Transformational leadership in nursing “involves an active involvement of both the leader and team members” . This allows everyone on the team to have a voice and be more involved in the care that is given to the patient. Transformational leadership involves four components: idealized influence, inspirational motivation, intellectual stimulation, and individual consideration. This is the type of leadership that all new nurses should strive to achieve because it has been strongly linked to positive patient outcomes.
In a labor and delivery unit, nurses have the ability to have a one-on-one connection with their patients during each shift. This allows for more collaboration between the nurse and the patient. Nurses in this hospital unit are able to care for the mother, baby, and family members during the most exciting time of their lives. Everyone on that team needs to be included in order for the delivery of the baby and the transition to parenthood to go smoothly. The more time a nurse spends focusing on one patient, the better she becomes at anticipating her patient’s needs and the more knowledge she can provide throughout the labor process. Transformational leadership is an important attribute that these nurses need to demonstrate in order to include everyone involved. It involves a relationship with everyone having a shared vision and trust in one another. Nurses on a labor and delivery unit need to establish trust in all their relationships in order to be successful in their career. A bedside nurse who demonstrates transformational leadership in her every day routine becomes the nurse who everyone else turns to. She is the one who has the power to effect change and do what is best for her patients. This is a type of leadership that won’t go unnoticed on the floor.
Transformational leadership isn’t just a style for managers or supervisors only. According to Clancy, “nurses providing leadership at the point-of-care are a critical part of the future of patient care. Thus the leadership role in nursing practice is more than that of an administrative manager” . Bedside nurses are more than capable of demonstrating this type of leadership to their patients and to other bedside nurses. They are the ones who are consistently with the patients, and they know what needs to be changed in a unit. By practicing this style of leadership, bedside nurses are more likely to be able to make the necessary changes for their unit and for the other nurses and patients around them. Transformational leadership has been linked to “improved performance and outcomes in healthcare performance. The more nurses who practice this leadership, the more improvement will be seen in the healthcare field.
The first component a bedside nurse needs to demonstrate is idealized influence. Idealized influence “builds confidence, admiration, respect and trust, providing employees with a sense of mission”. Nurses who display enthusiasm and have a sense of purpose when they are at work are likely to be transformational leaders. A labor and delivery nurse who adapts idealized influence is determined to build all of her relationships with patients on trust and respect. She tells her patient everything she knows about what to expect throughout the day. This style emphasizes an open line of communication between the nurse, patient, and family in the room. Being honest with the patient with every discussion ensures that the relationship will continue to grow because they are building trust and confidence in each other. When it’s time to deliver, the nurse is able to calmly talk the patient through the process. After the delivery, the nurse continues to inform the mother what is happening to her and her baby and there is never a question left unanswered. If the nurse doesn’t know the answer, she doesn’t hesitate to hunt down the right answer for her patient. At the end of the day, a transformational leader knows that the more her attitude meets her actions, the more likely she is to have other staff start to follow her lead.
The second component of transformational leadership is inspirational motivation. Inspirational motivation “involves encouraging others to achieve the goals and aspirations of the organization while also achieving their own aims”. The main way a transformational bedside leader encourages her patients to achieve their goals is by motivating them psychologically. A bedside nurse isn’t the one giving out orders to the other staff members, but they can motivate in other ways. By continuing to set their own goals throughout a shift and achieve those goals shows other nurses the importance of staying motivated during a shift. Labor and delivery is a specialty unit that can change at any minute so it is important to stay on top of the charting in order to be prepared for the situation to change. At the beginning of a shift, the bedside nurse should write down her goal for the day on the board and encourage other nurses to do the same. Having a goal that needs to be accomplished is good motivation to continue to work hard until that goal is achieved. It has been shown that “leaders who involve other staff, foster team work, encourage motivation and reward good work performance can improve job satisfaction and impact quality of work life”. The more a transformational leader can encourage other staff members the more likely they are to achieve their goals. A bedside nurse who comes in with a daily goal and constantly accomplishes it motivates others around her to have the same mindset when going into work. Transformational leaders want to work in a positive and passionate environment, so they will lead by example.
Intellectual stimulation is the third component of transformational leadership. Intellectual stimulation “encourages staff innovation, challenging the beliefs of staff and service” . Leaders who practice this concept suggest new ideas to help the staff approach issues in new ways. An example of a bedside nurse demonstrating intellectual stimulation is recording how long it takes to answer call lights for the patients on the labor and delivery floor and creating a new way to lower the time. The patient’s satisfaction and well-being is the main concern. The nurse would talk to the patients and staff about what they thought could be improved. She should then take that information and bring a new idea to the staff, like having the call lights go directly to the nurses’ phones. She should challenge her fellow employees to do everything they can to reduce call light times with her. At the end of the month, the bedside nurse should ask her patients if they were satisfied with call light responses to see if her ideas were working. By involving the patients and other nurses, there are more ideas that can be pulled together to create a good plan that could become policy hospital wide. In the labor and delivery world, anything can happen or go wrong in an instant. Ensuring that the call lights are being answered in a timely fashion is important for this patient population. Babies are ready for delivery at their own speed not the speed of the nurses. A transformational leader demonstrating intellectual stimulation is able to take this information and use it to benefit her floor and her anxious mothers.
The last component of transformational leadership is individualized consideration. Individualized consideration is when leaders “encourage and support individuals to reach higher levels of achievement, assisting full actualization, by the leader acting in an advisory capacity”. Labor and delivery is a fast paced environment. The day can take a turn in seconds. A nurse that comes into work with a positive attitude will likely rub off on the other staff members. She would show individualized consideration by supporting the other staff and offering her help whenever she was available, even if it’s as simple as watching the patient while the nurse runs to the bathroom. A leader understands that teamwork will help improve the attitudes of the staff members because it can lighten their daily work load. Lastly, a bedside nurse who demonstrates individualized consideration is able to have a relationship with all of the staff members and patients on her unit. Being in the room for the birth of a child is an amazing feeling, and she gets to share that with her patient each and every day so having a good relationship is important. The nurse understands the importance of individualizing care for her patients and makes sure that is a big part of her interactions. It doesn’t take long to get to know the patients and it can be beneficial for both parties involved. The more the nurse can get to know the mother, the more comfortable she will be in expressing her feelings and concerns to the nurse. Being able to have that bond with a patient will rub off on other nurses on the unit and will demonstrate to everyone exactly what individualized consideration is.
Transformational leadership is a quality that all nurses should strive to achieve. It allows everyone around to feel like they have a voice and are on the same team. Whether it’s a labor and delivery nurse or a baby nurse, everyone knows the end goal is to do what’s best for the patient. Transformational leadership involves four components that all need to be incorporated in order to achieve this style of leadership. Bedside nurses can become leaders every day just by doing the right thing and advocating for their patients. Being a patient advocate and leading by examples are positive ways to influence the rest of the staff to follow along. Promoting individualized care for the patient is another way a bedside nurse can lead by example. By demonstrating transformational leadership on a daily basis, the labor and delivery unit can become a more positive, passionate, and patient-centered floor that all leaders want to be a part of.
- Clancy, M. (2015). Transformational leadership in nursing: From expert clinician to influential leader. Springer Publishing Company.
- Cummings, G. G., MacGregor, T., Davey, M., Lee, H., Wong, C. A., Lo, E., & Muise, M. (2010). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 47(3), 363-385.
- Huber, D. L. (2017). Leadership and nursing care management. Elsevier Health Sciences.
- Johansson, C., Miller, V., & Hamrin, E. (2018). The relationship between transformational leadership and job satisfaction among nurses: A multilevel analysis. Journal of Clinical Nursing, 27(1-2), e286-e293.
- Kelly, L. A., McHugh, M. D., & Aiken, L. H. (2011). Nurse outcomes in Magnet® and non-Magnet hospitals. Journal of Nursing Administration, 41(10), 428-433.
- Kelly, P., & Haidar, M. (2017). Emotional intelligence: A crucial component of nursing leadership. Journal of Healthcare Leadership, 9, 71.
- Li, C., Jiang, X., & Zhu, L. (2017). Effects of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 65(5), 597-605.
- Loke, J. C., & Chow, F. L. (2015). Transformational leadership, empowerment, and job satisfaction: The mediating role of employee empowerment. Journal of Advanced Nursing, 71(7), 1611-1623.
- Nohria, N., Groysberg, B., & Lee, L. E. (2008). Employee motivation: A powerful new model. Harvard Business Review, 86(7/8), 78-84.
- Wong, C. A., & Cummings, G. G. (2009). The relationship between nursing leadership and patient outcomes: A systematic review. Journal of Nursing Management, 17(8), 888-905.