Nurses Week: Innovative Care Through “The Right Stuff”

Nurse leaders are described as visionary, focused, responsible, trustworthy, motivated, flexible, energetic, and willing to accept change. Angela Barron McBride, Ph.D., RN, FAAN, FNAP, describes nurse leaders with “the right stuff” as ones that can synthesize wisdom, intelligence, and creativity.¹ It is helpful to acknowledge that leaders are not necessarily born with these characteristics; rather, they develop over time and through experience. Believing that one is not cut out to be a leader halts the forward momentum required for improving and expanding upon leadership skills.

The application of theories associated with leading creates a foundation for nurses to begin addressing critical questions. Theory guides problem-solving and contributes to evidence-based health care practices. It is important to understand that no single theory may fully address the dynamics related to leadership.

Contingency Theory

The contingency leadership theory suggests that leaders adapt their leadership styles in relation to changing situations. For example, a nurse manager may use an authoritarian style when responding to emergency situations, such as a cardiac arrest, but use a participative style to encourage team members to care for patients when they are short-staffed. An effective leadership style is one that focuses on and aligns with the organization’s environment and goals and complements personal characteristics of the team.

Another example of the contingency theory is situational leadership. Leaders use a more autocratic style with staff members who are new and need more direction. For staff members who are tenured and experienced, the leader may use a delegating style because these individuals have more confidence when performing a task.

Transformational Leadership

The transformational leadership theory emphasizes the importance of interpersonal relationships. This theory focuses on the motives, desires, values, and goals of both leaders and followers to find a common cause. The goal of the transformational leader is to generate staff commitment to the vision or ideal of the organization as a whole, rather than staff members themselves. Transformational leaders are unique because they encourage staff members to pursue higher values, ones that are above the staff members' own interests. Transformational leaders also encourage others to exercise leadership, and they use their power to help staff members believe they can do exceptional things in the workplace. Transformational leaders are more likely to have committed followers who put extra effort into their work to enhance the organization’s overall performance.

Hierarchy of Needs

The hierarchy of needs theory suggests that individuals are motivated by a hierarchy of human needs. These needs begin physiologically and progress to safety, esteem, and self-actualizing needs. This theory implies that when the need for food, water, and air is met, the human spirit reaches out to others to develop self-esteem, competence, achievement, and creativity. Lower level needs drive behavior and must be met before higher level needs are addressed. As a nurse leader, applying this theory to practice includes an awareness of a staff member’s need for safety and security over creativity and inventiveness when transitioning into a new position within the organization.

Expectancy Theory

The expected theory implies that an individual’s perceived needs influence his or her behavior. The theory suggests that motivated behavior is increased if a person perceives a positive relationship between effort and performance. Motivated behavior is further increased if a positive relationship exists between good performance and outcomes or rewards. Application to practice includes providing specific and detailed feedback about positive performance to all staff members on a regular basis.

Think of a nursing supervisor whom you have encountered in the past, and consider the following questions:

• What leadership theory did he or she use?
• How effective was the theory?
• What type of influence did that leadership theory have on the staff?

Growing Your Skills Day-to-Day

Leadership is not isolated to nurses in administrative positions. During patient care delivery, nurses are expected to identify evolving situations, develop and implement a plan of care, and communicate effectively. Nurses practice in a wide array of settings and establish their leadership skills while facing unknown predicaments. Leadership characteristics develop and flourish over time as nurses take on challenges, apply principles, and examine possibilities each and every day.

Are you interested in pursuing a nursing degree at CTU? Request information and speak with an admissions advisor today!

1. McBride, A. B. (2011). The growth and development of nurse leaders. New York, NY: Springer.

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