Transformational Leadership in Nursing


Leadership is important in all organizations that utilize people to attain their goals, missions, aims, and objectives. It involves influencing other people to facilitate the accomplishment of a given goal. Leaders arrange, manage, direct, and guide other people towards the attainment of common mutual objectives and goals. Leadership occurs through the interaction of three main contexts, namely leaders, followers, and the situation that prompts the deployment of leadership skills. Many scholars contend that leaders should demonstrate qualities such as the ability to listen effectively to others and the willingness to speak in an honest and kind manner. Besides being approachable, they should make well-informed decisions. These skills are incredibly important in nursing considering that many healthcare organizations are characterized by high turnover, especially among new recruits.

In healthcare settings, leadership has undergone different changes. It has changed from bureaucratic, transformational, and participatory leadership to headship through followership. These changes have occurred in the quest to address the emerging leadership problems in healthcare facilities. Amid these changes, this paper discusses the application of transformational leadership in nursing settings. However, irrespective of the type of leadership in a healthcare organization, it is important to lead effectively. While presenting transformational leadership theory as an essential ingredient for leadership in nursing, a discussion of its effectiveness is also important. The paper first offers a theoretical perspective of effective leadership before offering a literature review on transformational leadership in the nursing setting. The last section discusses the application of transformational leadership in nursing.


A leader is a person who plans, controls, directs, and/or guides other people towards the attainment of common mutual objectives and goals. It has organizational and personal elements. The success of leadership requires a commitment to these two aspects. Leadership serves to influence the relationship between the organization, leaders, and employees who act as the tools for change within an organization, which must reflect the shared purpose for the interaction of both employees and leaders. In the nursing setting, effective leadership is important to enhance organizational commitment and work morale for nurses to ensure that they do not consider leaving the healthcare organizations because of work-life imbalances or dissatisfaction. One of the ways of accomplishing this goal is by ensuring that the work environment transforms to meet the emerging employee needs to minimize work stress and burnout. This claim suggests the importance of effective transformational leadership in nursing facilities. In nursing faculties, leaders are the vision carriers. Effective leadership demonstrates the ability of leaders to influence other people’s way of thinking.

Literature Review

Polychroniou (2009) contends with this assertion by claiming, “Leadership involves influencing people to get things done to a standard and quality that is above their norm in a willing way” (p.343). Therefore, effective leadership entails complex processes that are often characterized by influential strategies, the interaction of various actors (followers and leaders), and a range of anticipated outcomes (Samad, 2009). Leaders play a variety of roles, including serving as sources of inspiration, inducing organizational change through corporate leadership, and serving as the main source of organizational power and vision (Samad, 2009). It is crucial to observe how individuals transform when they are psychologically occupied (Kehler, 2011). Since one of the noble responsibilities of leaders within an organization is to bring about change, effective leaders also need to be emotionally intelligent.

Emotional intelligence is an important aspect of transformational leadership in nursing settings. Leaders need to develop the capacity to express the collective idea in a manner that instigates other individuals to perform in harmony with the preferred institutional agenda (Schachter, 2009). This claim suggests that effective leadership is ideally result-oriented. In the effort to ensure that leaders achieve their duties, it is essential for them to appreciate that their precise achievement of job requirements is dependent on their capacity to learn from their followers the things they do not know. Such things may influence the success of their nursing facilities. This goal can only be attained if the leaders in question understand the people’s concerns by persuading them to open up to new ideas, revelations, and insights (Samad, 2009). Butler and Chinowsky (2006) support this argument by asserting, “a continuous learning process can be exercised, in particular, through engaging in a constant dialogue with peers, advisers, consultants, team members, suppliers, customers, and competitors” (p.121). In this process, it is relevant for leaders to articulate the emotional affiliations of people in their daily leadership tasks. Indeed, research evidences the role of emotional capabilities for effective leadership to be practiced (Polychroniou, 2009).

Effective leadership occurs in an environment of compromise. To this end, Mitrabinda, Hii, and Goo (2012) confirm, “effective leadership is different…It has to do with internalized values and the willingness to sacrifice for others” (p.126). This claim means that developing the ability to care about the people that one lead precedes effective leadership. Additionally, it is impossible to lead with a complete sense of commitment. Effective leadership does not involve micromanaging. However, it provides clear and concise guidance while at the same time allowing people to do their jobs effectively through making compromises. Crucial to note also is that effective leadership develops in an environment of mutual trust and respect. With trust, it becomes possible to transform nursing facilities to make it easier to implement organizational change.

Transformational leaders need to demonstrate the ability to eliminate all volatile situations within an organization, which may hinder employees’ collective performance. The goal is to ensure the attainment of high-quality results or realize the institution’s aims and objectives (Ruderman, Hannum, Leslie, & Steed, 2006). Successful leaders motivate and inspire other people. They also foster the development of a positive work environment. This role is crucial in ensuring that any challenging nursing opportunities that may exist within the nursing facilities are transformed into strengths. Anand and Udaya (2010) support this position by adding that transformational leadership skills are important in encouraging work motivation and ensuring that the subordinate staff members play their roles of increasing organizational effectiveness. Without effective leadership, a nursing facility can suffer from blurred vision, which often lacks a clear focus on the desired future direction of an organization.

Leaders of nursing facilities deploy different leadership types such as transactional and transformational theories. Transformational leadership encourages trust and the building of leader confidence. Basri, Rusdi, and Sulaeman (2014) present the leadership theory, which aims at changing internal work values and structures to build faith with the objective of eliciting increased work proficiencies. To this extent, it may be applicable in nurse turnover management by addressing its possible causes. The deployment of the transformational leadership theory to change internal structures of nursing facility systems may foster a fair distribution of tasks to reduce issues such as work strain and stress that lead to burnout.

Nursing leaders demonstrate transformational leadership through their possession of the capacity to set vision and inspiration, which are necessary for the followers. Leaders who have transformational leadership skills assess situations of their nursing institutions to facilitate the formulation of strategies for increasing growth and overcoming operational challenges (Sakiru & D’silva, 2013). The skills also enable nurse leaders to ensure adequate and effective communication of success strategies and visions to all nurses. Communication is critical in building good relationships with nursing organizations. Indeed, resolving operational challenges such as high nurse turnover requires good vertical and horizontal communication. This strategy enables nurses to address their conflicts within a healthcare facility to curb nurse voluntary turnover.

Transformational leadership builds on the theoretical paradigms of the role of EI (emotional intelligence) in enhancing leadership. For instance, Mitrabinda et al. (2012) suggested that EI has the ability to predispose leaders to deploy transformational behaviors in their work environments. In nursing settings, only leaders who possess a high degree of emotional intelligence can accurately perceive and evaluate the extent to which various anticipations of subordinates can be attained. This goal is achieved through the leadership sub-component of transformational motivation.

Achieving the success that is enumerated in the mission and vision of a transformational leader requires help from a detail-oriented organizational leadership team. Hence, the incorporation of transactional aspects of leadership is critical in terms of ensuring that the transformational leader’s vision moves in an appropriate direction. An insignificant oversight can derail an organization’s vision, thus making it take a long time to be developed and/or implemented. Overreliance on passions and emotions introduces the demerit of transformational leadership since they (passions and emotions) make it overlook the reality and truthfulness of a given situation such as circumstances that lead to high nurse turnover. Nevertheless, the capacity of transformational leaders to conduct the overall change of an organization to meet the emerging needs is important in overcoming turnover intentions among nurses.

Effective management of followers is important in nursing settings to enhance their motivation and commitment to their work. Dye (2010) reveals how transformational leadership is important in predicting the emotional attachment of followers to the motivational and emotional arousal of leaders. This claim suggests that transformational leaders possess skills in followership, which is incredibly important in an organization where following the set goals and visions is necessary to ensure the attainment of collective success.

A leader can accomplish his or her leadership role through delegation and participation as opposed to the control and enforcement of rules and regulations. This leadership approach is likely to create positive schemas about one’s capacity to function as a leader in terms of employee cognitions. Although the followers’ theoretical approaches emphasize that followers should be accountable to the manner in which they accomplish their functions in the organization. Followers still know that their leader can appreciate and accept his or her responsibilities for having delegated the tasks to them. This strategy is opposed to the laissez-faire leadership approach in which a leader rejects the responsibility of his or her position. Changing work environments to ensure that people take accountability for their actions requires the transformation of organizational systems for determining the effectiveness of employers. Indeed, this plan is vital in nursing settings where reporting on nursing procedures and caregiving is mandatory.

Followers are dynamic. They respond appropriately to any stimuli in their work environment. They can make the work of a leader easy or difficult by complying or failing to comply with the set organizational standards. In such situations, the goal of a nursing leader is to look for mechanisms for enhancing compliance. This process involves the transformation of an organization by developing and implementing policies that address the issue of conformity to rules and regulations that govern the nursing practice. Transformational leaders can respond ardently to their followers’ dynamics in nursing care organizations by participating in the achievement of the set vision. Transformational leadership in nursing helps in elevating the interest of all followers in the effort to generate awareness and acceptance by followers. Through transformational leadership, nursing facilities can motivate their followers to facilitate their performance.

Transformational leadership involves the articulation of a realistic vision, which is shared among all people within an organization. Bass and Steidlmeier (2010) declare a realistic vision essential in stimulating people intellectually. Through transformational leadership, leaders can harness employee differences to ensure long-term success and the mobilization of the vision and objectives, which transform an organization. Transformational leadership facilitates the achievement of values that influence certain outcomes through people by ensuring that they work in a cooperative manner that transcends their individual self-interest. In the nursing care organizations, it is important for nurses to cooperate and remain motivated to ensure they deliver quality care. This claim suggests the importance of transformational leadership in nursing. The next section discusses how transformational leadership can be applied in nursing.

Implications for Advanced Practice Role

Transformational leadership underlines the importance of taking collective responsibility for ensuring employee empowerment. Under this approach, parties to a given organization need to work cooperatively to attain a common goal. This process transforms both the leader and the followers. Transformational leadership has the significance of creating organizational change while at the same time increasing innovation and creativity levels in terms of how to handle new problems. The theory also underlines the necessity for prescribing a mission to the followers. When employees choose to follow the set doctrines, leaders need the assurance that they (employees) will be engaged in a process that will lead to the achievement of worthwhile outcomes. Setting the purpose and mission is incredibly important in nursing.

Nurses take care of people on a daily basis. Such people may be healthy or ill. Although they may want to deliver diversified healthcare services, it may be impossible to guarantee quality care when there is no specific focus, which is provided for by the mission and statement of purpose for a nursing facility or nursing unit within a healthcare facility. Indeed, in situations where people do jobs without a clear definition of the expected outcomes, confusion emerges concerning the elements that lead to nurse turnover.

Procedures such as recruitment and successful retention of nursing personnel are an incredible challenge, especially in a business environment that is characterized by workforce shortage. For nurses, a scholarly research in recruitment identifies several factors that may influence nurses to accept nursing jobs within different nursing care organizations ((Jones, 2009). The research reveals factors that influence nurses’ decisions to stay on the jobs (Jones, 2009). Factors such as salary, the reputation of the health facility, the nature and status of unions, and more importantly the autonomy of work determine the recruitment and subsequent retention of the nurses. It is also crucial to address the factors that may influence the decisions of a given nurse to stay within a given facility. Such factors include recognition and inclusion of an individual nurse in the decision-making process of a health facility, the nature of workload, and the interrelation of a nurse with fellow workers within the departments and even the entire of organization (Jones, 2009).

Considering the factors that may influence the decision of nurses to remain in work for a given healthcare organization, it is important for the appropriate leadership style to be deployed to encourage their retention by addressing their productive working life. Work environment induces negative emotions, especially after considering the challenge that some nurses have to deal with almost dying people. Emotional intelligence in nursing care leadership comes into play. Emotional intelligence has a big relationship with a leader’s capacity to manage emotions. In this line of argument, Lowe and Kroeck (2006) assert, “transformational leadership appears to be dependent on the evocation, framing, and mobilization of emotions, whereas transactional leadership appears to be more dependent on subordinates’ cognitions, and that it tends to follow a rational model of motivation” (p.386). Opposed to the assertion that EI can help to induce transformational leadership, Khalili (2012) says that transformational leadership is a function of the superior ranks of the subsidiary staff people and the presentation of work effectiveness from supervisors. This claim has prompted the emergence of additional paradigms for studying the role of EI in leadership with reference to nursing care settings.

In the contextualization of the relationship between transformational leadership, EI is considered an incredible tool for perceiving various situations accurately such as an individual’s emotional expressions and assessment of the impact that such (Hawkins & Dulewicz, 2009). This assessment is crucial, especially when emotions are determinants of an individual’s thoughts and decision-making processes. EI is also essential in enhancing the capacity of leaders to understand well a myriad of workplace emotions (Khalili, 2012). To this extent, EI is essential in leadership in aiding to help leaders to develop emotional knowledge and the capacity to regulate emotions while at the same time helping them to manage and promote emotional intellectual growth. EI is particularly important for nurses considering that they encounter work stress that often leads to burnout.

Schachter’s (2009) work suggests that individuals have differences that are articulated to the tendencies of appraising their emotions together with those of other people. These findings suggest that people who have high EI levels can open up to organizational internal and external experiences that may impede success. These findings are significant and crucial in the context of nursing leadership. The success of a nurse leader in executing his or her mandates is dependent on the ability of such a leader to handle various emotional stimuli that emerge in the day-to-day operations of an organization in an effective manner by transforming them (stimuli) to ensure they do not influence followers’ productivity. It is important for a nursing leader to develop the capability of communicating effectively on circumstances that may impede the success of a nursing organization. Transformational leaders are great communicators.

Alston (2009) reveals how EI predisposes leaders to deploy transformational behaviors in their work environments. Directly congruent with the concept of idealized influence as an important aspect of transformational leadership, leaders who can manage and understand nurses’ emotions can act with self-control. Self-control has the impact of ensuring that nursing leaders trust their followers. Hence, only leaders who possess a high degree of emotional intelligence can perceive and evaluate the extent to which various anticipations of subordinates can be attained. This goal is achieved through the leadership sub-component of transformational motivation. This claim confirms Leban and Zulauf ‘s (2011) findings that EI leaders need to understand the needs of the people they lead as the basis of making appropriate decisions within healthcare organizations.

In the study of leadership styles that deployed 56 project managers, Clarke (2010) concludes that EI relates to the vital elements of transformational leadership. These elements include individualized consideration, idealized influence, and inspirational motivation. In a different research, Alston (2009) reveals a very high correlation between inspirational motivation and EI. These findings are critical in the process of deriving the role that EI may play in fostering effective transformational leadership among nursing leaders.

Transformational leadership skills ensure that organizations reduce the actual turnover and turnover intents. The skills foster the retention of top talent. Turnover plans are normally common amongst new recruits. Beecroft (2008) supports this line of argument by claiming that the turnover rate among first-year nurses is in the range of 35 to 60 percent in the US. Cognition of these outstanding rates calls for the deployment of imperative and effective employee retention strategies. Beecroft (2008) regards the causes of the high turnover intents among the new nurse recruits as being instigated by the delegation of responsibilities to new recruits, yet such people do not have the necessary experience.

The above position implies that even though delegation is an incredible strategy for enhancing work morale of people as developed by human resource studies, it fails to work well in situations that involve new workforce due to work pressures that new nurses encounter while operating in an unfamiliar environment. In fact, Chu and Price (2007) provide evidence that confirms how attitude and work pressure influence nurses in terms of job satisfaction and their commitment to organizations. Therefore, transformational leaders need to evaluate and develop the appropriate organizational strategies for promotion and motivation to ensure the allocation of tasks that are appropriate for a given nurse depending on his or her expertise, skills, and experience.


The transformational leadership theory facilitates the framing of various nursing tasks in a manner that can motivate health officials. This strategic framing of roles helps followers (nurses) to articulate their professional work with their personal values. To achieve this goal, transformational nursing leaders exhibit behaviors such as inspirational motivation and intellectual stimulation. To this extent, transformational leadership helps to realign a nursing unit or facility to ensure that it performs through people.

The paper reveals how transformational leadership finds application in nursing care facilities in terms of enhancing nurses’ intellectual capacities through the facet of emotional intelligence (EI), individual consideration, inspirational motivation, and idealized influence. Intellectual stimulation entails the capacity of nursing leaders to encourage and/or ensure that followers (nurses) participate in developing the solutions of a problem that influences them through the development of innovative and creative strategies for handling their daily tasks. Nursing leaders may achieve this goal by requesting nursing staff officials to bring forth ideas on how to handle work-related problems.

Individual considerations demand nursing leaders to express and recognize that nursing staff members possess personal strengths, feelings, and needs that must be considered in leadership styles that are deployed within healthcare facilities. Nursing leaders needs to mentor and support all followers to foster their individual growth by creating opportunities for professional development in a bid to prepare them to take challenging assignments. Inspirational motivation encompasses the capacity of a nursing leader to ardently motivate and inspire nursing staff members to nurture and build strong interpersonal relationships to ensure cooperation in work.

Nursing leaders can enhance inspirational motivation through the description of goals, objectives, vision, and the anticipated outcomes of a particular healthcare facility. This process involves motivating nursing staff people so that they can play their role in ensuring successful achievement of the objective, goals, and vision. Idealized influence calls upon nursing leaders to become effective role models who can perform above par in any tasks that are allocated to the followers. Therefore, a transformational nursing leader should not give nursing staff responsibilities that he or she cannot execute. Idealized influence occurs when nursing leaders adhere to the actions that support legal foundations that define the conducts of nursing. This conformity also requires the portrayal of qualities such as honesty, enthusiasm, and dependability. To this extent, transformational leadership influences the outcomes of nurses and patients. It also ensures job satisfaction, which reduces turnover among nursing practitioners.

Reference List

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