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NURSING LEADERSHIP PHILOSOPHY

Kayla Adkins

Delaware Technical Community College

NUR 400 Nursing Leadership

Ms. Brown

October 11, 2020

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Nursing Leadership Philosophy

Nursing leadership theories and styles have changed over the years. There used to be two

styles that were mainly used thirty years ago, and they were autocratic and bureaucratic. Fast

forward a couple years and there are now ten theories that can be used to help explain nurse

leadership styles. These styles are Deming's theory which focuses on management and staff

interaction, group work/teamwork and/or team ownership is the focus. Drucker’s theory where

staff should participate in as much planning and establishment of goals and decision making as

possible. Contingency theory focuses on the situational variables that affect the leader-member

relationship, task structure, and position power. Management grid model which includes five

styles of leadership; impoverished leadership, country club leadership, authority, organizational,

and team leadership. Connective leadership theory which focuses on caring and connecting to

others. Emotional intelligence theory which supports the need for leadership to develop a work

environment that supports and encourages staff to work or perform at an optimal level.

Knowledge management theory recognizes the importance of the knowledge worker,

interprofessional collaboration, and accountability. Leadership 2.0 examines what is required for

people to get into leadership positions and the skills required to be a great leader or at least more

effective than other leaders. Servant leadership delegates authority to engage staff.

Transformational leadership focuses on the need for leaders who are willing to embrace change,

reward staff, guide their staff members in understanding their roles, importance of a positive

work environment, and work toward developing staff that are self-aware and able to take risks to

improve (Finkelman, 2016).

Transformational leadership begins with a vision and mission statement. The leaders that
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display this type of leadership style often display many of the following characteristics, self-

confidence, self-direction, honesty, energy, loyalty, commitment, and the ability to develop and

implement a vision (Finkelman, 2016). These leaders developed this theory because the leaders

needed to be ahead of change as much as possible, focus on change and how the leader adapts to

change as opportunity for improvement, engaged in the change process, and draws staff into the

process in which change can lead to opportunities (Finkelman, 2016). Transformational

leadership is conceptualised as incorporating the four dimensions of idealised influence,

inspirational motivation, intellectual stimulation, and individualised consideration (Nielsen, et

al., 2019). “Idealised influence occurs when the leader acts as a role model and articulates high

performance expectations. Inspirational motivation is displayed when the leader communicates a

clear and attractive vision of the future providing meaning to followers. Intellectual stimulation

occurs when leaders motivate and challenge followers to think for themselves and to be creative.

Individualised consideration is conveyed when the leader pays attention to followers’ individual

needs, strengths, and aspirations” (Neilsen, et al., 2019).

Having the characteristics of a transformational leader is very important not only if you

are trying to be a leader, but also in nursing. As a nurse it is very important to make sure that you

are able to work as a team effectively, and to have a leader that is able to make that happen.

Having the qualities of a transformational leader promotes a healthy work environment that

generates great follower satisfaction, retention, and effectiveness (Clavelle, et al., 2016). At the

hospital where I currently work I have had the chance to encounter a handful of leaders and learn

their different teaching and leadership styles. Even though I work with managers that doesn’t

always mean that they are effective leaders, there are some co-workers of mine that show better

leadership styles than some of the managers. Managers typically focus on managing or
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maintaining equilibrium and daily operations, whereas leaders are focused on change and often

have broader views of organizations and strategies (Finkleman, 2016). The co-workers that I

work with are the reason that I have chosen the transformational leadership style as one that I

aspire to achieve one day, because of the effectiveness that it has on others.

It is now more important for me now than ever to display this transformational leadership

style because I am now a charge nurse on my floor. As stated multiple times already

transformational leadership is about vision, ability to inspire followers, trust, sharing a bond with

followers, and being able to empower others (Curtis, et al., 2011). Even before I was a charge

nurse, my co-workers and managers recognized that I was a great leader and would allow me to

precept new nurses on the floor. As a nurse I am always looking for ways to help the unit as a

whole and help our teamwork grow. To help initiate changes on the unit I attend general surgery

meetings. These meetings include the surgeons, the champion from the floor, the manager from

the surgical floor, and other workers who associate with the surgeons. At these meetings I bring

any information from the floor that any of my coworkers are concerned about and ideas that we

think the surgeons should be aware of and I also recommend any changes that I think need to

happen in order to improve our workflow of the unit. The surgeons at these meetings bring up

any information that they feel needs to be improved on the floor whether it be from nasogastric

tube insertions, strict intake and output, early ambulation, or even something as simple as

making sure the bowel movements are charted and up to date. It is then my job as the general

surgeon champion to take these issues and update my coworkers on the new changes and follow

up to see how they are working on our unit. This is just one example of how I am able to

incorporate transformational leadership into my everyday nursing.

My everyday nursing displays the characteristics of transformational leadership because I

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try to reward staff to the best that I can, I help guide other staff members in understanding their

roles, and I always try to keep a positive work environment because it helps keep my other

coworkers in high spirits. Clavelle (2016) states that example behaviors displayed by this type of

leadership include, committed and trustworthy, confident, articulates a vision of future and

encourages others, questions the norm and facilitates expression of ideas, and considers

individual abilities, needs, and aspirations. I am very committed to my job and love what I do

and I have been told by my coworkers, surgeons, and patients that they can tell that I am in the

right field of work because it shows how much I care about my patients. I am very confident in

what I do and that surprised me because when I first started working in the hospital I was shy

and timid. Also when I was orienting as a new nurse my preceptor told me that I was the best

new grad and I was a very good nurse even though I had only been a nurse for a short amount of

time, so this helped build my confidence and I now tell new grads to not stress when they first

start because it will get easier. Encouraging others I believe is one of the most important pieces

of making a good leader because if you build that trusting relationship with your coworkers they

will come to you for any questions or concerns they may encounter.

Being a nurse means the rest of your career is filled with learning something new

everyday and to be a great nurse you have to be willing to accept the changes and implement

them. I work with nurses who have been in this field for over forty years and they are still

learning something new everyday. When I started on the floor there were skills that I was taught

and to this day they have remained the same but there have also been some skills that have

changed and it is a matter of adapting to these changes and making sure that your coworkers are

adapting just as easily as you did, and if they didn’t then finding ways to help make the transition

easier on them.
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One of the biggest parts of being a nurse is being an advocate for your patients. As I

stated before patients have told me that I am very good at my job and that if they have something

they are concerned about they feel comfortable enough to ask me because they know I will get

them the answers they are looking for. For example there have been times that surgeons were

going to discharge their patients but the patient nor did I feel that they were ready to go so I

brought my concerns up to the surgeon and they allowed them to stay another night. There have

been other times when the surgeons tell the patients they are going to change their pain medicine

and get side tracked and never put the orders in so I follow up with them to ensure they place

those orders so the patients are not in pain. It could even be something as small as sending the

doctor a page to see what time they will be rounding on their patients, so the patients can give

their family a heads up if they are going to be discharged. Being an advocate means that you put

your thoughts and opinions behind you and listen to the patient and make sure their concerns are

voiced and you do everything that you can to support their decisions. This displays

transformational leadership characteristics because you are showing compassion and that you

sincerely care about your job and your patients.

Effective communication plays a huge role in being a great leader. Not only does the

communication have to be clear with your coworkers but also with the doctors, unit managers,

case managers, and the supervisors that round on the floor daily. Effective communication is

needed from nurses to doctors because we are with the patient for twelve hours a day, whereas

doctors see the patients for a maximum of thirty minutes a day. Therefore we need to be the eyes

and ears for the doctors so we are able to tell them when something is not going right or if we

think something needs to be changed or added. Case managers play a huge role in getting

patients home or to rehab so it is very important to keep them in the loop of patient status and
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critical information. At my hospital we have multidisciplinary rounds (MDR) everyday which

includes doctors (sometimes), charge nurse, primary care nurse, and the case manager. This is an

effective way to discuss the patient's care and status regarding discharge.

Displaying a transformational leadership style can also be described as leaders who

transform the values, desires, aspirations, and priorities of their employees and motivate

employees to outperform expectations (Adam, et al., 2016). Also, the participative decision-

making style practiced by transformational leaders gives employees a sense of involvement

(Adam, et al., 2016). This leadership style is something that I am working on everyday to better

my relationship with my fellow coworkers. My ultimate goal is to become a manager or

supervisor on a surgical unit one day so that I am able to reward my staff the way that I have

been rewarded, help them better themselves and motivate them to outdo themselves frequently,

but most importantly making them feel that they are an asset to my team and never want to leave.

I can only hope that one day I am able to be half the leader that my supervisor and manager are.
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References

Adam, M. B. H., Choi, S. L., Goh, C. F., & Tan, O. K. (2016). Transformational leadership,

empowerment, and job satisfaction: the mediating role of employee empowerment.

Human Resources for Health, 14(1). https://doi.org/10.1186/s12960-016-0171-2

Clavelle, J., Fitzpatrick, J. J., Griffin, M. T. Q., & Spano-Szekely, L. (2016). Emotional

Intelligence and Transformational Leadership in Nurse Managers. JONA: The Journal of

Nursing Administration, 46(2), 101–108. https://doi.org/10.1097/nna.0000000000000303

Curtis, E. A., Vries, J. de, & Sheerin, F. K. (2011). Developing leadership in nursing: exploring

core factors. moam.info. https://mafiadoc.com/developing-leadership-in-nursing-

exploring-core-factors_59c3e8f81723dd285cbc6170.html.

Finkelman, A. (2016). Leadership and management for nurses: Core competencies for quality

care. Boston, MA: Pearson.

Nielsen, K., Tafvelin, S., Schwarz, U. V. T., & Stenling, A. (2019). Leading well is a matter of

resources: Leader vigour and peer support augments the relationship between

transformational leadership and burnout. Work & Stress, 33(2), 156–172.

https://doi.org/10.1080/02678373.2018.1513961