A vision for tomorrow: transformational nursing leaders

BACKGROUND: Interviews with 8 transformational nursing leaders are presented. PURPOSE: My purpose was to provide a picture of leadership principles and values as practiced by transformational nursing leaders. METHOD: Interviews were conducted as person-to-person, by telephone, or through e-mail. DISCUSSION: The leaders shared their transformational leadership qualities, ideas of a successful environment, effective change strategies, antecedents for success, and visions for the future of nursing practice. CONCLUSIONS: All of the transformational leaders interviewed strive for excellence, value integrity, shape their environment for success, demonstrate perseverance, attempt to improve the lives of others, possess a genuine love for people, motivate others with inspiration, "invent" the future, and share the path toward self-discovery.     

Leadership style and organisational commitment among nursing staff in Saudi Arabia

Aims

To examine how nurse managers’ leadership styles, and nurses’ organisational commitment in Saudi Arabia relate.

Background

Effective leadership is influential in staff retention; however, recruiting and maintaining nurses is an increasing problem in Saudi Arabia.

Methods

Using a survey design, the Multifactor Leadership Questionnaire and the Organisational Commitment Questionnaire were distributed to a sample of 219 nurses and nurse managers from two hospitals in Saudi Arabia.

Results

Transformational leadership was the most dominant leadership style. After controlling for the influence of manager/staff status, nationality and hospitals, transformational leadership was the strongest contributor to organisational commitment. Perceptions of both transformational and transactional leadership styles, increased with age for nurse managers and nursing staff.

Conclusion

Introducing the Full Range of Leadership model to the Saudi nursing workforce could help to prepare Saudi nurses for positions as nurse managers and leaders.

Implications for Nursing Management

The study provides insight into the type of leadership that is best suited to the dynamic and changing health care system in Saudi Arabia. It is possible that transformational leaders could influence and induce positive changes in nursing.     

Congruent leadership: values in action

Aim(s)  To discuss the significance of an appropriate leadership theory in order to develop an understanding of clinical leadership.
Background  Leadership theories developed from management and related paradigms, particularly transformational leadership, may be ineffective in supporting nurses to gain insights into clinical leadership or to develop and implement clinical leadership skills. Instead, congruent leadership theory, based on a match between the clinical leaders' actions and their values and beliefs about care and nursing, may offer a more firm theoretical foundation on which clinical nurses can build an understanding of and capacity to implement clinical leadership or become clinical leaders.
Evaluation  The information used is drawn from the contemporary literature and a study conducted by the author.
Key issue(s)  Leadership can be better understood when an appropriate theoretical foundation is employed.
Conclusions  With regard to clinical leadership, congruent leadership is proposed as the most appropriate theory.
Implications for nursing management  It is important to recognize that leadership theories based on a management paradigm may not be appropriate for all clinical applications. Education should be aimed specifically at clinical leaders, recognizing that clinical leaders are followed not for their vision or creativity (even if they demonstrate these), but because they translate their values and beliefs about care into action.     

The Relationship Between Nursing Leadership Practices and Hospital Nursing Retention

With the current nursing shortage and the shrinkage of the American workforce, the challenges of recruiting and retaining nurses for hospital nursing are becoming increasingly difficult. Nursing leadership is responsible for the retention of nurses once they are recruited. Leadership styles exhibited by leaders are a major contributing factor to a nurse's decision to stay in a current position, transfer, or seek employment elsewhere or outside the profession. Researchers have found a link between the effectiveness of a transformational leadership style and that of a transactional leadership style in retaining nurses in hospitals.     

Disruptive Leadership: Making Waves,Thriving When It Is Hard to Be a Leader

Over the last 2 years, nursing leaders have operated in a fluid and disruptive environment, constantly adapting to changes in the workplace. The global pandemic challenged these leaders on various fronts: workforce, technology, and regulatory, threatening the status quo of traditional orderly change. Factors external to organizations and a highly contagious disease were forcing rapid hourly and daily changes. Today, nursing leader skills are also morphing, requiring a revisit of the competencies needed for visionary leadership. Traditional models of leadership need to shift from transformational to disruptive. This article reviews and offers suggestions for competencies needed in the future by nurse leaders.     

Developing Tomorrow’s Leaders Through Unit-Based Councils

Unit-based councils (UBCs) are a helpful tool in creating future nurse leaders. By engaging in UBCs, nurses have the ability develop professionally, not only in the nursing, but also into strong leadership roles. Nurses are provided with the skills and tools needed to create positive change in their nursing unit, promote interprofessional collaboration between colleagues, and develop skills that are necessary when stepping into a leadership role. UBCs develop an environment of collaboration and trust between nurses, and empower them to become stakeholders in their practice.     

Leadership and management in mental health nursing

blegen n.e. & severinsson e. (2011) Journal of Nursing Management 19 , 487–497
Leadership and management in mental health nursing Background Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader’s influence and regard leadership and management as distinct from the nurses’ practical work. Aim The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. Method A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995–July 2010. Results Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Conclusion Mental health nurses’ leadership, management and transformational leadership are positively related in terms of effectiveness and nurses’ skills. Implication for nursing management It is important to consider mental health nurses’ management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization.     

Leadership skills for the 21st century

In today's ever-changing health care environment, nurses, especially administrators and managers, require leadership skills that provide direction for a new generation of nurses. Currently, there is a shortage of nurses globally. Along with this shortage of nurses, there is a shortage of nurse leaders. The importance of cultivating new nursing leaders is imperative for a healthful society. Gaining knowledge to become an effective nurse leader is one way to ensure quality health care for the future.     

Teamwork,clinical leadership skills and environmental factors that influence missed nursing care – A qualitative study on hospital wards

AimTo explore how nursing teams in clinical inpatient nursing hospital wards perform teamwork to prevent or reduce missed nursing care and how teamwork is influenced by clinical leadership skills and environmental factors.BackgroundEarlier studies on missed nursing care identified teamwork and leadership skills as promising factors in inpatient care that can positively influence quality of care and reduce missed nursing care. The effective use of teamwork in hospitals requires understanding what it is, how it is performed by nursing teams and how it is influenced by clinical leadership skills and environmental factors.DesignA qualitative exploratory study was undertaken between January and March 2021.MethodsA total of 16 registered nurses who worked on various hospital wards, participated in three online focus groups. Data were analyzed with thematic analysis according to Braun and Clarke.ResultsThematic analysis revealed four themes. First, nurses perform teamwork and clinical leadership skills in various ways. Some nurses work in pairs and have common goals, while other nurses work individually. This influences teamwork. Second, nurses are informal teachers, visible in teaching and learning from each other, contributing in constructive teamwork. Third, senior nurses are seen as informal leaders, forming connection between nursing wards and formal leaders, resulting in awareness of each other and the progress of patientcare. Finally, environmental factors influence the performance of teamwork.ConclusionsResults of this study show how knowledge regarding missed nursing care can be increased. Results can be used for developing training programs and embedding education in practice aimed at constructive teamwork, clinical leadership skills and missed nursing care.     

Elevating Nursing Leadership at the Bedside

If we are to achieve healthy work environments that produce competent nurse leaders at the unit level, care must be taken now to ensure a talent pool of nurse leaders for the future. When nurses at the bedside share in the decision-making authority in their work environments, front-line leadership emerges. Growing talent from within at organizational, microsystem, and corporate strategy levels is important for succession. By investing in our front-line nurses, we can enhance leadership at all levels within the healthcare system and enable nurses to be well-positioned in effecting transformational change.     

安徽省873名中医院护士长变革型领导力影响因素分析

目的 了解安徽省内中医院护士长变革型领导力现状,并分析其影响因素,为提高护士长管理效能提供参考依据。方法 采用便利抽样法,选取安徽省内56所中医院873名护士长作为调查对象,使用一般资料调查表、护士长变革型领导力自评量表、护士长核心能力评估量表进行调查。采用多重线性回归分析护士长变革型领导力的影响因素。结果 中医院护士长变革型领导力得分为（109.43±12.40）分,多重线性回归分析结果显示：医院等级、护理管理能力、人际关系能力、护理科研能力及护理教育能力进入回归方程（P<0.001）,共解释总变异的53.0%。结论 中医院护士长变革型领导力处于中上水平。中医院护士长护理管理能力、人际关系能力、护理科研能力、护理教育能力及所在医院等级是变革型领导力的影响因素。建议中医医院管理者重视对护士长核心能力的培养,促进护士长变革型领导行为,并采取有效措施对变革型领导力的提升效果进行评价、追踪,提高护理质量。     

Statistical testing of the full-range leadership theory in nursing

The aim of this study is to test statistically the structure of the full-range leadership theory in nursing. The data were gathered by postal questionnaires from nurses and nurse leaders working in healthcare organizations in Finland. A follow-up study was performed 1 year later. The sample consisted of 601 nurses and nurse leaders, and the follow-up study had 78 respondents. Theory was tested through structural equation modelling, standard regression analysis and two-way anova . Rewarding transformational leadership seems to promote and passive laissez-faire leadership to reduce willingness to exert extra effort, perceptions of leader effectiveness and satisfaction with the leader. Active management-by-exception seems to reduce willingness to exert extra effort and perception of leader effectiveness. Rewarding transformational leadership remained as a strong explanatory factor of all outcome variables measured 1 year later. The data supported the main structure of the full-range leadership theory, lending support to the universal nature of the theory.     

Developing a preceptorship/mentorship model for home health care nurses

Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship/mentorship that meets the unique needs of home health care nurses. The methods utilized included focus groups, key informant interviews, and a workflow analysis. Factors that influence preceptorship such as nursing workload, preceptor training and remuneration were examined to develop a new model that offers career enhancement and leadership opportunities for preceptors and mentors, and promotes a welcoming environment for preceptees. Reward and recognition programs were created for preceptors to acknowledge their leadership contribution at the front line. This study demonstrates how evidence and innovation were used to create a preceptorship/mentorship model to develop community nursing leaders of the future.     

Succession planning for academic nursing

Academic nursing must plan for the future by retaining, developing, and recruiting academic nurse leaders, utilizing best practices in succession planning. This article presents a case study in which an evidence-based model was developed to provide academic nurse leaders with a guide for succession planning. A formal succession plan gives purposeful direction in identifying and developing emerging leaders and is especially useful for individuals who are new to a major leadership role. The author collaborated with an academic nurse leader at a selected College of Nursing in gathering information essential to forecasting future leadership needs. An Executive Summary report, highlighting recommendations, was provided to the academic leader in order to initiate a formal succession plan. The model provides a means for the assessment of current leadership skills and talents, analysis of future needs for academic nurse leaders, and development of evidence-based recommendations to strengthen and improve an academic succession plan. The succession planning model lays the groundwork for academic nursing leaders to achieve and uphold a highly qualified nursing leadership workforce to meet the future needs.     

Developing a Preceptorship/Mentorship Model for Home Health Care Nurses

Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship/mentorship that meets the unique needs of home health care nurses. The methods utilized included focus groups, key informant interviews, and a workflow analysis. Factors that influence preceptorship such as nursing workload, preceptor training and remuneration were examined to develop a new model that offers career enhancement and leadership opportunities for preceptors and mentors, and promotes a welcoming environment for preceptees. Reward and recognition programs were created for preceptors to acknowledge their leadership contribution at the front line. This study demonstrates how evidence and innovation were used to create a preceptorship/mentorship model to develop community nursing leaders of the future.     

Growing our future nursing leaders

The need for strong nursing leadership to meet the future challenges of the healthcare delivery system is widely acknowledged, yet many of today's nursing leaders express concern about a lack of interest in leadership among their younger nurses. This article reports on a qualitative research study that involved focus groups with 48 younger nurses under the age of 40 who were not currently in formal leadership positions. Using a ConCensus process, participants were asked questions to identify and prioritize the factors that influence their decisions to accept or reject nursing leadership positions. In this study, participants did see a potential in the nursing leadership role to make a difference for both patients and staff. Adequate compensation for the role and true decision-making power were factors of concern for younger nurses. Feedback from current leaders about nursing leadership positions is not positive. Strategies that current nursing leaders will need to consider to encourage interest in nursing leadership will be discussed.     

Preliminary clinical nursing leadership competency model: a qualitative study from Thailand

This qualitative study explored the clinical nursing leadership competency perspectives of Thai nurses working in a university hospital. To collect data, in-depth interviews were undertaken with 23 nurse administrators, and focus groups were used with 31 registered nurses. Data were analyzed using content analysis, and theory development was guided by the Iceberg model. Nurses' clinical leadership competencies emerged, comprising hidden characteristics and surface characteristics. The hidden characteristics composed three elements: motive (respect from the nursing and healthcare team and being secure in life), self-concept (representing positive attitudes and values), and traits (personal qualities necessary for leadership). The surface characteristics comprised specific knowledge of nurse leaders about clinical leadership, management and nursing informatics, and clinical skills, such as coordination, effective communication, problem solving, and clinical decision-making. The study findings help nursing to gain greater knowledge of the essence of clinical nursing leadership competencies, a matter critical for theory development in leadership. This study's results later led to the instigation of a training program for registered nurse leaders at the study site, and the formation of a preliminary clinical nursing leadership competency model.     

Academic leadership style predictors for nursing faculty job satisfaction in Taiwan

The purpose of this study was to examine the influence of nursing deans' and nursing directors' transformational and transactional leadership styles on nursing faculty job satisfaction in baccalaureate and associate degree nursing programs in Taiwan. The study provides a mechanism by which nursing deans or nursing directors can obtain feedback from nursing faculty about leadership styles. Such feedback can then serve as the basis for further development of academic nursing leadership potential in Taiwan. The theory of transformational versus transactional leadership style guided this study. A cross-sectional mailed survey design was conducted. A convenience sample of 233 nursing faculty participated in this study. Idealized influence, intellectual stimulation, and contingent reward leadership styles significantly and positively predicted job satisfaction. However, active management-by-exception significantly and negatively predicted job satisfaction. Nursing leaders should implement effective leadership styles. Study implications for nursing education administration, limitations, and recommendations for future studies were discussed.     

Intentional Modelling: A Process for Clinical Leadership Development in Mental Health Nursing

Clinical leadership is becoming more relevant for nurses, as the positive impact that it can have on the quality of care and outcomes for consumers is better understood and more clearly articulated in the literature. As clinical leadership continues to become more relevant, the need to gain an understanding of how clinical leaders in nursing develop will become increasingly important. While the attributes associated with effective clinical leadership are recognized in current literature there remains a paucity of research on how clinical leaders develop these attributes. This study utilized a grounded theory methodology to generate new insights into the experiences of peer identified clinical leaders in mental health nursing and the process of developing clinical leadership skills. Participants in this study were nurses working in a mental health setting who were identified as clinical leaders by their peers as opposed to identifying them by their role or organizational position. A process of intentional modeling emerged as the substantive theory identified in this study. Intentional modeling was described by participants in this study as a process that enabled them to purposefully identify models that assisted them in developing the characteristics of effective clinical leaders as well as allowing them to model these characteristics to others. Reflection on practice is an important contributor to intentional modelling. Intentional modelling could be developed as a framework for promoting knowledge and skill development in the area of clinical leadership.