Characteristics and Examples of Transformational Leadership in Nursing

Today’s healthcare leaders continuously face the challenge of meeting high expectations and adapting to change. Transformational leadership, the preferred management style of Magnet hospitals, has been shown to transform entire teams to a higher level of practice.

What is Transformational Leadership?

Transformational leadership is a management style that motivates employees to take ownership for their roles and perform beyond expectations. Instead of assigning tasks from the top, transformational leadership teaches people how to think rather than just do what they are told. Transformational leaders are inspirational and can motivate employees to find better ways of achieving a goal. They are able to mobilize people into groups that can get work done, raising the well-being, morale and motivation level of a group through excellent rapport. These leaders also excel at conflict resolution. Sometimes called quiet leaders, they lead by example.

Transformational leaders specialize in:

  • Working to change the system
  • Solving challenges by finding experiences that show that old patterns do not fit or work
  • Wanting to know what has to change
  • Maximizing their teams’ capability and capacity

The History Behind Transformational Leadership

In 1978, James MacGregor Burns, a political scientist and historian, introduced a leadership theory that he called transformational leadership. Burns was interested in the leadership styles used by key figures in history, including Mahatma Gandhi, Franklin D. Roosevelt and John F. Kennedy. Burns described transformational leadership as occurring when “two or more persons engage with others in such a way that the leader and followers raise one another to high levels of motivation and morality.” This theory differed significantly from older leadership styles, such as transactional leadership, because it proposed that meeting the needs of followers was vital to achieving high work performance.

Characteristics of a Transformational Leader in Nursing

  • Is a model of integrity and fairness
  • Sets clear goals
  • Has high expectations
  • Encourages others
  • Provides support and recognition
  • Stirs people’s emotions
  • Gets people to look beyond self-interest
  • Inspires people

Healthcare organizations, known for being highly bureaucratic, have traditionally used transactional leadership strategies. Although transactional leadership can help organizations meet their goals in the short term, it will not provide the inspiration to create and nourish a new culture for healthcare organizations.

Transactional leadership is known for:

  • Task-and-reward orientation
  • Management by exception
  • Few opportunities for creative thinking
  • Decision making by senior management
  • Limited opportunities for employees to be involved

How Transformational Leadership Benefits an Organization

Managers who use transformational leadership principles create a climate where employees have a greater commitment to their organizations and higher levels of morale, job satisfaction and work performance. Healthcare organizations that adopt transformational leadership see gains in staff satisfaction, which in turn may have an important effect on reducing the rate of patient care errors. The Institute of Medicine, a private, nonprofit institution now called the Health and Medicine Division of The National Academies of Sciences, Engineering, and Medicine, said that transformational leadership and evidence-based practice create a work environment that promotes patient safety. A recent study in Belgium also suggests that transformational leadership exerts a significant positive impact on the safety performance of nurses.

In addition, this leadership style is also associated with employee retention. Those who work for transformational leaders typically devote significant effort to ensure that their organization is successful and are more likely to stay in their job, because they feel their work is valued. One of the best uses of this leadership style is for organizations that have aspirations — such as receiving Magnet-designation or reducing patient readmittance rates — and want to change and adapt to get there. A transformational leader can influence the structure of the organization and motivate current employees to buy into the new direction.

Pros and Cons of Transformational Leadership

Transformational leadership works well in organizations where change is needed. It likely won’t be the right fit for new organizations where no structure exists. There are cases where the managing role is important. To get something done quickly, an organization needs a leader/manager who can provide clear direction and a direct path to delivery to speed an initiative to completion depending on the particular situation at hand.

Transformational Leadership PROS

  • Excellent at communicating new ideas
  • Good at balancing short-term vision and long-term goals
  • Experience building strong coalitions and establishing mutual trust
  • Backed by integrity and high emotional intelligence

Transformational Leadership CONS

  • Ineffective in initial stage or ad-hoc situations
  • Requires an existing structure so that further development and growth can occur, meaning it’s not ideal for new organizations
  • Bad fit in bureaucratic structures

Where Leaders Live

In truly highly reliable organizations, leadership skills are encouraged throughout the organization. While it’s often common to focus leadership efforts at the highest levels of a hospital or health system, middle-management leaders are key to an organization’s success and directly impact many front-line caregivers and healthcare workers.

Learn how organizations are focusing on filling their leadership pipelines by developing existing, high-performing staff in the white paper below.

Maria Morales

Curriculum Designer for Clinical Education, Relias

Maria Morales, MSN, RN, is Curriculum Designer for Clinical Education: Nursing, Medicine, Pharmacy, and Allied Health at Relias. Her background includes adult critical care nursing, postanesthesia nursing, and nursing education.

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