Nurse leaders can make a positive impact on all aspects of clinical care by serving as role models, creating a positive working environment, setting the standard for patient care and helping their health care organizations function more effectively.1
The scope of leadership in nursing goes beyond job titles and positions of authority. Leaders can emerge from any role. They鈥檙e marked by their critical thinking and interpersonal skills, which allow them to effectively influence the members of their team and others they encounter.1
Leadership is important to increase positive patient outcomes, which require a variety of professionals to work together to facilitate high-quality care. Collaboration among all members of a patient鈥檚 care team promotes patient safety, and nurse leaders are often at the center of interprofessional collaboration.2
This article will discuss the importance of for optimal patient outcomes and health care management, as well as types of leadership styles and roles.
The foundations of nursing leadership
Nursing leaders display qualities that cause others to look to them for guidance as they train new nurses, manage their teams and ensure their patients receive the best care. Although nurse leaders can have different styles of leadership, the following qualities make them more effective:
Compassion
Compassion is usually the quality most associated with all nurses, for good reason. To provide effective care, nurses need to be able to understand and empathize with their patients. Nurse leaders also need to have compassion for the nurses and other professionals on their teams. Health care can be an extremely stressful job, and the best leaders understand this and attempt to alleviate stress rather than add to it.3
Integrity
Patients and their families trust nurses to make critical decisions that affect their health and lives. Nurses have to make decisions that meet the needs of their patients and families, their leaders and health care organizations, the Board of Nursing for their state and the ethical standards of the nursing industry.3
Clear communication
In a health care setting, miscommunications can be fatal. Effective leadership and management in nursing depend on clear communication at every touchpoint鈥搘ith patients, other nurses and every member of the health care team. Active listening is critical when managing nursing staff so you can be sure your team understands your instructions and expectations.4
Strong Advocacy
As a nurse leader, you鈥檒l have to advocate for your nursing staff and your patients. Nursing is a demanding job, and due to staffing shortages and an aging population nurses are often overworked. It may be necessary for you to speak up to make sure your nurses have the resources they need and that your organization follows fair staffing guidelines.4
Nursing leadership examples and styles
There are many different types of nursing leadership styles. The most effective type for you will depend on factors such as your personality and your working environment. Some of the most common leadership styles include the following:
Autocratic
An autocratic nursing leader makes decisions quickly without asking for input from staff or others. This leadership style can be off-putting, but may work well during emergency situations.4
Transformational
Transformational leadership in nursing is inspiring and motivates teams to achieve their best. This type of leadership emphasizes the personal growth and development of your team members. It鈥檚 an ideal style for mentoring relationships.4
Transactional
Nurse leaders with a transactional style focus on getting the job done quickly and efficiently. This style may be seen as abrupt by some, but it can work well in fast-paced environments where time is short and minimizing errors is a top priority.4
Situational
Nurse leaders need to be flexible, and the situational style exemplifies this trait. Nurses who use this style of leadership adjust their actions and responses based on the situation. If you adopt a situational approach, you may use an autocratic approach in an emergency but a transformational style during one-on-one mentoring.4
Why is leadership important in nursing?
Nursing leadership has a direct impact on the quality of patient care, staff morale, and nursing performance.
High-quality patient care
According to a review published in the health sciences journal 鈥淗ealth SA,鈥� nurse leaders have a primary role in establishing and maintaining practices that affect patient safety. As a nurse leader, you can create better patient outcomes by creating a culture that prioritizes safety. To do this, you鈥檒l need to assess and mitigate risks, evaluate the skills and performance of the staff who report to you, and educate your team on patient safety measures.5
Nursing performance
Effective nurse leaders bring out the best in their staff. According to a study published in the health care journal 鈥淚nquiry,鈥� nurse leaders whose leadership style motivates their teams positively influence nursing performance. Quality leadership was associated with better performance, while leaders who weren鈥檛 civil had teams who performed poorly.6
Leadership practices that encouraged autonomy and competencies in nurses while still fostering a culture of relatedness were most effective. Strong nurse leaders also respected the individual characteristics of the nurses working for them and provided them with the support they needed to be effective.6
Staff morale
Nursing can be a demanding job, and stress can negatively affect morale. Nurse leaders can positively influence staff morale by looking for opportunities to engage in meaningful communication on a consistent basis to identify issues and help resolve them. You may not be able to act on every suggestion of staff nurses. Issues such as pay increases or hiring more staff may be outside of your sphere of influence. However, you can make sure your staff feels heard and work with them to find solutions that will help give them as many resources as you can. Making sure to listen, and to act on their requests when it鈥檚 possible, also makes your staff feel valued.7
Types of nursing leadership roles
Nursing is a very flexible career. You can work as a leader in many different capacities, including the following:
Charge nurse
As a charge nurse, you鈥檒l be intimately involved in everyday operations by assigning jobs to your nursing staff and creating schedules. You鈥檒l also still be involved in patient care and work as part of the team. It鈥檚 a great first step into leadership and a good option if you don鈥檛 want to leave hands-on care behind. Some of your other responsibilities will include:8
Answering questions from staff nurses
Making sure staff nurses follow established protocols and procedures
Working with oncoming nurses to facilitate a smooth shift transition
Checking patient supplies and medications
Nurse manager
Unlike charge nurses, nurse managers work in upper-level leadership roles and aren鈥檛 usually involved in direct patient care. They often hold or certificates and work in an office setting. If you want to work as a nurse manager, your job duties might include:8
Hiring, scheduling, and supervising staff and charge nurses
Coordinating with other professionals鈥攕uch as therapists, social workers and pharmacists鈥攖o provide the best patient care
Overseeing financial matters for your staff
Serving as a human resources coordinator
Acting as a go-between for the clinical health care providers and the director of nursing or C-suite leadership
Director of nursing
The director of nursing oversees the entire nursing department at an organization. This requires an advanced degree such as a Master of Science in Nursing, a Doctor of Nursing Practice, or equivalent, as well as extensive nursing experience. In this position, your day-to-day responsibilities will include:9
Setting department goals
Developing a business plan and budget to support it
Hiring staff
Establishing new policies and procedures
Nurse educator
If you prefer more theoretical work to you might thrive as a nurse educator. These professionals teach nurses at all stages of their careers, from nursing students to experienced nurses who are working on advanced degrees.10
Nurse educators can apply their leadership skills to work in hospitals, universities, or community health organizations. If you want to keep working in a clinical setting, you鈥檒l primarily be focused on improving patient care through education. If you work in an academic setting, you鈥檒l be educating nurses as they obtain degrees or certifications.10
The role of nursing leadership in patient care
, particularly nurse managers, are the primary drivers for implementing evidence-based practices in patient care. These practices focus on providing the best care based on current research, rather than relying on second-hand information or gut feelings. There are as many different evidence-based practices as there are diseases, so nursing leaders have to use their critical thinking skills to analyze research and bridge the gap between theory and practice while setting an example for staff nurses.11
Some benefits of nursing leadership promoting evidence-based practice include:11
Ensures better patient outcomes
Lowers health care costs through the prevention of complications
Shares decision-making with patients
Increases nursing autonomy and promotes higher job satisfaction
Keeps nursing practices relevant
Challenges faced by nursing leaders
Nursing has always been a challenging job, but the COVID-19 pandemic dramatically increased those challenges. The good news is that the emotional health and well-being of staff nurses are at the highest levels since July of 2020鈥揳lthough it鈥檚 still a problem in many areas. This indicates that health care organizations as a whole are working on overcoming many of the pandemic-related issues.12
However, nurse leaders report the most significant challenges they face now are recruiting and retaining staff, a shortage of financial resources and workplace violence. Almost 70% of nursing leaders recently reported problems recruiting and retaining qualified staff, up sharply from 24% in July 2020. In August of 2021, 75% of leaders reported the emotional well-being of their staff was their major concern, but this number dropped to 45% by November of 2023.12
Unfortunately, workplace violence has risen as a major concern for 24% of nursing leaders, up from 0% in July 2020. Nurses are a frequent target of verbal and physical assault by patients, families, the public, and even coworkers and physicians. This hostile work environment likely contributes to other challenges such as staff recruitment and retention, and also interferes with effective patient care.12
Nurse leaders have addressed these challenges in various ways. To deal with staffing shortages, they鈥檝e added more licensed practical nurses and certified nurse assistants, along with nonclinical staff to relieve the burden. They鈥檙e also allowing employees to take time off when necessary and making sure their staff has enough time for meal breaks.12
Workplace violence is a trickier issue. Resolving it requires an overarching strategy that includes measures such as enhanced security, training in de-escalation strategies and creating a culture of safety. Leaders also point out the need for health care workers to be able to access trauma-informed care and for increased advocacy to raise public awareness about the problem.12
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Sources
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