How Nursing Leadership Styles Can Impact Patient Outcomes and Organizational Performance

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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 is important to understand the different leadership styles that are often found in the workplace, as well as their effects on the staff and those under their care. To learn more, checkout this infographic created by Bradley University’s Doctor of Nursing Practice program.

How Nursing Leadership Styles Can Impact Patient Outcomes and Organizational Performance

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Transactional Leadership

A leader of this type will try to ensure that the staff complies with rules by instituting a system of rewards and punishments. Those individuals who follow his or her instructions and achieve the set targets will be rewarded accordingly. On the other hand, those who fail to obey and to reach the goals will be punished for their transgressions. This style is firmly focused on the supervision of subordinates, keeping the organization running smoothly and improving group performance. There is a keen interest in the work done by followers to find deviations. This leadership style is effective in managing a crisis and completing highly detailed projects.

Transformational Leadership

This style is leadership by example. Followers see their leader’s behaviors, and they are inspired to change for the better. They see the hard work from the top as well as the concern for their well-being. They perform beyond all expectations because they put in more effort than usual. They no longer put themselves first as they place more importance on what is best for the organization. Leaders provide a clear vision of the future that motivates staff members to exceed themselves. Old assumptions and traditions are questioned to come up with novel ideas for solving problems more effectively.

Democratic Leadership

With this style, the team is encouraged to speak up and join in the decision-making process. The open communication makes all staff members feel that their voices matter. They are more concerned about the things that go on in the organization knowing that they can influence situations if they act on them. Workers are given their own personal responsibilities and are accountable for reaching certain targets. They get feedback on their performance, which allows them to adjust if necessary. The focus is on improving the quality of the systems and processes, not on finding errors made by the individual team members.

Authoritarian Leadership

This approach is the opposite of the democratic style as the leader calls all the shots. Decisions are made rapidly without any form of consultation with the staff. All the power is concentrated at the top, and individuals at the bottom can only follow. Those team members who disagree and don’t do as they are told are often punished to keep them in line. Knowledge may be kept in the hands of a few to keep the power within their ranks. When mistakes happen, authoritarians make an example of the offenders by punishing them in front of their peers. The blame is always on the individuals despite faulty processes. On the other hand, this style may be required in emergency situations when fast action is necessary.

Laissez-faire Leadership

In this style, very little supervision is exercised by the leaders. They prefer to take a hands-off approach to daily operations. They would rather let people do what they need to do on their own, perhaps trusting that they will be able to do well without guidance. While it does promote independent thinking, this approach can have several negative consequences. Important decisions are not made on time. Few changes ever happen at the workplace. Quality improvements happen only when the situation begs for it. This style is frequently used by inexperienced leaders who are still learning, as well as transitional managers who are simply waiting for someone to replace them.

The Impact of Leadership Style on Patient Outcomes

A number of studies have looked into the relationships between nursing leadership and patient outcomes. The results are quite fascinating, as they reveal definite links between the two. For instance, transformational leadership was associated with reduced medication errors in the majority of the studies. It seems as though things are done much more carefully inside the hospital when this approach is taken. The style also was related to lower patient mortality in half of the studies. Patients somehow get better care and treatment, which allow them to survive their ordeal.

The relational types of leadership that include the transformation and collaborative styles have a common effect on patient satisfaction. People are generally happier with the service that they receive for both acute care and home health care. The need for restraints is also lessened as patients are much more cooperative with their nurses. Aside from the lower incidence of medication errors, there are also fewer reported hospital-acquired infections. If one is going to go to a hospital, then it is definitely preferable to be admitted to those that champion these relational leadership styles, as the outcome is more likely to be positive.

Nurse Preferences and Findings

The National Institute of Health as well as the Journal of Nursing Administration published related studies in the past. It was found that transformational leadership was a positive contributor to a safer climate within the hospital. It was associated with reduced staff turnover when compared to the others. The nurses were happier with their work and chose to stay as a result. On the other hand, the laissez-faire approach was shown to negatively contribute to unit socialization. It also created a culture of blame among team members that only served to stress everyone unnecessarily.

Additional findings showed that nurses were quickly able to distinguish the difference between transformational and transactional leadership. They might be similar styles, but the implementation and results are divergent. Nurses were much more in favor of the transformational approach as it promotes intrinsic motivation and job satisfaction. They liked the idea of positive behavior influence and inspirational motivation, considered by many to be the most effective out of all the options out there. In truth, all the styles have their place and the mark of a good leader is wisdom in implementing the right style at the right time.


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