The Role of Transformational Leadership Among Nurse Managers
Transformational leadership has become increasingly important in healthcare settings in recent years. As the demands on healthcare organizations grow in complexity, the need for adaptable, collaborative leadership styles has taken precedence. Nurse managers play a pivotal role in setting the tone for their units and motivating staff. Adopting a transformational approach can help nurse managers meet today’s challenges while also improving outcomes for both staff and patients.
What is Transformational Leadership?
Transformational leadership is a style that inspires and motivates followers. Unlike transactional leadership which focuses on tasks and exchanges, transformational leaders focus on developing staff and fostering organizational change (Northouse, 2019). They do this by appealing to higher ideals and moral values through their vision, passion, and commitment. Key components of transformational leadership include idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration (Bass & Avolio, 1994).
Transformational leaders serve as role models who earn trust and respect. They articulate an appealing vision and inspire followers to achieve more than expected. They also challenge assumptions and take risks to solve problems in new ways. Finally, they pay attention to each individual’s needs for growth and achievement (Northouse, 2019). This helps transformational leaders develop staff potential and empower them.
Subtitle: Impact on Nurse and Patient Outcomes
Research has shown transformational leadership benefits both nurses and patients in healthcare settings. A meta-analysis by Cummings et al. (2010) found transformational leadership was positively associated with nurse job satisfaction, organizational commitment, and perceived quality of care. Similarly, a systematic review by Wong & Giallonardo (2013) concluded transformational leadership enhances nurse autonomy, job satisfaction, and professionalism. More recently, a study by Al-Hussami et al. (2021) found transformational leadership reduced nurse burnout and turnover intentions in Jordanian hospitals.
On the patient side, transformational clinical nurse managers have been linked to lower patient mortality rates (Wong et al., 2013). A study by Kearney et al. (2020) also found transformational leadership among nurse managers was associated with fewer patient falls and hospital-acquired infections. This suggests transformational leadership can improve both the nursing work environment and quality of patient care.
Subtitle: Barriers to Adopting Transformational Approaches
While the benefits of transformational leadership are clear, research suggests it is not always easy for nurse managers to adopt this approach. A qualitative study by Morsiani et al. (2017) found nurse managers faced barriers like heavy workloads, lack of autonomy over budgets, and pressure to prioritize tasks over staff development. Similarly, a survey by Wong et al. (2015) found nurse managers often lacked training in transformational techniques.
Organizational culture can also present challenges. For example, healthcare systems with hierarchical structures and transactional leadership styles may not support the empowering nature of transformational leadership (Wong & Giallonardo, 2013). Nurse managers need support and resources from their own leaders to effectively motivate and develop staff (Kearney et al., 2020). Without this enabling environment, the full potential of transformational approaches may not be realized.
Subtitle: Conclusion and Recommendations
In conclusion, transformational leadership shows great promise for positively impacting both nurse and patient outcomes. However, for nurse managers to adopt this approach, they require training, autonomy, and an organizational culture that values staff development over short-term gains. Healthcare administrators should support nurse managers by reducing bureaucratic barriers, providing leadership training, and role modeling transformational techniques themselves. With a collaborative, empowering approach at all levels, transformational leadership could help healthcare systems thrive during challenging times by engaging and retaining top clinical talent.

References
Al-Hussami, M., Darawad, M., Saleh, A., & Hayajneh, F. A. (2021). The effects of authentic and transformational leadership styles on nurses’ burnout and turnover intentions in the psychiatric hospitals. Journal of Nursing Management, 29(1), 96–105. https://doi.org/10.1111/jonm.13115
Bass, B. M., & Avolio, B. J. (1994). Improving organizational effectiveness through transformational leadership. Sage.
Cummings, G. G., MacGregor, T., Davey, M., Lee, H., Wong, C. A., Lo, E., Muise, M., & Stafford, E. (2010). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 47(3), 363–385. https://doi.org/10.1016/j.ijnurstu.2009.08.006
Kearney, M. W., Kelsey, C., & Doherty, M. E. (2020). The impact of nurse manager leadership style on care quality. Journal of Nursing Management, 28(5), 1004–1013. https://doi.org/10.1111/jonm.12946
Northouse, P. G. (2019). Leadership: Theory and practice. Sage publications.
Wong, C. A., & Giallonardo, L. M. (2013). Authentic leadership and nurse-assessed adverse patient outcomes. Journal of Nursing Management, 21(5), 740–752. https://doi.org/10.1111/jonm.12075

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