Nursing leadership has been considered as an integral element of optimal quality healthcare delivery that influences health outcomes to a great extent. Leadership is about acting in a responsible manner in the respected organization for the fulfilment of goals and objectives of services. Being a leader is more than taking strong stances in decision making. It is more about acting as a source of inspiration and serving individuals in the setting whom the person is leading. Empowering others through leadership is related to devoting oneself to a group of individuals for successful achievement of set goals in the organizational context. Since leadership is a widely researched subject with different implications in different settings, understanding the concept requires extensive analysis of personal viewpoints of leaders. Conducting interviews with leaders in healthcare settings is a valuable way of coming across the perceptions and experiences of credible leaders. The present essay discusses in details an interview conducted with a healthcare leader in a health care setting. The paper is based on the informative interview that provided a chance to exercise personal communication and interpersonal skills. The focused are for the interview was leadership style, and key themes arising from the interview are highlighted. The interview provided a chance to gain deep insights into the different aspects of leadership styles and the applicability of the same in clinical practice. The essay is a reflection on personal experience and discusses personal learning from experience with support from relevant literature and research. Further, insight into future leadership practice is included in the paper, and recommendations for change are mentioned.
As a nursing student, I had developed an interest to understand further the benefits and challenges in healthcare leadership and how I can apply the same in practice. The topic of nursing leadership and development had always gained my attention, and I aim to prepare myself as a leader in future. One question that has made to think critically about is what the different leadership styles are and which one of these best suits the needs in a healthcare context. Throughout my course, I have explored different aspects of leadership and gained knowledge for future practice. The interview which is being reflected upon in the present essay was conducted with Ms Anne Murrey who works as a healthcare leader in charge at a reputed city hospital. The interview was an opportunity to discuss the different leadership styles in the nursing field exemplified through her who has fifteen years experience in her field. Anne had received an award by the healthcare department as an appreciation of her commitment, dedication and experience. This spurred me to interview her and understand further on the meaning of leadership, the mostly used leadership styles, the advantages of the same, the challenges faced and the responsibilities that come along as a nurse professional. In my personal interview, I decided to learn about the skills she employed to ensure effective leadership.
The very first question that I asked the interview was regarding what inspired her to become a part of the healthcare workforce. To this, she replied that the eagerness to work for the society and promote a better quality of life was instilled in her from her childhood. She had decided to study nursing as it is perceived as a divine way of serving the needs of the community. I agreed to her that nursing is a noble profession in which the aim is to alleviate human sufferings. I considered it to be desirable to commence on the discussion about leadership with a special focus on distinct leadership styles. I then engaged in understanding the definition of leadership as perceived by her. According to Anne, healthcare leadership is the behavior of the individual that directs the activities of the followers towards the shared goal of enabling better healthcare service delivery. The key aspects of the leadership role are enabling group activities and coping with change. According to her, a strong component of leadership is to focus on the strengths of the followers and influence them to fulfil a certainly agreed aim. The idea given by her led me to further understand the importance of appropriate leadership in healthcare service. Good leadership is a way of caring for the work environment and advocating for individual’s rights is crucial (Al-Sawai, 2013). According to Swanwick and McKimm (2017), leadership and delegation lead to a caring environment and patient’s safety is ensured in this process. Leadership further makes the employee’s secure about their ownership of patient care. Notably, suitable leadership is advantageous for both the employees and the patients.
As per my understanding, leadership is viewed by different people in a different manner. The idea of which leadership approach is suitable might vary between individuals. I was interested in knowing more about the qualities and features of a good leader. Anne answered my query and stated that a good leader is defined by the discreet leadership style she exhibits. However, at the core of an effective leadership styles lies the need of improving patient’s care. I was overwhelmed to know that Anne perceived listening to the follower’s ideas as the hallmark of leadership. She believed that the transition from working at the bedside to taking up the responsibility of a leader needs immense efforts. She commented that she had been fair in her decision making processes and established honest relationships with her colleagues. I later took interest on learning more about this aspect. According to Ward (2017), a leader is not to make judgments in a hasty manner without involving the concerned stakeholders. An effective relationship with the followers ensures that integrity is defended at all levels. Anne further commented that she had been following the set guidelines and rules and delivering compassionate care. An intricacy when bearing in mind leadership of healthcare professionals is the fact that the styles have not evolved within the healthcare context (Boyd et al., 2017).
Though I had a preconceived idea that there are different forms of leadership as applicable in diverse settings, I lacked a clear understanding of the leadership styles that have been more relevance to healthcare settings as evident from practice and literature. Anne reflected that the leadership styles that are more relevant in healthcare context are autocratic leadership, democratic leadership, transformational leadership, and transactional leadership. She took interest in describing in short the implications of apply these leadership styles and the benefits and challenges of the same. In her viewpoint, autocratic leadership revolves around the sole viewpoints of the leader. In such a leadership form, a leader has the sole responsibility and authority for taking decisions. Leaders do not consider the input of the followers in the decision making process. Anne commented that she had witnessed other leader exhibit such form of leadership wherein the autocratic leader only added to policies, procedures and guidelines in the setting. Autocratic leadership leads to poor healthcare delivery as a collaboration between healthcare workers are missing. Coming to democratic leadership, subordinates are involved in the decision making process and thus is highly contrasting with autocratic leadership. Transformational leadership, on the other hand, is mainly involves the initiation of the key change in organizations and individuals. Transactional leadership continues and maintains the status quo.
At this juncture I was interested to know which leadership style she preferred and why. Anne proceeded to discuss her preferred leadership style and how she exhibits the same. Anne was glad to inform that her favorite styles of leadership were democratic leadership style and transformation leadership style that she exhibited in per practice as per the needs of the situation. Since I believed that Anne was competent enough to act as a good leader and had already gained an immense reputation for her contributions, I decided to explore more about these two leadership styles through the interview and successive literature search.
Upon requested, Anne pondered over her experiences and opinions about the two leadership styles that she felt was very important in the present era. She felt that democratic leadership and transformational leadership holds the potential to enable professionals to address the evolving needs of patients presenting with diverse conditions. Anne stated that she prefers using democratic leadership style when the inclusion of other staff members is needed for completion of a task. At the time of need of active role of staff members, democratic leadership is useful. Such conditions include decision making process regarding a patient care when input from a multidisciplinary team is entailed. On one instance, a critical patient case was to be handled by the team and Anne though that the only way to motivate the staffs to put in their best efforts was to exhibit democratic leadership, thereby establishing a healthy relationship with the staffs. On the other hand, Anne prefers using transformation leadership when issues are highly complex and demands chief input from the leader. The need for inclusion of increased inspiration from the leader guides her to adhere to this leadership style. For instance, when there is an ethical issue to be resolved, she prefers this leadership form. Further, she also said that her leadership views were evolving and that I must further engage in continual research for understanding the core concepts of the leadership styles.
At this juncture, I was interested to know the advantages of democratic and transformation leadership styles and requested Anne to say a few words on the same, reflecting on her experience. Anne reported that while she worked previously at a different healthcare setting, the unit had a high employee turnover rate. Under this situation, she decided on to adhere to the democratic leadership style and met each subordinate in a private manner for gaining insight into their work process. The aim was to understand the key reasons behind the high attrition rate. Through the meetings, Anne learnt that the issues faced were lack of supplies, misunderstandings and long working hour. These factors had comprehensively led to increased burnout. After these issues were addressed, the turnover rates could be controlled.
While working at a differ healthcare setting, as described by Anne, Anne felt the need of demonstrating transformational leadership style at many instances, due to the demand of bringing practice change in the setting. She highlighted that the rising demands of the healthcare system demanded an advanced health information system to be used within the units. A large number of mistakes were being made to while maintaining a patient record and thus use of electronic health record was necessary. Anne as the transformational leader needed to instigate the change through a smooth process. She brought about the practice change in a three-step process. First, she made the team realize the issue that was being faced and the implications for it. This was done by carrying out one-on-one sessions with the members. Next, the need was to create a vision of the required practice paradigm. The advantages of using electronic health records were explained in details to the members. Lastly, the need of the hour was to work in collaboration and enforce the change. Training was provided to ensure that the members became acquainted with the process. Anne had concluded that transformational leadership was effective in influencing the members to support the change through persuasion. Goal setting and goal achievement was successful
I had heard about Lassiez-Faire leadership style previously, and thought of asking Anne about her opinion regarding the same. She opined that Laissez-Faire leadership style gives significant authority to the followers and is least satisfying. Further research made me realize that healthcare workers work under ineffective management supervision when this form of leadership is implemented (Merrill, 2015). The leadership style has been denoted as a delegate form of leadership where the guidance of the leaders is minimal. Since followers have the complete freedom to make their decisions, it is unfavourable for health outcomes. Care professionals might, under such a condition, take up inappropriate decisions regarding patient care that is not aligned with the current need (Thomas, 2015).
The interview ended by thanking Anne for her valuable time and consideration. A small token of appreciation was gifted to her for her valuable inputs and suggestions. The interview was a valuable experience that exposed me to the in-depth concept of healthcare leadership and more precisely the different styles of leadership that can influence care delivery. Anne inspired me to engage in continuous professional development and walk in the path of veracity and integrity. Anne has acted as a role model for me, and I want to become as hard-working and dedicated as she is in future. As she is not opinionated and is free of prejudice, her professionalism has guided me immensely.
At the end of the interview, I find it to be imperative to come up with desirable leadership skills in future so that I can integrate innovation into my practice. As a leader, I would ensure that my working environment is not dictatorial. Rather, I would want to make the same a consultative one so that there is no place for malpractices within the setting. I further endeavour to promote my professional morality and ethics in my concerned field. An aim would also be to stay abreast of advances in leadership methods by researching for ensuring effectiveness (Jumaa & Alleyne, 2017). In shall also uphold customer relations for inspiring confidence through offering sympathy, affection and empowerment. This would help to boast an interactive relationship with my clients and serve them better (Liang et al., 2016). A leader in a healthcare setting is a person who is supposed to exhibit interpersonal skills for influencing others while striving to accomplish a particular goal through a flexible repertoire of personal values and behaviours (Holten & Brenner, 2015). I further understood that a healthcare leader must take up the role of change enabler in alignment with the values and needs of the organization.
Based on the key insights gained from the interview, my preferred leadership style in future would be transformational leadership and democratic leadership. As a leader, my role would be critically important to my effectiveness and career advancement. According to Lin et al., (2015) transformational leadership is the distinct process in which changes are transmitted throughout the setting through persuasion. In this leadership theory, staff members are to be motivated to perform certain actions within the expected level. Weng et al. (2015) in this regard had mentioned that the four features of transformational leadership are confidence, trust, respect and charisma. As a transformational leader, I would stimulate my staffs and change their beliefs in alignment with the needs of thee organization. As opined by Spano-Szekely et al., (2016) transformational leaders must lead the followers to carry out a critical examination of their beliefs and viewpoints. However, there would be a need for providing inspirational motivation to the staff members so that the vision of the setting could be communicated appropriately (Fischer, 2016). I believe transformational leaders can motivate employees to look into the wider perspectives of healthcare service. A critical analysis of transformational leadership style would guide my future practice as a transformational leader. Transformational leaders are born leaders and cultivate skills through the process of supervising followers. Such form of leadership can lead to ineffective solutions under certain circumstances (Ross et al., 2014).
From the research of McKeown and Carey (2015) and Barr and Dowding (2015), I have gained an immense understanding of the democratic leadership that I would apply in my practice. Democratic leaders are to encourage open communication and include team members in the decision making process. I would pay attention to establish relationships with my follower so that a strong rapport is created with them. Democratic leaders share the responsibility of delegating tasks with the staff members, presenting the problem and asking for help. Consultation would be at the core of leadership. Huber (2017) opined that democratic leadership leads to less stress, rapid decision making, increased efficiency and less oversight.
In future, as a leader, I would communicate the vision of the organization in an exciting, meaningful and creative manner. I would also empower them to put in their best efforts in healthcare delivery. My motto would be to motivate staffs to perform beyond expectations through the capability of influencing attitudes. The outlook would include broader aspects other than management, supervision, an organization of work and monitoring of task. Personalizing the leadership style as per the needs, skills and different personalities of the team would be elementary (Xu, 2017). Acting as a mentor instead of a manager would be beneficial. Both transformational and democratic leadership would entail me to encourage creativity. Fostering innovation through challenging assumptions is crucial for my success as a leader. As opined by Finkelman (2015) providing intellectual stimulation and exuding inspirational motivation is crucial for completion of tasks by team members. The importance of continual learning in professional development deserves special mention. I would strive to carry out extensive research on the updated information on key leadership styles.
In conclusion, conducting an interview with the notable healthcare leader gave me an opportunity to learn more about the importance of leadership in the present era. It was an informative experience for me as I gather a renewed understanding of the key concepts of different leadership styles. Leadership theory is self-motivated and prolongs to change over time. At this juncture, I would like to mention that I feel leadership encompasses a holistic focus on shared culture and processes. Further, I have developed the understanding that for becoming a successful leader, I would need to demonstrate the appropriate leadership style as suited for the respective situation. Each leadership has its own merit and demerit, and the multidimensional aspects are to be analyzed before deciding upon which style to exhibit. The leadership styles that I came across through the interview were transformational leadership, transactional leadership, democratic leadership, autocratic leadership and Lassiez-Faire leadership. Some distinct examples of how these influence the task completion process was known. A gained a clear picture regarding the applicability of transformational leadership and democratic leadership in my practice. I would like to mention that my future practice would be guided by key insights gained from the interview.
Al-Sawai, A. (2013). Leadership of healthcare professionals: where do we stand?. Oman medical journal, 28(4), 285. DOI: 10.5001/omj.2013.79
Barr, J., & Dowding, L. (2015). Leadership in health care. Sage. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=hySJCwAAQBAJ&oi=fnd&pg=PP1&dq=democratic+leadership+nurse+health&ots=dhGP7yeS2S&sig=Eep9CkCCnN6mn3eKKMr1ZTfLG8A#v=onepage&q=democratic%20leadership%20nurse%20health&f=false
Boyd, A. M., Alt-White, A. C., Anderson, G., Schaa, K. L., & Kasper, C. E. (2017). Genomic Competencies for Nursing Practice: Implications for Nursing Leadership. Journal of Nursing Administration, 47(1), 62-67. DOI: 10.1097/NNA.0000000000000438
Crowell, D. M. (2015). Complexity Leadership: Nursing's Role in Health-Care Delivery. FA Davis. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=1IezCgAAQBAJ&oi=fnd&pg=PR1&dq=leadership,+health+nurse&ots=NKhmKWGISR&sig=A0BGZ9k0dcBqrW1lmEQKRnDmkic#v=onepage&q=leadership%2C%20health%20nurse&f=false
Finkelman, A. (2015). Leadership and management for nurses: Core competencies for quality care. Pearson.
Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of advanced nursing, 72(11), 2644-2653. DOI: https://doi.org/10.1111/jan.13049
Holten, A. L., & Brenner, S. O. (2015). Leadership style and the process of organizational change. Leadership & Organization Development Journal, 36(1), 2-16. DOI: https://doi.org/10.1108/LODJ-11-2012-0155
Huber, D. (2017). Leadership and Nursing Care Management-E-Book. Elsevier Health Sciences. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=OTg1DwAAQBAJ&oi=fnd&pg=PR1&dq=democratic+leadership+nurse+health&ots=QqCtxOgbVB&sig=zvNmdRqtWA3fMk59WK-6ZOD5wpc#v=onepage&q=democratic%20leadership%20nurse%20health&f=false
Jumaa, M. O., & Alleyne, J. (2017). Strategic leadership in health care in challenging times. Organisation Development in Health Care: Strategic Issues in Health Care Management. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=4pU4DwAAQBAJ&oi=fnd&pg=PT105&dq=leadership,+health+nurse&ots=ifvzdkuQif&sig=sfnGAjzinitZUpQokQ8Oqzo-xEo#v=onepage&q=leadership%2C%20health%20nurse&f=false
Liang, H. Y., Tang, F. I., Wang, T. F., Lin, K. C., & Yu, S. (2016). Nurse characteristics, leadership, safety climate, emotional labour and intention to stay for nurses: a structural equation modelling approach. Journal of advanced nursing, 72(12), 3068-3080. DOI: https://doi.org/10.1111/jan.13072
Lin, P. Y., MacLennan, S., Hunt, N., & Cox, T. (2015). The influences of nursing transformational leadership style on the quality of nurses’ working lives in Taiwan: a cross-sectional quantitative study. BMC nursing, 14(1), 33.DOI: https://doi.org/10.1186/s12912-015-0082-x
McKeown, M., & Carey, L. (2015). Democratic leadership: a charming solution for nursing's legitimacy crisis. Journal of clinical nursing, 24(3-4), 315-317. DOI: https://doi.org/10.1111/jocn.12752
Merrill, K. C. (2015). Leadership style and patient safety: implications for nurse managers. Journal of Nursing Administration, 45(6), 319-324. DOI: 10.1097/NNA.0000000000000207
Ross, E. J., Fitzpatrick, J. J., Click, E. R., Krouse, H. J., & Clavelle, J. T. (2014). Transformational leadership practices of nurse leaders in professional nursing associations. Journal of Nursing Administration, 44(4), 201-206. DOI: 10.1097/NNA.0000000000000058
Spano-Szekely, L., Griffin, M. T. Q., Clavelle, J., & Fitzpatrick, J. J. (2016). Emotional intelligence and transformational leadership in nurse managers. Journal of Nursing Administration, 46(2), 101-108. DOI: 10.1097/NNA.0000000000000303
Swanwick, T., & McKimm, J. (2017). ABC of clinical leadership. John Wiley & Sons. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=49neDQAAQBAJ&oi=fnd&pg=PP7&dq=healthcare+leadership,+book&ots=jrj-3XxyLv&sig=hgKMajr_vfWLYV33lq4Ga2eaAfk#v=onepage&q=healthcare%20leadership%2C%20book&f=false
Thomas, T. (2015). Management and leadership for nurse administrators. Jones & Bartlett Publishers. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=7oeHCgAAQBAJ&oi=fnd&pg=PR1&dq=leadership,+health+nurse&ots=Hve-HL1Li4&sig=iKi8nXlzlHLcaIbTCpNBcwzviyo#v=onepage&q=leadership%2C%20health%20nurse&f=false
Ward, K. (2017). Guest editorial: Nursing leadership and Australian College of Nursing's (ACN) work in capacity building for the Journal of Nursing Management. Journal of nursing management, 25(8), 585-586. DOI: https://doi.org/10.1111/jonm.12524
Weng, R. H., Huang, C. Y., Chen, L. M., & Chang, L. Y. (2015). Exploring the impact of transformational leadership on nurse innovation behaviour: A cross?sectional study. Journal of nursing management, 23(4), 427-439. DOI: https://doi.org/10.1111/jonm.12149
Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research. DOI: