Effective Nursing Leadership: Qualities, Styles, and Practice

Introduction

Today, increasing numbers of nurses are leaving the profession due to burnout caused by the ongoing COVID-19 pandemic, as well as the rigorous and sometimes overwhelming demands placed on nurses — especially those working in tertiary healthcare facilities. Consequently, the shortage of nursing staff across the country has intensified, and there is a clear need to better engage nurses in their workplace. These trends also underscore the importance of effective nursing leadership to address these issues in meaningful ways.

The purpose of this paper is to review the relevant literature in order to provide a definition of leadership, a comparison and contrast of the leader and manager roles, and a reflection on leadership and management styles in practice. In addition, an examination of personal leadership and management style is followed by a salient example of preferred leadership application. Finally, the paper presents a summary of findings in the conclusion.

Defining Leadership in Nursing

From a personal perspective, a definition of leadership would include the ability and willingness to organize, motivate, and direct a group of people to achieve a common vision for an organization — one in which they would otherwise have little incentive to pursue on their own. This means that leadership also involves developing an appropriate and informed vision for an organization. In addition, leadership involves creating direction, communicating effectively, and inspiring and empowering others to work toward the articulated vision. Leadership also includes making difficult decisions, accepting responsibility for the actions and outcomes of the people one leads, and serving as a role model for others to follow.

Taken together, this definition of leadership is consistent with the guidance provided by many organizational behaviorists, and it underscores the importance of professional nurses developing these leadership qualities throughout their careers. In this regard, Sims (2019) emphasizes that "In today's healthcare climate, there is a shortage of nurses and nursing faculty. We need effective leadership to navigate through this crisis. Although all nurses are leaders, we must develop the necessary skills to be effective" (p. 272).

While every effective leader and leadership style is unique to the individual, some common characteristics and qualities of effective leaders in healthcare settings include the following:

Effective leaders clarify expectations and direction. When people know the rules of the game, they are more likely to follow the playbook. Leaders must articulate exactly what they want and need from teams and every individual, and all goals must be tied to organizational objectives.

Effective leaders model expected behaviors. Leaders need to orchestrate opportunities for people to see them behaving in alignment with expectations. Letting others observe how a leader interacts with people and handles challenging situations not only teaches by example but also builds respect.

Effective leaders create desire and opportunities for learning. Skills such as communicating information, demonstrating empathy, listening, asking objective questions, providing feedback, and dealing with challenging people and situations can be taught to staff members who are willing to learn. It is the leader's responsibility, therefore, to create the business case and mindset for people to want to improve (Scott, 2019, p. 40).

Comparing Leader and Manager Roles

The fundamental concepts of leadership focus on "the big picture" — how organizations operate within their environment and how best to navigate external pressures while moving toward a future vision. By contrast, management involves organizing and directing people within the organization to achieve that vision by performing the day-to-day operational tasks required. These roles translate into several notable similarities and differences between the leader and the manager.

Although the roles may overlap in real-world settings, there are distinct differences worth noting:

Leaders create a vision; managers create goals. One of the defining criteria for leadership is developing and guiding others toward a vision. Conversely, managers establish the step-by-step, day-by-day goals required to move their organization toward achieving that vision (Arruda, 2016).

Leaders focus on the long term; managers think short-term. Leaders are purposeful and determined, remaining focused on achieving long-term goals despite the absence of immediate rewards. Managers tend to focus on shorter-term objectives and typically require more frequent recognition to remain motivated (Arruda, 2016).

Leaders take risks; managers control risk. Leaders are willing to assume risks and attempt new approaches, even when failure is possible. They recognize that failure is frequently a necessary step on the path to eventual success. Managers, on the other hand, tend to focus on minimizing risk and avoiding problems rather than embracing and resolving them (Arruda, 2016).

When individuals occupy an integrated leader-manager role, they must develop the ability to drive change — reflective of the leadership component — as well as the ability to effectively execute plans and goals, which reflects the management dimension. According to research on leadership transitions, this balance is critically important for achieving success in any organization (Arruda, 2016).

Conclusion

The research showed that while there may be some overlap between the two roles, leaders and managers perform fundamentally different tasks. While leaders set a vision for the organization, managers are responsible for achieving the step-by-step goals that will move the organization toward that vision. The examination of personal leadership style involved an uncomfortably honest self-assessment, which indicated that there is meaningful room for improvement — particularly in focusing on interpersonal communication and maintaining clarity about end goals. Finally, the hypothetical vignette described a situation in which patient care was compromised by a nurse manager's personal bias, but ultimately protected by a nursing supervisor who took the time to gather all the facts before making a decision.

References

Arruda, W. (2016). Nine differences between being a leader and a manager. Forbes. Retrieved from https://www.forbes.com/sites/williamarruda/2016/11/15/9-differences-between-being-a-leader-and-a-manager/?sh=46dba7b14609

Scott, G. (2019). The leader as coach: Effective coaching is key to patient satisfaction and quality care. Healthcare Executive, 24(4), 40.

Sims, J. M. (2019). Styles and qualities of effective leaders. Dimensions of Critical Care Nursing, 28(6), 272–274.