Leadership Styles in the Clinical Environment

Leadership Styles in the Clinical Environment
Leadership Styles in the Clinical Environment
The global healthcare sector is experiencing numerous sophisticated challenges in regards
to the provision of exceptional, safe and affordable care into the future. Some of the highly
sensitive aspects that need attention are the dynamic systems of healthcare, enhanced acuity in
patient diseases, technological innovation and the increased healthcare costs (Middleton, 2009).
For that reason, it is vital to sustain and enhance the quality of care offered in an attempt to
improve healthcare delivery. Leaders in healthcare professions play vital roles in the continuum
of care. They face challenges on a daily basis on issues that require the utilization of critical
skills in the derivation of solutions. Leaders develop key decisions that impact the lives of
patients in numerous ways (Perez, 2014). Leadership in the realm of healthcare allows care
providers to navigate the sophisticated and dynamic systems effectively in an attempt to solve
problems and make decisions relating to the affordability of service delivery and accessibility.
Notably, leaders should be well equipped and trained to formulate the right decisions at
appropriate times. Leadership is a vital concept in the nursing profession (Patelarou &
Vlasdiadis, n.d). Nurses need to consider the huge literature availed in the realm to develop an
effective leadership approach towards the delivery of high quality care and ascertain patient
safety. This paper evaluates and criticizes the different leadership styles nurses may use in
teaching others in the clinical environment, and gives examples on how the various leadership
styles may promote quality in enhancing teaching and learning outcomes for nursing practice.
Leadership Styles in the Clinical Environment
Autocratic Style of Leadership
The leadership style is characterized by the leader’s independence in making decisions and
maintenance of control over the decision making process. The nurse manager retains
responsibilities and limits the need to delegate duties to other people. An aristocratic leader
restricts the likelihood of making consultations with other people within the leadership structure.
Employees have a responsibility of following what the leader says (Walker et. al., 2011). Every
member of staff works under the supervision of the nurse manager and less or no consideration is
given to their input in the making of decisions. Workers do not have the freedom to inquire if
they see that the directive they have been given does not work. Doubts in regards to the validity
of a directive are highly disregarded.
Most literature materials consider this style an older and outdated form of leadership.
However, it has a number of advantages that are exceptional to it. First, the leader incurs less
stress because the stress of his fate is delegated in other people’s hands. Second, there is
enhanced efficiency because the people’s capability to work is increased by the presence,
oversight and expectations set by the leader (Dorgham & Sana, 2013). Third, the decision
making process is rapid because the leader does not have to call for meetings to compromise the
likelihood of reaching a decision. Leaders have an opportunity of responding quickly to people’s
needs and changes in healthcare. Fourth, the problem solving process is fast. The leader has the
authority to spot problems and issue directives which serve as solutions.
This type of leadership works well in prisons, jails, military and routine operations. The main
reason for its application in such places is that the lives of patients in the centers depend on the
functional capability of the workers. Consequently, it is necessary that the workers should follow
any directives that they are given. Punishment may also be enforced if the workers fail to follow
the enforced rules (AANAC, 2013). There is high intolerability to mistakes and individuals may
be blamed in case of faulty procedures. The leadership strategy is highly effective in cases of
confusing situations, emergencies and situations that do not have time for discussion. However,
it is not an effective method for use in routine operations because it does not enhance
communication, trust and collaboration.
Democratic Style of Leadership
This method promotes the participation of junior employees in the process of making
decisions for the organization. Even though the nursing manager has the authority to make the
final decision, he or she is expected to collect information and embrace feedback from workers
prior to making finalizations. The democratic style of leadership is effective in nursing
(Lockwood, 2017). The main reason for its effectiveness is the creation of an environment here
all employees feel valued and appreciated. Consequently, the members of staff strive to deliver
to the best of their abilities. The contribution of any employee in an organization is always core
in fostering a culture of growth. An approach that facilitates the growth of a firm is the best in
the clinical setting. This is because the skills and capabilities of all competent individuals are
crucial in contributing in equal measures to the success of the firm. However, this style of
management has a number of disadvantages in the realm of nursing. First, it requires feedback
from all stakeholders prior to making a decision, hence it is a time consuming process (Al-
Dossary, 2017). Secondly, it may lock out great ideas from members who lack the courage to
speak up. The approach prioritizes on a group of individuals who are confident and free to give
suggestions. However, apprehensive employee may lack the opportunity to offer their feedback.
Affiliative Type of Leadership
The affiliative type of leadership is fostered on harmony. It focuses on building positive
relationships with a main focus on trust and loyalty. Affiliative leaders are normally effective in
organizations where members of staff might be suffering from the problem of low morale
(Tyczkowski, 2015). The style can be explained on the basis of emotions. It is noted as an
emotional type of leadership. The first tasks of affiliative leaders are alleviation of stress and
fostering strong connections among members of staff. The next step meant for the functionality
of the technique will involve doing more practice on result oriented traits. Notably, nurse
mangers applying this style should be good at building relationships. In environments where a
group of individuals are incurring a work-load or working under a stressful environment, leaders
have an obligation of motivating team members (Sanaa, 2016). The state of maintaining
harmony, augmenting morale and rebuilding broken trust enhances interaction and
communication among staff members. The main disadvantage of this style is the impossibility of
using it alone. It can lead to poor performance if used as the only source.
Laissez-Faire Type of Leadership
With this type of leadership, employees receive encouragement to partake on a hands-off
approach where they are allowed to use a method that is appropriate for them. Nurse Managers
are not expected to supervise the members of staff. In most cases, leaders provide minimum
directions, hence allowing workers to perform different tasks on their own (Konstantinou &
Panagiotis, 2018). Employees take responsibility for decisions made by their leaders.
Consequently, the members of staff have a duty of setting goals and resolving all problems likely
to arise in the course of work. This type of leadership is likely to succeed in cases where staff
members in the nursing realm are highly competent, educated, encouraged and ready to deliver
the best results. The approach cannot work during instances where workers are incapable of
managing time, are unskilled and also inexperienced. Such conducts can result in negative
outcomes. Additionally, the decision-making process is highly ineffective. If people are allowed
to make their own decisions, there is a high chance that nothing will be achieved (Damayanthi,
2014). It is hard for something substantial to materialize in the absence of a leader. The people
involved might also talk in circles, hence making it hard for participants to reach an agreement.
The scenario might b more complicated if the people involved lack the necessary skills and
knowledge in making effective decisions. The working environment under the Laissez-faire style
is toxic. This is because it may result in bullying of some members of staff. It may be hard to
reach a point of coordination because diverse groups might reach at different solutions.
Situational Type of Leadership
This is a type of leadership style that embraces adjustments in accordance with the needs of
working. It is flexible and transformational depending on the requirements of the clinical setting.
Management in nursing does not depend on the skills and competencies of the manager;
however, he or she has a duty of modifying them on the basis of the need of the organization. It
relies on critical thinking skills of the leader and flexibility of his or her attitude (Curtis &
Sheerin, 2011). Strong analytical skills and the eagerness to act are highly appropriate in the
nursing setting. This type of nurse management is easy to use, because the leader needs to study
and analyze the existent situation in the organization before settling on the best way that can
produce the best outcome for the firm. Notably, the best results are realizable with the right
leader. Nurse Managers should be free to embrace new decisions and change management styles
in accordance with their need (Gol & Zare, 2017). Evidently, the style may sometime be
successful because of its adaptability mechanisms. Situational leaders tend to be portrayed as
rebellious individuals from long-term goals and strategic frameworks of an organization. This is
one of the major drawbacks of the approach.
Servant type of leadership
In the servant type of leadership, nurse managers prioritize on taking care of individuals who
serve patients. Their main focus is working hard to gain positive outcomes from members of
staff (Fawaz & Lubna, 2016). Nurse Managers pay attention to the requirements of their
employees. They also make inquiries in regards to the kind of help that they need. The endeavors
are all meant for the development of workers, both personally and professionally. The style
dictates that leaders should be active listeners, aware of the nursing environment, be persuasive,
be capable of developing the community, and be empathetic and great at conceptualizing all
possible things. Most literature materials refer to the approach as a caring style of leadership that
fosters trust among members of staff. The leadership style is specifically designed for the nursing
environment. By concentrating on the needs of the team and patients, the leadership style
enhances a positive and healthy working environment where all participants are taken care of and
well supported (Manning, 2017). Trust is an essential aspect in nursing. However, the high
emotions entailed in the approach may affect the performance capability of the organization.
Emotions are likely to overshadow the business-minded spirit that all organizations are supposed
to have, hence lowering productivity and leading stalled growth.
The various styles of leadership tackled in this section show that nurse managers play a
role of guiding people in their ability to contribute to the welfare of patients in various nursing
units. Managers have a responsibility of regulating all of the endeavors that affect the quality of
services offered to patients in the respective organization. The manager's ability to establish a
balanced approach of handling nurses, patients, patient’s families and other healthcare
professional leads to reliable patient outcomes. Leadership styles affects morale and productivity
of workers hence influencing the overall performance of the organization in the clinical setting.
The various styles of leadership present different elements that are likely to blend well the
attributes and capabilities of team members. Notably, all styles depend on the ability of the
Nurse Manager to provide support.
AANAC. (2013). Nursing leadership: Management & leadership styles. AANAC Extras.
Al-Dossary, R. (2017). Leadership in nursing. InTech.
Curtis, E. & Sheerin, F. (2011). Developing leadership in nursing: exploring core factors. British
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Dorgham, S. & Sana, A. (2013). Leadership styles and clinical decision making autonomy
among critical care nurses: A Comparative Study. Journal of Nursing and Health
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Fawaz, M. & Lubna, A. (2016). Effect of leadership styles on job satisfaction among critical care
nurses in Aseer, Saudi Arabia. Journal of the College of Physicians and Surgeons
Pakistan, 26 (5): 366-370.
Gol, M. & Zare, M. (2017). The relationship between leadership styles and personality traits of
nursery managers of hospitals affiliated to Tehran Medical Sciences Universities.
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Konstantinou, C. & Panagiotis P. (2018). Relationship between nurse managers' leadership
styles and staff nurses' job satisfaction in a Greek NHS hospital. American Journal of
Nursing Science, 7(3-1): 45-50.
Lockwood, W. (2017). Clinical supervision; Leadership styles. RN.
Manning, J. (2017). The influence of Nurse Manager leadership style on staff nurse work
engagement. The Journal of Nursing Administration, 46(9), 438-443.
Middleton, J. (2009). Nursing Times: Leadership skills for nurses. Nursing Times Leadership
Patelarou, A. & Vlasdiadis, K. (n.d). “Nurse manager” and “nurse leader”- Synonyms or
complementary terms? Review.
Perez, J. (2014). Impact of Nurse Managers' Leadership Styles on Staff Nurses' Intent to
Turnover. Nursing Theses and Capstone Projects. Paper 31.
Sanaa, A. (2016). Relationship between Head Nurses' Leadership Styles and Staff Nurses' Job
Performance. Journal of Nursing and Science, 5(1), 66-74.
Tyczkowski, B. (2015). Emotional Intelligence (EI) and Nursing Leadership Styles Among
Nurse Managers. Nurs Admin Q, 39(2), 172180.
Walker, R.., Cooke, M., Henderson, A. & Creedy, D. (2011). Characteristics of leadership that
influence clinical learning: A narrative review. Nurse Education Today.

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