Effective leadership is a prerequisite for any organization, and it is becoming increasingly important for the healthcare sector. Transformational leadership is an approach that is often recommended for application in healthcare settings. It allows influencing the basic attitudes and values of nurses by establishing a shared picture of reality (Sfantou et al., 2017). It motivates employees to create and disseminate knowledge and generate latent knowledge, which will become the basis for facilitating the personal and professional growth of nurses. Some experts in the field believe that self-management and transactional styles are more suitable for the environments of healthcare organizations. Despite the opposing views, it is clear that the level of culture existing in the team and the nature of relations with patients and colleagues is determined by the position of the leaders of each institution. The behavior of leaders provides an example and creates a cultural context that will be more effective than any established rules, formal behavioral, and ethical codes. Regardless of the leadership approach applied, the main task for nurses remains unchanged, which is addressing the healthcare needs of the population.
It is worth noting that the issue of leadership is relevant for any organization; however, it is becoming increasingly important in the healthcare sector, given the complex and sensitive nature of this industry. Transformational leadership is one of the methods that can increasingly often be observed in the recent literature. It implies the mutual influence of a leader and followers on each other, which brings both to a higher level of motivation (Lin et al., 2015). Transformational leadership creates significant changes in the work of nursing personnel by making them focused on achieving a high level of morality. Nursing personnel needs to feel trust, admiration, and respect for their leaders, and because of this, they will strive to achieve better healthcare and patient outcomes. Changes in the medical organization should be based on a common vision and goals. The purpose of this paper is to discuss the application and importance of transformational leadership as applied to nursing.
Relevance to Nursing
At present, nursing is considered one of the fast-growing health care areas. New technologies, as well as other aspects, find their application in medical practice. The leadership system in healthcare organizations should have organizational flexibility, features of a self-adjusting system that allows effectively responding, adapting to changes in the external environment for survival and achievement of goals. An efficient development mechanism implies fully-functional leadership, which includes a structural component (resource support such as material, labor, financial, information, and other resources) and a process component (technological support) (Sfantou et al., 2017). The road to improving the effectiveness of nursing care as a system goes primarily through improving the quality of leadership and rethinking its role and functions.
Transformational leaders influence the basic attitudes and values of employees by creating a shared picture of reality that allows them to successfully achieve organizational goals. Researchers believe that, as a rule, this leadership style provides greater productivity compared to any other type of leadership, including transactional one. Transformational leadership strives to achieve a shared vision for all employees of the institution (Sfantou et al., 2017). In its turn, it motivates employees to create and disseminate knowledge and generate latent knowledge, which will become the basis for facilitating the personal and professional growth of nurses. The lack of latent knowledge is one of the main obstacles to the practical implementation of ideas. Transformational leaders constantly contribute to the development of latent knowledge of the organization in order to achieve high efficiency. It is interesting that, in contrast, transactional leadership is based on traditional approaches to management through the establishment of the task of monitoring execution.
It is worth emphasizing that there are different points of view regarding what leadership style is most applicable to nursing. According to one group of authors, the transformational leadership style is the desired one because it includes intellectual stimulation, individual approach, and motivation. Statistics suggest that transformational leadership has shown positive results in achieving better outcomes in the majority of cases. Researchers believe that “leadership styles were found to be strongly correlated with quality care and associated measures” (Sfantou et al., 2017, p. 1). Moreover, “transformational leadership behaviours can influence the quality of the working life of nurses through indirect pathways” (Lin et al., 2015, p. 9). These findings validate the hypothesis that transformational leadership can and should be applied to nursing practice.
However, the opinions of researchers are divided, and the other part supports another point of view on the optimal leadership style for healthcare organizations. Some experts believe that self-management leadership style and transactional (traditionally opposed to transformational) style are suitable for the work of healthcare organizations (Fischer, 2016). Both approaches are seen as capable of stimulating the performance of functions similar to that of transformational leadership (Lapeña et al., 2018). Therefore, they assist in creating the necessary cultural changes within the nursing team and organization, stimulate communication, and provoke the creation of knowledge. According to this group of experts, transformational leadership is effective only in relation to employees who do not have unique competencies.
The application of transformational leadership needs to be combined with the cultural aspects of healthcare. The level of culture existing in the team and the nature of relations with patients and colleagues is determined by the position of the leaders of each institution (Fischer, 2016). The behavior of leaders provides an example and creates a cultural context that will be more effective than any other postulates of ethics and deontology, established rules, or ethical codes that many organizations introduce. The culture of the leader lies in need to combine the basic management principles with universal moral postulates and requires knowledge of the basic norms of relationships among people (Lin et al., 2015). The transformational leader needs to understand that the better their relationship with their subordinates is, the more effective the institution will be in reaching its objectives. The main condition for the efficiency of business communication is the leader’s understanding that the possibility of reaching the goals of the institution increases if communication is organized correctly. In addition, the atmosphere of mutual understanding, trust, and cooperation needs to be encouraged by the leadership as well.
Implications for Nursing Practice
It is important that leadership in the nursing environment needs to be designed to improve the forms and structures of governance. It should have a clear picture and act situationally through a targeted increase in the effectiveness of activities using the aggregate principles, methods, technical means, and management technologies (Lapeña et al., 2018). Moreover, given the sensitive nature of nursing work, it is necessary to maintain the integrity of organizations and intensify labor activity, the development of intelligence and behavior motives of both individual employees and the entire team. The main aspect of the application of transformational leadership is the need to ensure such a quality of interaction in which the staff will be managed well. Meanwhile, it should stay adaptive and have the main task of satisfying the needs of the population in quality nursing services.
It should also be noted that the implementation of this approach in the healthcare system and nursing practice, in particular, should consolidate strategically important principles and new technologies. The leadership system should be constantly improved and aimed at maintaining and strengthening the health of the population, the formation and effective functioning of the system of providing affordable and high-quality nursing services. It should also strive to develop and implement new health care management and quality management projects in the healthcare system (Fischer, 2016). Achieving these priorities is only possible with the right approach to leadership in which both agents – leaders and nursing staff – interact continuously.
Thus, it can be concluded that transformational leadership is an approach to the interaction between two parties, in which the leader can change the views and behavior of the nursing personnel, i.e., a leader is a transformational agent. Part of the expert community supports this approach and believes that in order to change the staff’s way of thinking and adjust their actions, the leader should be able to see the situation beyond its usual borders. The other part does not support this approach and believes that nursing personnel should be guided by a different set of principles. Regardless of which leadership approach is used, the main task of the nursing personnel remains unchanged, which is addressing the needs of the population.
Fischer, S. A. (2016). Transformational leadership in nursing: A concept analysis. Journal of Advanced Nursing, 72(11), 2644-2653. Web.
Lapeña, L. F. R., Tuppal, C. P., Loo, B. G. K., & Abe, K. H. C. (2018). Transformational and transactional leadership styles of nurse managers and job satisfaction among Filipino nurses: A pilot study. Nurse Media Journal of Nursing, 7(2), 65-78.
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(33), 1-9. Web.
Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards quality of care measures in healthcare settings: A systematic review. Healthcare (Basel, Switzerland), 5(4), 1-17. Web.