe, quality patient care. Enjoy your journey in our wonderful profession.

Developing future nurse leaders

  • Experienced nurse leaders who are known leaders in any practice setting should be encouraged to serve as mentors for other nurses.
  • Mentors should be on the lookout for nurses in the practice setting who show characteristics associated with leadership. Mentorees may be nurses who've just graduated from nursing school or those who have many years of experience.
  • Mentors should encourage mentorees to continue their formal and informal education by attending leadership conferences and earning an advanced degree or certification. Mentors must also continue to learn.
  • Nurse leaders understand the value of service. They should routinely engage in community-wide service activities that support the foundations of nursing practice.
  • It's important to remember that leadership entails a commitment to improving nursing care through research. Keeping up to date with research findings is important at all levels, from practical/vocational to doctorally-prepared RNs.
  • Nursing students and new graduates who envision themselves as future nurse leaders should make a plan for professional development. They should be encouraged to collaborate with nursing faculty and nurses in practice as they develop their action plan.
  • Professional socialization is important. Leaders take part in professional nursing organizations and community-wide social events. The key is to be involved.

REFERENCES

American Association of Colleges of Nursing. Fact sheet: the impact of education on nursing practice. www.aacn.nche.edu/media-relations/EdImpact.pdf.

    American Association of Colleges of Nursing. Nursing leadership: management and leadership styles. https://www.aanac.org/docs/white-papers/2013-nursing-leadership—management-leadership-styles.pdf?sfvrsn=4.

      American Nurses Association. Nine principles of nursing leadership. www.americannursetoday.com/nine-principles-of-successful-nursing-leadership/.

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        (Video) Leadership in Nursing

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              Foli KJ, Braswell M, Kirkpatrick J, Lim E. Development of leadership behaviors in undergraduate nursing students: a service-learning approach. Nurs Educ Perspect. 2014;35(2):76–82.

              (Video) Developing Leadership Skills in Nursing

              Hodgson AK, Scanlan JM. A concept analysis of mentoring in nursing leadership. www.scirp.org/journal/PaperInformation.aspx?paperID=36602.

                Kotter JP. Leading Change. Boston, MA: Harvard Business Review Press; 2012.

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                    Makaroff KS, Storch J, Pauly B, Newton L. Searching for ethical leadership in nursing. Nurs Ethics. 2014;21(6):642–658.

                    Organization for Associate Degree Nursing. Organization for Associate Degree Nursing and American Nurses Association joint position statement on academic progression to meet the needs of the registered nurse, the health care consumer, and the U.S. health care system. www.noadn.org/files/apin/15062_OADN_ANA_PositionStatement_Academic_Progression_2015_2.pdf.

                    (Video) Unit I| Lecture 02 : Introduction to Leadership & Management | Nursing leadership Urdu/Hindi 2022

                      Patterson BJ, Krouse AM. Competencies for leaders in nursing education. Nurs Educ Perspect. 2015;36(2):76–82.

                      Robert Wood Johnson Foundation. The case for academic progression: why nurses should advance their education and the strategies that make this feasible. www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf407597.

                        Sullivan EJ. Becoming Influential. A Guide for Nurses. 2nd ed. Upper Saddle River, NJ: Prentice Hall; 2012.

                          Vinales JJ. Mentorship part 1: the role in the learning environment. Br J Nurs. 2015;24(1):50–53.

                          Wong CA. Connecting nursing leadership and patient outcomes: state of the science. J Nurs Manag. 2015;23(3):275–278.

                          (Video) NCLEX Practice Quiz for Nursing Leadership and Management

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                          FAQs

                          What are the 4 leadership styles in nursing? ›

                          Regardless of their title, nurses in all roles are expected to demonstrate leadership, and must challenge themselves and the profession to develop effective leadership styles.
                          ...
                          These are:
                          • Transformational.
                          • Democratic.
                          • Laissez-faire.
                          • Autocratic.
                          • Servant.
                          8 Sept 2020

                          What is leadership nursing practice? ›

                          As Bell defines it, nursing leadership is: The ability to inspire, influence and motivate nursing staff and other health care workers to work together to achieve their highest potential and collective organizational goals.

                          How can nurses have good leadership skills in nursing? ›

                          Good communication skills and an understanding of developments in your profession and health care field are key to being perceived as a leader. share knowledge with students, novices and UCPs. Nurses are in an ideal position to assume leadership roles within today's health care system.

                          What are the 7 leadership styles in nursing? ›

                          Leadership Styles
                          • Transformational. Transformational leaders form strong relationships and inspire nurses to act independently to achieve a hospital's greater vision. ...
                          • Autocratic. ...
                          • Democratic. ...
                          • Laissez-Faire. ...
                          • Pacesetting. ...
                          • Strategic. ...
                          • Servant.

                          What leadership style is best in nursing? ›

                          Transformational Leadership in Nursing

                          The transformational leadership style in nursing is widely seen as the gold standard in nursing leadership because it promotes improved patient outcomes and greater job satisfaction among staff nurses, studies show.

                          What is the most effective leadership style in healthcare? ›

                          Transformational leaders in healthcare are noted to be the most favorable leadership style. They improve productivity and have high job satisfaction rates. Nurses who lead in this type of style can work in any setting.

                          Why Good leadership is important in nursing? ›

                          Leadership in the healthcare industry

                          Reviews and research have shown the importance of leadership within healthcare, linking it to patient mortality, quality of patient care and patient satisfaction, and better staff wellbeing and morale.

                          What are examples of leadership in nursing? ›

                          Examples of leadership in nursing might include being skilled at handling conflicts between staff members in a supportive manner. Nurses might also show leadership through the way they communicate with patients, such as answering tough questions about a medical condition in a kind and compassionate way.

                          What is the most important skill of the nurse leader? ›

                          Communication Skills: Essential for any good leader, the ability to clearly articulate one's ideas and convey information to others is vital for a nurse leader, especially when it comes to patient care.

                          What makes a good leader? ›

                          Good leaders are uplifting. They praise employees for a job well done, taking time to coach and train if there are lapses in performance. In good times and bad, good leaders bring out the best in their employees by encouraging them to be their very best.

                          How do you lead a nursing team? ›

                          6 tips for leading an effective nursing team
                          1. Know thyself. Nurse leaders need to be reflective about their own leadership style. ...
                          2. Create a shared vision. ...
                          3. Be emotionally aware. ...
                          4. Be positive. ...
                          5. Open lines of communication. ...
                          6. Trust to be trusted.
                          28 Feb 2019

                          How do nurses develop leadership skills? ›

                          5 Ways to Improve Nurse Leadership Skills
                          1. Pursue lifelong learning. ...
                          2. Mentoring goes both ways. ...
                          3. Confidence is a vital nurse leadership skill. ...
                          4. Enhance communication skills. ...
                          5. Get involved.
                          18 Jan 2019

                          What makes a good clinical nurse leader? ›

                          Clinical nurse leaders need to be detail oriented. They have to document every step of what they do for a patient. If the nurse is responsible for training floor nurses, then this person will also have to document the entire training process. These nurses must also be tuned in to the details of a patient's condition.

                          How does nursing leadership impact patient care? ›

                          Examples of these processes may include facilitating work conditions that promote optimum safe patient care, creating open communication with staff to support quality care standards, or promoting positive relationships with staff that promote work engagement.

                          How can I develop my leadership skills? ›

                          9 Ways to Develop Your Leadership Skills
                          1. Practice discipline. A good leader needs discipline. ...
                          2. Take on more projects. A great way to develop your leadership skills is to take on more responsibility. ...
                          3. Learn to follow. ...
                          4. Develop situational awareness. ...
                          5. Inspire others. ...
                          6. Keep learning. ...
                          7. Resolve conflicts. ...
                          8. Be a discerning listener.
                          12 May 2022

                          Why is good leadership important in healthcare? ›

                          They promote continuous development of the knowledge, skills and abilities of staff in order to improve quality of patient care, safety, compassion and the patient experience. They consistently encourage, motivate and reward innovation and introduce new and improved ways of working.

                          How do nurse leaders influence change? ›

                          4 ways nurse leaders can change workplace culture.
                          1. Become a transformational leader. The traditional healthcare workplace is transactional: you do a good job, you get rewarded. ...
                          2. Lead the transition to value-based care. ...
                          3. Use disruptive strategies. ...
                          4. Empower your staff.
                          7 Aug 2019

                          What is the role of a leader in healthcare? ›

                          Leaders are tasked with bringing individuals together, ensuring that everyone within the business has the opportunity to grow as healthcare professionals and to promote their abilities and their approach to their work.

                          How do you demonstrate clinical leadership? ›

                          Clinicians showing effective leadership need to draw upon their values, strengths and abilities to deliver high standards of care. This requires clinicians to demonstrate competence in the areas of: • Developing Self Awareness • Managing Yourself • Continuing Personal Development • Acting with Integrity.

                          What is transformational leadership style in nursing? ›

                          Transformational leadership in nursing is a management style that motivates nurses to take ownership of their roles and perform beyond minimum expectations. This leadership style motivates team members by appealing to their desire to demonstrate higher moral values and integrity in practice.

                          Why the leadership is important? ›

                          Leadership is important because it inspires, motivates, and sets an example for people to accomplish positive changes in the world. Leaders establish a vision, provide a plan of action, and build strong relationships with their followers. As a result, they guide people to accomplish incredible feats together.

                          What is leadership nursing essay? ›

                          Leadership is one of the most important skills in nurse managers. It is a process of interaction between the leader and the staff, influencing them positively toward achieving the goals and tasks of the organisation. Transformational leadership is very effective and is commonly used in hospitals.

                          What challenges do nurse leaders face? ›

                          Using content analysis the challenges faced by the nursing leaders as identified in the studies were group into six (6),namely workload, Human resource recruitment and staffing, budget, Change management and team diversity, Unclear job description and patient safety and expectations.

                          How do nurse practitioners show leadership? ›

                          Leading by example, mentoring the next generation of nurses, working to improve health policies and standards, striving for excellence in care delivery and standing up for equitable treatment — these are just a few areas where nurse leaders can make an impact.

                          How many leadership styles are there in nursing? ›

                          To become an effective leader in this profession it's important to know the six leadership styles in nursing and which of those would be best for your team.

                          What are examples of leadership in nursing? ›

                          Examples of leadership in nursing might include being skilled at handling conflicts between staff members in a supportive manner. Nurses might also show leadership through the way they communicate with patients, such as answering tough questions about a medical condition in a kind and compassionate way.

                          What is an example of transformational leadership in nursing? ›

                          For example, a nurse leader with a transformational style would find creative ways to inspire staff with a vision for the future, including meeting with groups of staff or using staff e-mails to lay out goals and ways of reaching them.

                          Why is good leadership important in nursing? ›

                          Reviews and research have shown the importance of leadership within healthcare, linking it to patient mortality, quality of patient care and patient satisfaction, and better staff wellbeing and morale.

                          How do you lead a nursing team? ›

                          6 tips for leading an effective nursing team
                          1. Know thyself. Nurse leaders need to be reflective about their own leadership style. ...
                          2. Create a shared vision. ...
                          3. Be emotionally aware. ...
                          4. Be positive. ...
                          5. Open lines of communication. ...
                          6. Trust to be trusted.
                          28 Feb 2019

                          Why is it important to know your leadership style in nursing? ›

                          Leadership and management styles notably affect nurse performance and job satisfaction. Effective nurse leaders directly impact quality of care and patient experience. Some of the best leaders ensure efficiency and proficiency while delivering mentorship.

                          What makes a strong nursing leader? ›

                          Strong communication, critical thinking, and organizational skills are common characteristics expected of any leader. In addition, a positive attitude, honesty, loyalty, and passion for their work all defines a good leader.

                          What is the most important skill of the nurse leader? ›

                          A nurse leader must be equipped with top-notch communication skills to maximize success across the board. Effective communication can encourage collaboration among members of all levels and positions in the health care sector.

                          How do nurse leaders inspire others? ›

                          Modeling the way

                          You model the way by setting the example for others to follow, demonstrating open communication and enthusiasm for nursing excellence and patient care.

                          What are the four pillars of transformational leadership in nursing? ›

                          This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealised influence; inspirational motivation; intellectual stimulation; and individual consideration.

                          What are the four pillars of transformational leadership? ›

                          There are four factors to transformational leadership, (also known as the "four I's"): idealized influence, inspirational motivation, intellectual stimulation, and individual consideration. Each factor will be discussed to help managers use this approach in the workplace.

                          What are the key principles of leadership? ›

                          11 principles of leadership
                          • Admit your mistakes. To err is human, but some leaders are uncomfortable with the idea that their team could see them make a mistake. ...
                          • Be a good listener. ...
                          • Be innovative. ...
                          • Communicate. ...
                          • Continuously brush-up on your leadership skills. ...
                          • Create common values. ...
                          • Embrace change. ...
                          • Lead by example.
                          19 Jun 2020

                          What is effective leadership? ›

                          Effective leadership is about executing the company's vision (or redefining and improving it, in some cases) and setting the tone and the culture for that particular organization. Leadership means creating and planning, securing resources, and looking out for and improving errors.

                          Why the leadership is important? ›

                          Leadership is important because it inspires, motivates, and sets an example for people to accomplish positive changes in the world. Leaders establish a vision, provide a plan of action, and build strong relationships with their followers. As a result, they guide people to accomplish incredible feats together.

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