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Transformational Leadership in Nursing

What leadership qualities do you most admire and appreciate? Chances are, you see a good leader as someone who initiates change, creates a vision, inspires, engages followers, motivates and demands commitment and involvement from each team member. It's likely they are transformational people.

What Is Transformational Leadership?

Transformational leadership comes from the word transform, where leaders seek to change the workplace to promote success. In the 1970s, James MacGregor Burns first introduced the concept in his book, Leadership, when describing greats like Mahatma Gandhi, Franklin D. Roosevelt and John F. Kennedy.

Later, Bernard M. Bass described four elements or domains of transformational leadership: idealized influence, inspirational motivation, intellectual stimulation and individualized consideration.

Domain

Description

Perception of Others

Idealized Influence

Role Modeling

"Walks the talk."

Inspirational Motivation

Inspiring

"Supportive and encouraging."

Intellectual Stimulation

Innovating

"Thinks outside the box."

Individualized Consideration

Valuing Others

"Genuinely concerned."

In any setting, including the nursing field, transformational leadership is crucial to a successful workplace and workforce.

How Is Transformational Leadership Used in Healthcare?

Historically, healthcare has used transactional leadership — the exact opposite of transformational leadership. In a transactional leadership style, superiors make decisions from the top down, with limited opportunities for employee involvement or creative thinking — often involving a task/reward system. To take organizations to the next level of performance and success, focus must change from transactional, "task-oriented" leadership to transformational, "vision-oriented" leadership. 

Today, transformational leadership is one of the most effective leadership styles in healthcare. It is the cornerstone of the American Nurses Credentialing Center (ANCC) Magnet Recognition Program (Magnet). This program characterizes transformational leaders as translating vision to action and helping others reach their highest potential.

What Are the Characteristics of a Transformational Nurse Leader?

Transformational nurse leaders motivate and empower staff to reach goals that align with those of the organization's mission and vision for the future. They are often mentors or role models and lead by example. They usually exceed expectations and are more visible and actively involved with staff.

Most transformational nurse leaders are supportive, trusting and have a knack for challenging and aligning others and ideas.  

What Is a Specific Example of Transformational Leadership?

Nurse leaders at NewYork-Presbyterian/Columbia University Irving Medical Center use critical input from frontline staff to navigate the current challenges of the coronavirus pandemic. Wilhelmina Manzano (senior vice president, chief nursing executive, and chief quality officer) explains that staff nurses are "supported by a team of highly dedicated transformational nurse leaders who promote shared governance structures that enhance the voice of nurses."

"Shared governance" is a professional practice model that provides a structure and process for partnership, equity, accountability and ownership, putting practice-related decisions in the hands of those doing the work.

What Are the Benefits of Transformational Leadership?

Transformational leadership benefits staff, leaders and an organization. Most importantly, it benefits patients. Numerous studies have shown that transformational leadership improves staff morale, job satisfaction and employee retention. It creates trust, admiration and loyalty among staff members, ultimately improving the work environment and patient satisfaction. Also, it improves patient outcomes, resulting in fewer medication errors in intensive care units, for example.

Nurse leaders must employ the principles of transformational leadership to meet the challenges of an ever-changing healthcare environment. Today's leaders must transform values, beliefs and behaviors and create environments where team members feel supported.

Learn more about The University of Alabama in Huntsville's Master of Science in Nursing (MSN) – Nursing Administration online program.


Sources:

Burns, JM. (1978). Leadership. New York: Harper and Row.

Bass, BM. (1985). Leadership and performance beyond expectation. New York: Free Press.

American Nurses Credentialing Center: Magnet Model — Creating a Magnet Culture

Relias: Characteristics and Examples of Transformational Leadership in Nursing

NewYork-Presbyterian: Magnet Excellence

National Center for Biotechnology Information: Nursing Leadership Styles and Their Impact on Intensive Care Unit Quality Measures: An Integrative Review

Chron: Four Elements of Transformational Leadership


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