Contemporary Theories of Leadership In Nursing

The Contemporary Theories of Leadership In Nursing. Leadership is an ongoing process, and nursing leaders must continually improve their skills and knowledge. By understanding and applying these modern leadership theories, nursing leaders can create a positive and supportive environment that promotes both patient well-being and staff satisfaction.

What are Contemporary Theories of Leadership In Nursing

Modern nursing leadership theories emphasize adaptability, team development, and creating supportive environments. Transformational, situational, and servant leadership play important roles. They focus on fostering a shared vision, adapting to individual and situational needs, and prioritizing the well-being of patients and staff.

Contemporary Theories Of Leadership

There are numerous contemporary leadership theories that grew from examining the multiple factors that contribute to successful leadership. Many modern theories continue to include concepts developed in earlier research but have expanded to include a multidimensional approach. In the late 20th century, leadership theorists started to notice that for leaders to be effective, the values and beliefs of the environment needed to be considered.

Change cannot occur simply by a talented leader’s imposing it; rather, relationships within the organization need to be cultivated to promote a productive and healthy environment. This marked a significant shift in leadership theories from those based on industrial models to theories that are more relationship focused. This progression is noteworthy for nursing because it incorporates the multifaceted nature of health-care organizations.

Nurses find themselves being called to leadership in ever-changing, complex environments where there are multiple stakeholders, increasing pressures of cost containment, and pay-for-performance initiatives. In the past, leadership theories were broken down into two types: relational and attribution. Currently, leadership theories have become multifactorial.

Relational Leadership Theories

Relational leadership theories focus primarily on the relationship that occurs between the leader and the team member. There is less emphasis on a leader’s traits, the situation or context, or the end result and more emphasis on the leader’s relations with others. Relational theories such as quantum, transactional, transformational, and connective share the objective of optimizing the rapport among team members and building teams.

Quantum Leadership

Quantum leadership draws some of its basic tenets from quantum theory in physics: The transition has begun in moving from views that are orderly and linear to those that are holistic and relational (Porter-O’Grady, 1999, p. 38). Traditionally, leaders have looked at work activities from the basic perspective of identifying tasks, jobs to be completed, and roles to be performed. The quantum leader looks at the system, the processes, and the relationships between workers and tasks to determine efficiency and job performance.

The unpredictability of a world dominated by chaos mandates models of leadership that incorporate flexibility and adaptability. Quantum leadership involves the premise of an increasingly complex, dynamically changing health-care environment. Nurses as leaders today are faced with ever-increasing complexity in both job duties and techno logical advances. Quantum leadership offers nursing a framework within which to develop leadership skills to assist in advancing the goals of their organizations.

Transformational Leadership

This theory focuses on inspiring and motivating team members to achieve a shared vision. Transformational leaders act as role models, encourage innovation, provide individual support, and communicate a compelling vision. It emphasizes optimal employee development and fostering a culture of trust and collaboration.

Situational Leadership

This theory emphasizes the importance of tailoring leadership styles to the specific situation and the maturity level of employees. Effective situational leaders can adapt their approach to the task, individual skills, and context of the situation. It involves understanding the readiness of team members and adjusting the level of guidance, support, and delegation accordingly.

Servant Leadership

Servant leadership prioritizes the needs of others, especially those of team members and patients. Servant leaders focus on developing and empowering people and fostering a culture of collaboration and mutual respect. This approach emphasizes active listening, empathy, and a commitment to the well-being of the team and patients.

Quantum Leadership

This theory, also known as complexity leadership, considers the complexity and dynamism of healthcare environments. Quantum leaders focus on creating environments that foster creativity, adaptability, and innovation to respond to complex challenges. It empowers teams to find solutions to complex problems and promotes a culture of learning and continuous improvement.

Caring Leadership

This theory emphasizes the importance of care and compassion in leadership and focuses on the well-being of patients and staff. Caring leaders create environments that foster empathy, mutual respect, and a sense of shared purpose. They value the uniqueness of each individual, promote self-actualization, and focus on mutual benefit.

Human-Centered Leadership

This is a more recent theory that emphasizes the importance of placing people (patients and staff) at the center of healthcare. Human-centered leaders focus on building relationships, fostering collaboration, and creating a supportive and inclusive environment. They recognize the complexity and dynamism of healthcare and emphasize the need for leaders to be adaptable and responsive to the needs of individuals and the system as a whole.

Transactional Leadership

Transactional leadership is one of the most common styles of leadership in health care institutions. The transactional leader focuses on the goals of the organization, with a directive style establishing expectations for team members and motivating with rewards. With this type of leadership, both the leader and the team member gain something from the interactions, although theirs is not necessarily a shared vision.

The leader is focused on getting the job done, and the team member is motivated by the reward earned. This approach limits innovation and the ability for team members to truly engage in the outcomes of their work. Given the focus of task completion, the concrete rewards that followers receive are more generally limited to a sense of a job well done (Burke et al., 2006).

Transformational Leadership

As health care has evolved and increased in complexity, it has become necessary for leadership models to address identified aims of quality improvement, particularly in keeping with the recommended aims of the IOM: the provision of safe, effective, patient-centered, timely, efficient, and equitable care (IOM, 2001). One leadership theory that fits well with these aims is transformational leadership.

Transformational leadership involves an active involvement of both the leader and team members. It is a process in which leaders and team members “motivate each other to attain and achieve levels of success” (O’Neill, 2013, p. 179). There is a unified investment in achieving the goals of the organization with shared values. A transformational leader guides staff in creating an environment in which all members contribute to meeting the mission of the organization.

The leader provides a vision that has included the input of all members, thus encouraging members to reach their highest potential and often exceed expectations. Transformational leaders transform organizations. In the process, all nurses at all levels of the organization are involved in decision making. Transformational leaders are able to help followers grow by responding to needs, empowering individuals, and aligning goals and objectives across all levels in an organization (ANA, 2013).

Transformational leaders are comfortable with challenging themselves, learn from their failures, and consistently demonstrate effectiveness in organizational change and innovation (O’Neill, 2013). Transformational leadership is viewed as an effective type of leadership for nurses to lead the change necessary to meet the demands of the current health-care system. This type of leadership has been identified as one of the five components of the Magnet Recognition Program.

Connective Leadership

Although transformational leadership attends to the creation of relationships by consensus building, resolving conflict, and establishing common goals, another popular theory focuses on caring. Connective leadership incorporates the needs of diverse stakeholders within the health-care environment through acknowledgment and use of the strengths of members and by including them in the leadership process (Lipman-Blumen, 1992). Nurse leaders and managers must consider not only whom they are guiding but where they may be leading them. Today’s health care environment demands a seamless continuity of care across multiple settings.

Connective leaders identify and foster strengths of team members by including them in the processes of change within the organization (Klakovich, 1996). A successful connective leader can develop future leaders who begin contributing early in their career, well before undertaking a formal nursing leadership position.

Attribution Leadership

Theories Attribution leadership theories share the historical perspective of trait theories, by considering the characteristics or attributes of the leader as the cornerstone within leadership relationships. In contrast to trait theories, attribution theories also take into consideration either the context or the interrelation aspects. Nurse leaders are neither born nor practicing within a vacuum.

An attribution leadership theory used in nursing is authentic leadership. Leaders engaged in authentic leadership hold firmly to their values, beliefs, and principles and inspire their followers. The determination and courage of the authentic leader in difficult and challenging times create an environment that is predictable, efficient, and steadfast. In addition, the integrity of the leader is evidenced by a strong commitment to truth telling, thereby decreasing ambiguity in the system and increasing efficiency and productivity (Shirey, 2006).

When leader’s integrity is at a high point, a healthier work environment is achievable. The health-care environment can present challenges from multiple conflicting stakeholders with competing agendas, and these challenges require fortitude and steadfastness from leaders. For example, financial pressures may be placed on nurse leaders and managers to adjust nursing care to fit within specific parameters that are not in keeping with their own value system (e.g., being asked to change nurse-patient ratios to unacceptable levels). An authentic leader will be challenged to hold steady to his or her beliefs and values.

The authentic leader must embrace self-awareness and self-regulation to enhance moral leadership (Waite, McKinney, Smith-Glasgow, & Meloy, 2014, p. 283). In moral leadership, the core ethical principles of nursing are held in highest regard. An authentic leader, while holding these principles in mind, “develop(s) heart and compassion by getting to know the life stories of those with whom they work and by engaging co-workers in shared meaning” (Shirey, 2006 p. 261). The five distinguishing characteristics of authentic leaders are purpose, heart, self-discipline, relationships, and values (p. 260).

Key Considerations for Nursing Leaders

Flexibility

No single leadership style is effective in all situations. Therefore, nursing leaders must be adaptable and able to shift between different approaches as needed.