Contrasting Leadership Styles in Nursing

Leadership is essential in the nursing profession, particularly given technological advancements, financial difficulties in healthcare facilities, and shifts in the industry. As Hood (2010) notes, leadership entails guiding others towards common objectives. This piece will delve into the differences between leadership and management, while also analyzing two distinct styles of leadership - Transactional and Transformational - and how they impact nursing performance.

There is often a debate about the distinction between Leadership and Management.

Leadership and management are often confused, but they are distinct concepts.

Leadership entails convincing others to adopt a vision and prioritize the collective good over individual interests (McGuire & Kinnerley, 2006). Leaders motivate through enthusiasm, hope, optimism, and innovation.

Leadership includes management traits, but does not have the power to carry out their visions. Managers are designated within an organization and must concentrate on tasks such as budgeting and monitoring quality. Although the structure of an organization mandates that managers prioritize efficient operations, it does not guarantee that they have leadership skills.

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Managers primarily deal with problem-solving related to maintaining production levels and profitability (Hood, 2010; McGuire & Kinnerley, 2006; Carney, 2009).

James McGregor Burn (1978) introduced the theory of transformational leadership as a process that motivates subordinates by appealing to higher ideals and moral values. A transformational leader focuses on empowering staff, fostering creativity, and promoting innovation in the workplace (Sellgren, Ekvell, & Tomson, 2006). This leadership style emphasizes relationships with employees and their well-being alongside task completion (Hood, 2010). By utilizing enthusiasm, strong interpersonal relationships, and a clear vision, a transformational leader inspires peers and coworkers to remain motivated and diligent in achieving organizational goals and tasks.

This type of leadership, as explained by Allen (1998), can be equally effective in the most stressful circumstances by focusing on employee satisfaction and promising a better future. Sellgren et al. (2006) have shown a correlation between transformational leadership and nursing quality, increasing productivity and staff cohesion. Through staff cohesion, consensus is reached amongst staff, allowing all to feel they have contributed to decision-making processes about unit practices/policies. Despite taking more time, reaching a consensus results in participants committing to executing decisions (Hood, 2010).

Transactional Leadership emphasizes the reciprocal relationship between leaders and followers, with followers being motivated to fulfill tasks and meet expectations set by the leader. This leadership approach centers on offering precise direction, oversight, feedback, and rewards for accomplishments. Transactional leaders utilize contingent incentives such as financial bonuses or advancement opportunities to motivate followers and achieve organizational goals.

Transactional leadership, as defined by Hood (2010) and Sellgren, Ekvell, & Tomson (2006), relies on rewards and punishments to motivate employees. Positive reinforcement is provided for meeting expectations and goals, while negative consequences are enforced for failing to meet them. This style of leadership prioritizes tasks over relationships with employees and emphasizes structure, role expectations, and rewards.

According to B.M. Bass (1985), contingent reward behavior leads to improved role clarity, job satisfaction, and performance. This leadership style is most effective in sales and commission-based occupations where strong job performance is crucial for income. However, a drawback is that commitment can fluctuate and personal motivation may decrease until rewarded (Sellgren, Ekvell, & Tomson, 2006). Additionally, this structured leadership style limits creative growth and employee satisfaction (McGuire & Kinnerley, 2006).

Leadership Styles in the Nursing Field

Within healthcare settings, it is crucial for nurses in leadership positions to possess both skill and knowledge. Due to the constant advancements and changes in healthcare, nursing leadership must be results-oriented, creative, and innovative in their respective units (Gellis, 2001).

Transactional leadership in nursing may be ineffective due to its limited advantages. While it can assist healthcare facilities in managing staffing issues resulting from nurse shortages, depending solely on incentives such as additional pay for extra shifts is insufficient for encouraging nurses to enhance their level of care. Emphasizing only rewards and punishments could potentially harm patient results and contradict the ethical guidelines established by the ANA.

According to research, transformational leadership is considered more effective than transactional leadership as it creates a supportive environment where individual differences are acknowledged, promotes two-way communication, and values effective listening skills (Bass, 1985). This style of leadership also enhances conformity, adaptation, diligence, and commitment from employees/followers. Transformational leadership is highly important in nursing as it motivates nurses to enhance their problem-solving abilities, become visionaries, improve their communication skills, engage in research, and excel as educators.

Transformation leadership is typically acquired through experience, empowerment, and self-exploration (Hood, 2010). Reluctant or premature placement of nurses in leadership roles can result in ineffective leadership abilities due to insufficient education and uncertainties about the role (Carney, 2009).

Nurses can improve their leadership skills through both informal on-the-job training and formalized leadership training sessions. According to Hood (2010), focusing on self-management, social capabilities, and job proficiency is crucial for nurses looking to enhance their leadership abilities. Shared leadership, as recommended by Kerfoot & Wantz (2003), can assist staff in developing problem-solving skills. However, some nurses may lack the confidence to apply these skills in leadership roles. By participating in formal leadership training sessions, nurses can enhance their communication, motivation, conflict resolution, organizational analysis, and team-building skills. This not only encourages more nurses to take on leadership roles but also empowers them to foster a culture of inspirational leadership within healthcare organizations. Ultimately, this investment leads to improved patient care, organizational progress, and future development.

In conclusion

There are two distinct styles of leadership in nursing: Transformational and Transactional. Transformational leadership involves inspiring and motivating followers to prioritize the leader's vision/goals over their personal needs through empowerment, while Transactional leadership relies on rewards or punishments, offering little motivation for followers to become visionary. Transformational leadership is more advantageous in nursing as it encourages adaptation, communication skills, visionary pursuit, and occupational growth in a rapidly changing industry. It is crucial to formalize leadership training to enhance nursing care delivery, improve patient outcomes, and advance organizational goals.

References
Allen, G. (1998). Leading. Retrieved from http://ollie.dcccd.edu/mgmt1374/bookcontents/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 work 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.