Transformational Leadership - The Best Strategy for Nurses

Philosophy of Nursing Leadership

What are the best leadership theories when healthcare and nursing are involved? What style of leadership is most effective in today's healthcare environment? This paper addresses those questions and provides the scholarly literature on the topics in question.

Leadership Theories -- Nurses in Primary Health Care

"Leadership is seen in terms of unifying people around values and then constructing the social world for others around those values and helping people to get through the change" (Taylor, 2009). Moreover, leadership is needed -- and the development of leadership skills is needed -- in order to provide a vision, to bring people together, to sort out important values, and to facilitate the right actions to provide care for patients (Taylor, 40). Leadership doesn't usually just suddenly arrive in a person, it must be learned. According to Stubbs and Forbes-Burford (2009), leadership requires "courage, resilience and commitment" (Taylor, 41).

The author mentions several leadership theories, including "Great man theories," "Trait theories," "Situational-contingency theories," "transactional theories," and "transformational theories." The transformation theory will be discussed in detail later in this paper, along with transactional theories; but it is interesting to look into "Great man theories" because these theories take the position that leaders "are born and not made," and those kinds of leaders will "arise when a great need arises" (Taylor, 41). This theory seems rather shallow, and anyone can argue that leaders are not "born" but they are developed given the right motivation and environment.

As for "Trait theories," a leader is born with certain inherited traits, and develops certain behavioral characteristics that become useful in the sense of providing leadership along the path the person follows. People born with these traits -- assertiveness, adaptability, confidence, intelligence, and social skills -- are likely to become leaders, Taylor explains on page 41.

One negative as to trait leadership is that the "context in which leadership takes place is not acknowledged"

Through the lens of critical social science

Annette Solman is executive director of nursing at the Children's Hospital in New South Wales, and Adjunct Professor at the University of Technology in Sydney, Australia. She writes that because healthcare practices are "constantly changing" and "unpredictable"; and because these dynamics can result in "stress and crisis" for healthcare workers, leadership is "critical to supporting and leading staff through these complex times within healthcare" (Solman, 2010). The way in which Solman addresses this question is through a blend of "critical social science theories," using "practical development principals" and a "situational leadership framework," which will enact "transformational leadership" (Solman, 472).

The literature on leadership for nurses, according to Solman's writing, begins with a "situational leadership framework," which, along with "transformational leadership," helps to develop nursing staff. Solman's take on "transactional leadership" is that it does not fit well within the present healthcare milieu. "It is not the desired approach," she insists, and while "situational leadership" has been overlooked in recent years she believes that "transformational leadership" is the current theory that is most frequently promoted in the healthcare environment (473).

Looking at transactional leadership, it is characterized by a "reward and punishment system" when working with nursing staff toward certain specific goals (Solman, 473). In other words, here are the goals and the rules; if you follow them successfully, you will be rewarded, but if you fail, you will be punished or called out in some form.

However, transactional leadership is a "precursor" to transformational leadership. That is because transformational leadership goes several steps beyond what transactional leadership tries to accomplish. Transformational leadership supports nurses whether they achieve the goals and rules; it is considered an enlightened way to lead.

Transformational leadership

In the New York Times-owned journal about.com, Kendra Cherry explains that the concept of transformational leadership was launched by presidential biographer James MacGregor Burns. Burns believed that leaders and followers "…make each other to advance to a higher level of moral and motivation" (Cherry, 2010). The transformational leader, in this case the nursing leader who adheres to transformational style, uses strength of "vision and personality" to inspire others to change their "expectations, perceptions, and motivations" in pursuit of common goals (Cherry p. 1).

Bernard Bass worked to expand Burns' ideas; Bass believed transformational leaders "garner trust, respect, and admiration" from those who follow that leadership.

The basic components of transformational leadership are: a) "intellectual stimulation" (they encourage creativity and urge followers to "explore new ways of doing things"); b) "individualized consideration" (transformational leadership develops "supportive relationship" and this kind of leadership "keeps lines of communication open" so that followers are always feeling as though they are fee to share ideas and make contributions); c) "inspirational motivation" (the vision that transformational leaders have is articulated in understandable ways, and the passion transformational leaders exhibit motivates followers); and d) transformational leaders are role models, they "stimulate and inspire followers to both achieve extraordinary outcomes," and by doing so, they help followers to become transformational leaders) (Cherry, p. 2).

Meanwhile, Solman explains that situational leadership analysis is a "useful tool" for the leader that uses transformational leadership strategies. That is because the situational leadership can "aid in identifying the level of support" that is needed in a nursing environment that seeks "enlightenment" and "empowerment" (474). According to the work of Touchstone (2009), the framework that a situational leader works from assists in the "development of staff using a range of reflective supportive processes" (474).

An example of using critical social science in the nursing milieu

On page 474 Solman presents what she calls "a practical example" can be examined when a nursing staff "expressed problems getting through the day-to-day work of the patient care unit." The staff had problems identifying what the major "contributors were" to the situation they found themselves in, Solman explained (474). They worked hard and provided a high level of care, but they felt like they were in a crisis all the time, and weren't progressing (and were aware that the patients became "readmissions" regularly), Solman explained.