Leadership in Nursing and Management

“Not all leadership is about changing or challenging people’s vision of the )futre”(Stanley,
With reference to leadership, including clinical leadership, critially analyse and discuss the
statement quoted above. Your discussion should also address the debate about leadership
and management and draw different theories of leadership and managment to examine this
statement and support your argument

Leadership in Nursing and Management

This health leadership and management paper shall explore the theories of leadership and
management that would suit the dynamics of clinical nursing settings. The leadership style that is
utilized determines the management outcomes that executives in the health profession and other
fields achieve. Nurses and nurse leaders are in leadership positions because they make final
decisions on patient care. The nurses also influence the care that is given to the patients once
they leave the hospital based on the type of education that they give to the patient’s families or
loved ones. According to Stanley (2011), “Not all leadership is about changing people’s vision of
the future.” Indeed, leadership in all fields, especially in clinical management can concentrate on
different parameters, other changing of people’s visions. The clinical leadership can deal with
the maximum potential achievement by nurses and accomplishment of current tasks in delivery
of care to patients. Leadership encompasses attitudes and values which are evident in the manner
in which leaders and managers execute their roles. There are several leadership and management
theories which do not involve change, which are applicable in the nursing field.

Congruence leadership and management Theory
One of the most applicable leadership theories that would utilize a clinical management
paradigm is one with a perspective of congruence. A congruent based leadership theory would
utilize the health-based leader’s actions and integrate the principles and values that they attach to
leadership. Leadership in the clinical setting is best applied through the considerate application
of care based values by the healthcare managers. In nursing, several theories such as the
Nightingale’s Environmental Theory and Roy’s Adaptation Model have been utilized to explain
the rationale behind the care that nurses should apply to patients (Stanley, 2011). In nursing,
leadership does not speak to the exception of challenging or trying to change the current status of
the vision held by nurses. Instead, the nursing leadership that is used in managing clinical
institutions should focus on congruence in maximizing excellent care delivery to the patients at
hand. According to Hunt (2014), the United States has one of the highest nurses’ turnover rates
of about 14.1% per annum. One of the commonest complaints ad reasons for the high nurses’
turnover is poor leadership and lack of congruence in the healthcare setting. The type of
professional relationships that exist between nurses and nurse leaders effectively influences
patient outcomes. Nurse leaders influence the autonomy of clinically based roles and execution
of assigned roles by nurses. Nurse leaders that practice congruence in the relationship with
nurses that they supervise can replicate the relationship to suit the delivery of required patient
Congruence management in nursing contributes to the consideration of the culture and
specific requirements that particular patients would want to be considered. In the current
competitive healthcare market, nurses should increase the level of congruence care that they give

to patients. Nurses also attain positivity and cooperation from patients when they replicate
congruence from their leaders and managers; to their patients.
Transformational leadership
Leadership in nursing is a multi-dimensional phenomenon that requires the leader to
inspire high levels of morale and motivation among the followers. Transformational leadership
contributes to motivation among the nurses which improves productivity in the healthcare
setting. Leaders that use transformational management style contribute to a sense a commitment
among nurses. The healthcare setting can get hectic, hence the need for a leader that ensures that
nurses do not get overwhelmed by the situation at hand. The transformation ensures that there are
high levels of engagement with employees so that he or she is aware of the tasks assigned to the
different nurses. The leaders assist the nurses in transforming their abilities to excel in different
tasks that they face. The American Nurses Credentialing Center proposes transformational
leadership as one of the parameters in the Magnet Model (Harris and Cohn, 2014).
Transformational leadership application in the nursing field contributes to critical
thinking by clinical practitioners to utilize available competencies and tools to deliver the best
possible care and outcomes for patients. Transformational leadership would contribute to a
consistent improvement in the delivery of services by nurses to patients even in the absence of
the nurse leaders and managers. Transformation leadership in the clinical nursing setting would
contribute to a lower employee turnover. Employees have high and commendable performances
when their managers and leaders contribute to guiding their tasks to achieve stellar
performances. Harris and Cohn (2014) are in agreement with Stanley’s (2011) statement on
maintenance of the status quo in leadership and management in clinical nursing. The
transformational leadership establishes a culture of referring to certain pillars of excellence

associated with a department or health institution. Therefore, nursing practitioners understand,
and follow through on set systematic processes until they are hardwired, while maintaining
consistent communication on the performance of the action plan in place.
Emotional Intelligence based leadership
According to Heckemann, Schols, and Halfens (2015), emotionally intelligent leadership
utilizes emotions in ensuring that employees excel in applying their competencies at the
workplace. The leader maximizes the recognition of emotions in the employees to foster self-
awareness and empower employees at the workplace. The nurse leaders’ use emotional
intelligence in managing nurses, which they transfer as a care tool in managing their patients.
Emotional intelligence is critical in the nursing field because all patients are different. Therefore,
nurses should utilize standard nursing practices in tailoring the required care to patients. Such
emotional intelligence in delivering care promotes patient satisfaction and contributes to high
productivity among nurses. Emotionally intelligent leaders are capable of resonating to the
motivating factors of the different employees so that they are tuned to being as productive as
According to Udod and Care (2013), nurse leaders that utilize emotional intelligence in
managing employees can detect changes in attitude which affects performance. The nurse leader
would then seek a solution to the performance related issue and contribute to the employee’s
motivation and morale levels increase. Such resonation with employees promotes high
performance among nurses since they can relate to their leaders and managers as colleagues, and
not on a leader- employee relationship grounds only. Nurse leaders that utilize emotional
intelligence in leadership are aware of the current and future requirements of the organization,

and foster a positive working environment for the nurses (Heckemann, Schols, and Halfens,
Servant leadership and management
The servant leader utilizes their personal competencies in overcoming challenges in the
field such as the highly stressful nursing field in the healthcare setting. Delivering high quality,
culturally sensitive care can be quite challenging in the competitive healthcare setting. However,
effective nurse leaders are willing to be ethical in executing their roles and responsibilities; while
serving as role models through diligence (Johansson, Ulrika, Jarenbrant, Krerstin & Jorgen,
2016). The nurse leader should be willing to implement the objectives that they ask employees to
execute. The servant nurse leader is humble since he or she holds vast clinical knowledge and
experience, yet is ready to disseminate the expertise to the nurses in the different teams. The
clinical nurse leader utilizes a “hands on” approach in leading nurses, which completely
convinces the nurses that they can achieve the objectives that they have been assigned.
According to Della (2016), the nurse leader possesses skills in persuasion and conflict resolution,
all geared towards enhancing performance and productivity among nurses. The leader
emphasizes the importance of all the team members among the nurses to ensure that they utilize
each other’s strengths, and there is knowledge transfer while appreciating their differences and
culture diversity. Nurses that appreciate their colleagues’ cultural diversity are likely to transfer
the respect to patients from diverse backgrounds. The patients value the kinds of competencies
that are implemented through servant leadership since they are treated as the main stakeholder in
According to AANC (2014), the nurse leader should utilize a management style that integrates as
much interaction with employees as possible. Management by walking around (MBWA), would

suit the clinical nursing field due to the expertise that should be disseminated by the leader. The
management style promotes a positive reinforcement of the company’s culture and achievement
of team goals. The nurse leader utilizes their commitment to developing a team spirit and
cultivating the growth of competencies for the diverse team members.
In conclusion, it is possible for a nurse leader to effectively manage nurses without
challenging or changing their vision of the future. The nurse leader’s function would focus on
fostering a creative and positive environment for employees. The leader would also use their
emotional intelligence skills to detect any attitude changes in employees that would contribute to
poor performances in the corporation. The continuous monitoring of the department or
organization’s strategy would contribute to the nurse leader sticking to a consistent
communication plan to trigger corrective measures within set timelines. The leader should also
initiate behaviors that would trigger habits geared towards high productivity while utilizing
efficiency in cutting costs. The nurse leader utilizes technology and competencies in ensuring the
organization’s costs are kept to a minimal, and the employees are consistently trained on new
trends. The nurse leader is committed to utilizing broad competencies in ensuring that nurses
deliver the best care to patients. Leaders should adapt congruence, emotional intelligence, and
servant leadership skills to influence nurses through their clinical competencies which they
utilize for nurses to follow. The positive attitude that the nurse leaders adapt foster a favorable
working environment while utilizing the company’s culture to deliver satisfying health care to
patients. Such exertions would contribute to the attainment of the available goals in an
organization, rather than a focus on challenging and changing people’s vision of the future
(Stanley, 2011). A leader has strong and diverse roles, other than being a change leader. The
major roles that the leader should emphasize through their competencies and consistent

interaction with the nurses have been thoroughly dissected in this paper. The nurse leader is not
synonymous with “change leader,” rather, an emotionally intelligent servant leader that fosters a
positive environment for clinical expertise and high-quality patient care should be explored. A
self-aware nurse leader contributes to the growth of their team members while executing the
organization’s objectives through competent nurses in an effective manner.


AANC. (2014). Nursing Leadership: Management and Leadership Styles. AANC.
Della, A. (2016). Servant leadership, Emotional Intelligence: Essential for Baccalaureate Nursing
Students. Creative Nursing. 22 ( 3): 176-180.
Harris, D. & Cohn, T. (2014). Designing and Opening a New Hospital with a Culture and
Foundation of Magnet: An Exemplar in Transformational Leadership. Nurse Leader. 12
(4): 62-68.
Heckemann, B., Schols, J. & Halfens, R. (2015). A Reflective Framework to Foster Emotionally
Intelligent Leadership in Nursing. Journal of Nursing Management. 23: 744-753.

Hunt, D. (2014). Does Congruence between Nurses and Supervisors affect Job Satisfaction and
Turnover. Journal of Nursing Management. 22: 572-582.
Johansson, H., Ulrika, H., Jarenbrant, C., Krerstin, U. & Jorgen, W. (2016). The Impact of
Servant Leadership Dimensions on Leader-member Exchange among Healthcare
Professionals. Journal of Nursing Management. 24 (2): 228-235.
Stanley, D. (2011). Clinical Leadership: Innovation into Action. Australia: Palgrave Macmillan.
Udod, S.A. and Care, W. D. (2013). “Walking a Tight Rope”: An Investigation of Nurse
Managers’ Work Stressors and Coping Experiences. Journal of Research in Nursing. 18
(1), 67-79.