How Nurse Leadership Styles Impact Patients

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Nurses play vital roles in health care organizations. How they are managed by their leaders can drastically affect their performance and influence patient outcomes. It’s important to understand the different nurse leadership styles that are often found in the workplace as well as their effects on staff and those under their care.

To learn more, check out the infographic below, created by Bradley University’s Doctor of Nursing Practice program.

An overview of different nurse leadership styles and their impact on patient care and staff performance.

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Nurse Leadership Styles

Nurse leaders can employ several different leadership styles, which impact staff and patients in different ways. The effectiveness of a particular leadership style is often dependent on the situation or setting in which it’s being applied. The following are some of the most common styles of leadership in nursing.

Transactional Leadership

A transactional leader offers rewards and punishments for good and bad behaviors. This style of leadership focuses on efficiency and results rather than morale and community. While transactional leadership can be effective in emergencies, it can foster competition. This style may draw more attention to mistakes than positive behaviors.

Transformational Leadership

A transformational leader works with their team to find long-term solutions, build community, and provide mentorship. Transformational leaders are inspirational and supportive, basing their interactions on positivity. One potential weakness of transformational leadership is a lack of day-to-day efficiency. For example, if a leader is responsible for quick, administrative decision-making, it can be difficult to make every step transformative.

Autocratic Leadership

Autocratic leaders accept little input from their teams and base their decisions on their own opinions and experience. These leaders can be efficient in a crisis or emergency. On a day-to-day basis, however, the approach can foster resentment and negativity. Despite making most of the decisions themselves, autocratic leaders should give their teams space to voice concerns and ideas.

Participative Leadership

Participative leaders listen to their teams before making decisions. Because their teams regularly interact with patients, families, and other staff, participative leaders can learn a lot from their experiences. However, in an emergency, taking the time to listen to every member of a team can delay decision-making. This style of leadership provides feedback to nurses who want to grow professionally.

Laissez-Faire Leadership

Laissez-faire leaders offer minimal guidance and feedback. Nurses and staff have more freedom over decision-making and performance. Highly experienced nurses can thrive, but inexperienced nurses may flounder without direction. This style of leadership may work well in facilities that provide repetitive, long-term care.

How Nurse Leaders Improve Patient Outcomes

Nurse leaders often begin as part of a nursing team and grow through experience before assuming a leadership role. This means they have an understanding of what nurses need to succeed. A good nurse leader applies experience to their decision-making. They use their team as a resource and reciprocate with helpful, encouraging decision-making.

Improving Quality of Care

Health care managers can improve quality of care by encouraging their teams to develop and apply quality innovations. They can build healthy relationships with their teams and model good behavior and practices. Health care managers also provide training for other leaders and their teams.

Patient Experience

Nurses play a significant role in a patient’s experience, and a positive nurse-patient relationship can improve a patient’s attitude and quality of care. Under good leadership, nurses are more satisfied at work, which can translate to improved patient care and outcomes. Multiple studies have demonstrated a notable correlation between leadership style and nurses’ job satisfaction. An organized health care facility results in fewer mistakes in patient care.

The Different Impacts of Nurse Leadership Styles

The type of leadership style a nurse uses can have different impacts on patient care and outcomes. Relational leadership styles, such as transformational leadership, are positively associated with improved patient satisfaction, patient outcomes, and lower patient mortality. Evidence suggests that task-oriented leadership styles, such as transactional and laissez-faire leadership, tend to have a negative correlation with nurse job satisfaction and performance.

Nurse Preferences and Findings

Recent studies on nursing leadership styles found that transformational leadership is identified as a positive contributor to a safer work climate. It’s associated with lower staff turnover trends in comparison with other leadership styles and is considered to be the most effective. Nurses greatly favor transformational leadership, with all characteristics positively correlating with intrinsic motivation and job satisfaction.

Transactional leadership encourages nurses to think about possible rewards for good work, instead of focusing solely on patient care. Transactional leadership maintains existing standards and operations.

Autocratic leadership can foster resentment but is effective in emergencies or chaotic situations.

Leading the Way

Leadership plays a large role in how effectively a health care facility functions — better leadership produces better results. Studies show that democratic leadership styles like transformational leadership can foster a sense of community and motivate nurses to work smarter and harder. When health care staff are less stressed and have the support they need, patients receive better care.


BMJ, “Why Healthcare Leadership Should Embrace Quality Improvement”

Dignity Health, 5 Healthcare Leadership Styles You Should Try as a Nurse

Evidence-Based Health Policy, Management and Economics, Nursing Leadership Models in Promoting and Improving Patient’s Safety Culture in Healthcare Facilities

Health Management, Nursing Leadership Practices and Patient Outcomes

International Journal of Environmental Research and Public Health, Leadership Styles and Nurses’ Job Satisfaction

Nursing – New Perspectives, Leadership Styles in Nursing