Nursing Leadership Styles Influence on Performance and Work

Styles the Nursing Leaders Have Utilized

Nursing is an essential element of any system of healthcare providing establishment. It should be stated that the way a team-leading nurse decides to manage his or her colleagues might be considered as a foundation of productive and efficient work. A plethora of scholars and practitioners have emphasized the importance of the leadership nursing style that one implements in the work environment. Hence, the issue of the impact of an appropriate choice of nursing leadership approach seems relevant to discuss.

Within the scope of the scholarly dimension, there are plenty of opinions on which leadership style a nurse should be founded. Nevertheless, it might be assumed that five primary managing approaches are worth to be analyzed. These styles are as follows: autocratic leadership, laissez-faire leadership, democratic leadership, transformational leadership, and servant leadership (Posnick, n.d.). Although academic sources provide much more managing strategies options, it seems reasonable to focus on the above ones as they tend to be the most applicable in the nursing framework.

Autocratic Leadership

A nurse that follows the principle of autocratic leadership makes all crucial decisions on his or her own. Such a leader provides the team members with strict and direct orders and suffocates their creativeness, not allowing them to express any extent of independence. This leader discourages the subordinates from making even a little mistake and, usually, implements several sanctions for that. The autocratic style might be the most appropriate option for dealing with an easy task when high-level cooperation is not required. Furthermore, it is a good variant for emergencies in which fast decision-making is a necessity. However, the above approach will not serve as a foundation for building trust and gaining advantages from the professionalism of the colleagues.

Laissez-Faire Leadership

The laissez-faire nurse might be characterized as the complete opposite of the autocratic style. This nurse allows the collective to be free in expressing their ideas, opinions, and possible solutions to various issues. The leader makes an accent on collaboration and a friendly work environment, which allows achieving a significant extent of intersection and interdependence. Laissez-faire style may be the most applicable to the conditions when the team has a great qualifications and experience. Nevertheless, when there is a lack of knowledge, and specific settlements are to be made, laissez-faire leadership does not work well.

Democratic Leadership

The democratic manager fosters the freedom of exchanging opinions to figure out the best possible solutions. The leader collects feedback from the team and takes into account any reasonable idea. Nevertheless, it should be stated that the final decision is always up to the manager.

This style is an excellent foundation for creating accountability, as well as developing working relationships based on trust. However, when it comes to quick and operative decision-making, this style seems irrelevant as it might take time to listen to each team member and make a fully collective solution.

Transformational Leadership

If a nurse tends to adhere to the principles of transformational leadership, then, he or she tries to focus on long-term goals rather than on day-to-day routine. It means that the transformational leader wants to improve the health care providing system as a whole. Such a manager always aspires to point out any possibilities of the improvement of processes and adapt leadership norms to this purpose. It might be assumed that the nurse transforms the managing style to ongoing situations and necessities. This strategy might fit well when a health care establishment and its system need many crucial changes. It should be emphasized that the fast process of making routine decisions is not a characteristic of transformational leadership.

Servant Leadership

The servant nurse makes an accent on team success by encouraging the development of individual teammates. This manager focuses on the needs of the collective and tries to do everything possible to realize the potential of his or her colleagues. The nurse is ready to spend some extra time to teach the team something new, believing that such an approach will contribute to notable results. The leader provides them with continuous feedback regarding which professional aspects are necessary to improve. Then, the servant manager develops and implements individual plans for each team member and expresses the will to help with diverse issues related to work. It should be mentioned that in the framework of nursing, such a leadership style has become quite popular nowadays, and many scholars note plenty of its benefits (Eva et al., 2019; Best, 2020). Servant managing might be a suitable variant when a collective has a diverse staff that can handle various issues. However, in stressful situations – when a top-down solution is to be made – the above strategy does not fit well.

All the described leadership styles might be combined to take the primary advantages from each. Such an approach might result in progressive relationships in the team and establishing a solid reputation of the leader as whatever strategy he or she decides to adhere to, the colleagues will appreciate these efforts. Moreover, the most significant practising nurses-managers tend to follow the latter approach. A rational combination of styles serves them as an essential prerequisite for individual and group achievements.

Types and Levels of Conflicts Experienced by Nurses

Academicians provide a vast number of the classification and interpretation of conflicts that may arise in a nurse’s work environment. Nevertheless, it seems rational to adhere to the following classification as it gives exhaustive and convincing arguments. Within the scope of nursing, the Nursing Conflict Scale (NCS) offers types of conflicts as follows: intragroup, competitive, disruptive, intergroup, intrapersonal, and interpersonal (Higazee, 2015). The investigation showed that intragroup and competitive conflicts take place more often than the other ones. It is claimed that the latter two “are related to each other as both arise among nurses for instance, because of competition on opportunities … and the injustice from some nurse managers” (Higazee, 2015, p. 4). Higazee (2015) states that the following popular kind of conflict is the disruptive one – also called interprofessional. It arises between a nurse and a physician during the process of patient care due to some factors. These factors are “role boundary issues; scope of practice; responsibility; accountability; and people in dominant positions” (Higazee, 2015, p. 4). The three above types of conflict negatively affect the performance of nurses to the greatest extent.

There are three levels of conflicts accepted in the nursing framework internationally – low, moderate, and high. The level is identified according to the criteria of the extent to which conflict affects the results of work, as well as of a degree of escalation. The case study of El Dahshan and Moussa (2019) reveals that in Saudi Arabia, nurses experience intragroup and competitive conflicts most often. Then, Saudi nurses tend to face a mostly moderate and low level of conflict (El Dahshan & Moussa, 2019). It should be emphasized that disputes are an inevitable part of the work of nurses; thus, it is vital to know how to handle them appropriately.

Conflict management styles have been an object of various discussions. The approved list of these styles might be as follows: accommodation, aggressiveness, avoidance, compromise, dominance, emotional, ethnicity, integration, oblige, and third party (Asfahani, 2017). Asfahani (2017) reasonably claims, “The unmanaged conflict has chronic negative effects on organizational performance” (p. 1258). Hence, the capability to deal with conflicts applying diversified leadership strategies is an essential element of a nursing management system. The case study of Saudi Arabia showed that leaders use an “oblige form of conflict management style which is the win-lose approach” (Asfahani, 2017, p. 1258). It means that when it comes to a stressful situation, nurses-managers tend to follow an autocratic leadership approach that indicates giving strict orders and directions to subordinates. They found such a decision on their experience that demonstrates success in conflict-solving by applying the oblige conflict leadership. However, an international practice also discloses the efficiency of compromising and integrating, which means to make concessions and to unite efforts in decision-making, respectively.

The right choice of leadership style is a crucial element of conflict management. In this regard, this leadership style is a tool that provides a nurse with instruments to figure out the best way to handle a conflict. Thus, whatever method is chosen, it should contribute to coherent and gradual negotiations that lead to a de-escalation of a dispute – of any type and level. A proper leadership style might be considered the foundation of goal-oriented decision-making and productive cooperation, which results in positive patient outcomes (Asfahani, 2017). Given the fact that conflict is an unavoidable phenomenon, nurses-leaders are to continually develop and improve their management skills by obtaining relevant literature and enriching experience. It might be assumed that the latter will contribute to a great extent of cooperation.

Impact of Communication and Decision-Making in Nursing

Patients always expect high-quality care providing from a nurse; hence, he or they should find the practice on the best practices and evidence. Such an approach may help to establish trust relations with a patient, which leads to the smooth and transparent process of health care. For this, rational and advanced communication and decision-making might be considered essential prerequisites. These are vital to developing a harmonized system that allows providing patients with services of the highest quality.

Developed communication contributes to creating an individual approach to every patient by allowing nurses to identify his or her crucial requirements and needs. It should be emphasized that high-quality communication makes patients express themselves freely, not fearing to say any delicate and important information. To achieve such relationships, nurses tend to use some communication tools such as “asking empathic questions so that the care is fine‐tuned to the individual patient preferences” (Hertog & Niessen, 2019, p. 7). Hertog and Niessen (2019) note that the quality of communication might be among the most critical indicator of nurses’ performance as it has a significant influence on patient outcomes. Thus, via communicating with patients accordingly, a nurse gains plenty of benefits, among which is the opportunity to adapt the health care providing strategy to a patient’s needs that appear after the treatment began.

Furthermore, if quality communication might be defined as a tool for excellent relationships with patients, then, decision-making is an instrument that implements the gains from this communication in the process of care. Hence, the development of fast and evidence-based decision-making is also an integral part of a nurse’s practice (Johansen & O’Brien, 2015). It is intersected and interdependent with communication; thus, the quality of decision affects the quality of communication and vice versa. Founding the health care on the information gained from trust and productive dialogue with a patient, a nurse gets many options on how to organize treatment. At this point, the nurse should demonstrate high-quality decision-making as he or she is to choose the best possible variant.

Influence of Leadership Styles on Nursing Performance and Work Environment

The leadership style of a nurse might be considered as a critical aspect of productive and notable services of care. For a nurses-managers, it is essential to improve their managing approach continuously because working conditions and other circumstances cannot be characterized as absolutely stable and unchangeable. Hence, being a leader, the nurse has to guide not only his- or herself but also the team as a whole. The colleagues are to provide the highest-quality care in any situation, and the responsibility for this is – in the first turn – on the manager. The latter should conduct such a leadership strategy that will positively affect nursing performance, patients’ conditions, and work environment. An appropriate managing style might harmonize the relations within a team, as well as the distribution of tasks.

Nursing performance seems to indicate a great extent of dependence on the leadership style chosen by a manager. It should be stated that he or she should undertake an investigation and analysis to apply the most proper option of leading. In the other case, patient outcomes will be quite insignificant as the team will be involved in an unhealthy work environment (Manning, 2016). For instance, if the leader decides to adhere to autocratic leadership when the collective is experienced and qualified, then, the whole performance will be spoiled as noticeable professionals will not affect health care significantly. In the above conditions, “support and investment in staff are critical for the unified achievement of a common goal of provision of excellence in client care” (Cummings et al., 2018, p. 50). These arguments allow assuming that leadership style is a critical part of the performance of the team and the satisfaction of patients. Thus, nurses-leaders should monitor all indicators that might affect the work environment.

Furthermore, to demonstrate significant dedication to work, a nurse is to have a great extent of job satisfaction that is considerably affected by the leadership style of a manager. Cummings et al. (2018) state, “decreased job satisfaction can be an indicator of quality care issues” (p. 50). Hence, if nurses feel uncomfortable with the leader, as well as the inappropriacy of the managing approach, for the manager, it seems reasonable to conduct many changes. Job dissatisfaction hinders the coherent and coordinated process of health care, as well as task distribution because nurses are not encouraged to do their job remarkably. It might be assumed that to avoid such a situation, the leader must collect feedback from colleagues consistently.

References

Asfahani, A. M. (2017). Impact of conflict management style on ethical decision-making process: Case study of Saudi Arabia. International Review of Management and Business Research, 6(3), 1246–1261.

Best, C. (2020). Is there a place for servant leadership in nursing? Practice Nursing, 31(3). Web.

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19–60. doi:10.1016/j.ijnurstu.2018.04.016

El Dahshan, M. E. A. & Moussa, Rania I. (2019). Levels and Types of conflict experienced by nurses in the hospital settings: A comparative study. American Journal of Nursing Research, 7(3), 301-309.

Eva, N., Robin, M., Sendjaya, S., van Dierendonck, D., & Liden, R. C. (2018). Servant leadership: A systematic review and call for future research. The Leadership Quarterly, 30(1), 111–132.

Hertog, D. R. & Niessen, T. (2019). The role of patient preferences in nursing decision‐making in evidence-based practice: Excellent nurses’ communication tools. Journal of Advanced Nursing, 75(9), 1–9. doi:10.1111/jan.14083

Higazee, M. Z. (2015). Types and levels of conflicts experienced by nurses in the hospital settings. Health Science Journal, 9(6:7), 1-6. Web.

Johansen, M. L. & O’Brien, J. L. (2015). Decision making in nursing practice: A concept analysis. Nursing Forum, 51(1), 40–48. Web.

Manning, J. (2016). The influence of nurse manager leadership style on staff nurse work engagement. JONA: The Journal of Nursing Administration, 46(9), 438–443.

Posnick, S. (n.d.). 5 nursing leadership styles you’ll come to learn as a nurse. The Job Network. Web.