Leadership is a very important aspect within the realm of Nursing. With constantly evolving technology, poor economics leading to major hospital cutbacks, and healthcare reforms, strong nursing leadership has never been more important or necessary. Hood (2010) defines leadership as a process of influencing others to attain mutually agreed upon goals. We will discuss the differences between leadership and management. In addition, we will examine 2 types of leadership styles: Transactional and Transformational and address the effectiveness of both styles in achieving high quality of nursing performance.
Leadership vs. Management
Many people think of management and leadership as interchangeable. However, there is a stark difference between the two. In defining leadership and management, the one crucial difference is that a person with leadership has the ability to persuade/influence others into following their vision and putting the needs of a group ahead of an individual’s own personal needs (McGuire & Kinnerley, 2006). Leaders have this ability to inspire by employing enthusiasm, hope, optimism, and innovative methods.
Leadership does entail having some management characteristics, but lacks the positional power to bring their visions to life. Management is usually an appointed position within a company (Hood, 2010). Performance standards for managers often require emphasis on transactional projects such as budgets, productivity, and quality monitoring (McGuire & Kinnerley, 2006). Management does not equate to having leadership abilities because an organization’s structure often dictates that a manager’s priority should be facilitating and promoting smooth operations within a workplace (Carney, 2009). Managers are troubleshooters and problem solvers, who are more or less interested in maintaining production and profits.
In 1978, James McGregor Burn (1978) developed the theory of transformational leadership and described it, “A process that motivates subordinates by appealing to higher ideals and moral values”. A transformational leader is someone that helps shape development of staff through empowerment and stimulating creativity and innovation within the workplace (Sellgren, Ekvell, & Tomson, 2006). Under this style of leadership, relationships to employees and concern for their well-being is just as important as completing the tasks (Hood, 2010). The transformational leader often uses their enthusiasm, close underlying interpersonal relationships, and vision to increase the motivation of their peers/co-workers to stay persistent and diligent through completion of organizational goals and tasks.
This type of leadership can be equally effective under the most stressful circumstances by keeping focus on employee satisfaction and promising the employee a better future (Allen, 1998). According to S. Sellgren et al. (2006), studies have shown a correlation between transformational leadership and nursing quality. Transformational leadership has been proven very effective in increasing productivity and staff cohesion. As a result of staff cohesion, consensus amongst staff evolves and develops. Consensus is effective because all persons feel that they have made a contribution in the decision-making process regarding unit practices/policies. And although it takes more time to reach a consensus, the participants have made a commitment to execute the decisions (Hood, 2010).
Transactional leadership uses strategy that is founded on the principles of incentives and punishments (Hood, 2010). Motivation is thought to be derived from responses to positive and negative reinforcers. If employees or subordinates perform hard work and meet certain criteria or expectations, then they are rewarded with something of value (i.e. increased salary, bonuses, promotions, etc…). However, if they fail to meet goals or expectations, then they face some form of punishment (i.e. probation, demotion, termination). This type of leadership system is much more task oriented and focuses very little on employee relationships (Hood, 2010). A transactional leader is much more focused on structure, role expectations and the possibility of reward to staff (Sellgren, Ekvell, & Tomson, 2006). It seems however there are benefits to this type of system.
According to B.M. Bass (1985),” The ultimate outcome of such contingent reward behavior is enhanced role clarity, job satisfaction, and improved performance”. This style of leadership appears to be most effective in occupations relating to sales and commissions. Commission based jobs that rely on strong job performances to either establish income or supplement salaried income respond effectively to this style of leadership. However, the disadvantage to this type of leadership is that commitment is variable and negotiable, and any personal incentive/motivation an employee may have to increase job performance diminishes until it’s rewarded (Sellgren, Ekvell, & Tomson, 2006). In addition, because this leadership style is so structured, it leaves little room for creative expansion or employee job satisfaction (McGuire & Kinnerley, 2006).
Leadership Styles and Nursing
Within healthcare settings, skill and knowledge are vital ingredients needed by a nurse in a leadership position. Because of the many medical advancements and changes that take place in healthcare, it necessitates that nursing leadership become more results oriented, creative, and innovative within their respected units (Gellis, 2001).
Within nursing, transactional leadership would have few benefits if applied. It does benefit healthcare organizations in combating staffing issues relating to nursing shortages. Incentive pay to pick up extra shifts has always been instrumental for organizations in need of nursing coverage. However, the overall methods of rewards and punishment would do very little to inspire nurses to increase their quality of nursing care. Patient outcomes would be greatly compromised if care was solely based on reward. Compromising patient care based on lack of reward and/ punishment would be highly unethical and in complete violation of the ANA’s standards of care.
Research has always supported that transformational leadership is more effective than transactional leadership because it increases a supportive climate where individual differences are recognized, two-way communication is promoted, and effective listening skills are valued (Bass, 1985). This leadership style also increases conformity, adaptation, diligence, and commitment from employees/followers. The need for transformational leadership in nursing is great because it encourages nurses to become improved problem-solvers, visionaries, communicators, researchers, and educators.
Transformation leadership is often a process that is learned and cultivated through experience, empowerment, and self-exploration (Hood, 2010). However, when nurses are placed into leadership positions reluctantly or prematurely, the lack of education for the role and uncertainties about what leadership in nursing means takes place and leads to ineffective leadership abilities (Carney, 2009).
Nurses receive informal on-the-job training for leadership positions by learning self-management skills, social capabilities, and job proficiency skills (Hood, 2010). It must be noted that shared leadership is probably the most effective way for providing staff the effective skills/ tools needed for problem solving (Kerfoot & Wantz, 2003). However, not all nurses have the self-belief or confidence to apply these acquired skills to leadership positions. One way of encouraging more nurses to assume leadership positions is by formalizing leadership training sessions which would help nurses learn and/ reinforce skills relating to communication, motivation, conflict resolution, organizational analysis, and building effective teams (Kerfoot & Wantz, 2003) . By investing in formalized leadership training, it helps to empower nurses while also promoting future growth of inspirational leadership which could lead to improvements in patient care/outcomes and organizational advancements for future generations.
There are two different styles of leadership: Transformational and Transactional. Transformational leadership influences followers to place their personal needs aside for the benefit of a leader’s vision/goals through empowerment, inspiration, and motivation. Transactional leadership is founded on the incentives of reward or punishment and offers little incentive to become a visionary. Transformational leadership appears to be more effective in nursing because it promotes adaptation, communication skills, visionary pursuit, and occupational growth to a rapidly changing industry. Efforts should be made to formalize leadership training for continued improvement in delivery of nursing care and patient outcomes, and organizational advancements.
Allen, G. (1998). Leading. Retrieved from http://ollie.dcccd.edu/mgmt1374/book contents/4directing/leading/lead.htm Bass, B. M. (1985). Leadership and performance beyond expectation.. New York, NY: The Free Press. Burns, J. M. (1978). Leadership. New York, NY: Harper & Row. Carney, M. (2009). Leadership in nursing: current and future perspectives and challenges. Journal of Nursing Management, 17(4), 411-417. Gellis, Z. D. (2001). Social wok perceptions of transformational and transactional leadership in healthcare. Social Work Research, 25(1), 17-25. Hood, L. J. (2010). Conceptual Bases of Professional Nursing (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Kerfoot, K., & Wantz, S. L. (January-February 2003). Compliance Leadership: The 17th Century Model That Doesn’t Work. Nursing Economics, 21(1), 42-44. McGuire, E., & Kinnerley, S. M. (July-August 2006). Nurse Managers as Transformational and Transactional Leaders. Nursing Economics, 24(4), 179-185. Sellgren, S., Ekvell, G., & Tomson, G. (2006). Leadership styles in nursing management: preferred and perceived. Journal of Nursing Management, 14(11), 348-355.
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