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Leadership in Nursing


Nowadays, there is a need for greater leadership skills development in all areas, especially in the healthcare domain, since they play a significant role in the profession of nurses. Hence, the paper focuses on leadership development among nurses. Nowadays, it is critical to understand that the current leaders will retire one day, and a new generation will occupy their positions. Moreover, the problem with the increasing population also demands the presence of appropriate leadership skills. Nonetheless, despite their importance, nurses often experience challenges while building leadership. In particular, lack of practice and experience can be a serious problem. Hence, it is important to develop effective solutions to these challenges, because leadership skills are in strong relation to better patient outcomes. Therefore, the nurses can develop leadership skills through effective education programs, social media, and appropriate structural approaches.

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In the health care area, there is a great need for leadership development. Hence, regarding the nurse professionals, the requirement relates to management and care skills. From this perspective, leadership skills are essential for organizational and collective goal achievement. Nurses have to develop their potentialities to reach the proficiency necessary in their profession, especially in the communication process performance. Moreover, they should promote the supportive environment development for the leadership exercise that will, consequently, lead to the improvement in the nurse management style and role model in different organizations. Also, there is a need for nursing leaders to self-evaluate and reflect on their leadership considering perceptions of the applied practices and actions because the relevant practices are the indicators of the nursing teamwork performance. Hence, nursing managers have a strong connection with transformational leadership through the nurse's innovative approach to the work environment. Transformational leadership has to be the basis for nurses because it contributes to caring quality. Nonetheless, it can be difficult to practice leadership skills due to the lack of leadership development education programs or insufficient practice implemented while at the universities. It is critical to realize the ways of improving leadership skills among the nurses. Therefore, they can develop leadership skills through effective education programs, social media, and appropriate structural approaches.

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Leadership Importance for Nurses

It is evident that the nursing profession requires corresponding leadership skills, but many nurses experience challenges with their respective development. Leadership in nursing demands many tools, such as operational expertise, strategy, knowledge, compassion, courage, and diversified communication. According to some researchers, the nursing leadership styles and relations aim to decrease adverse cases, mortality, and complications as well as to raise patient satisfaction (Lanzoni, Meirelles, & Cummings, 2016). In the research, leadership is defined as the interpersonal impact on the given situation to gain more objectives. Hence, healthcare leaders are the change agents that can develop necessary cohesion and positively impact organizational culture through their leadership practices and behavior (Lanzoni, Meirelles, & Cummings, 2016). The main goal of the research is to realize the nurse leadership meaning performed in primary health care services. Also, leadership is considered as the resource in the process of managing people and developing leadership teams, intending the organization and health work qualification (Lanzoni, Meirelles, & Cummings, 2016). Therefore, leadership skills are extremely significant fur the nursing profession.

It is worth noting that the current nurse professionals should express and share these skills for the development of future leaders. However, in addition to the realization of the need to perform succession planning, the adequate leadership planning absence became a great challenge for nurses nowadays. The increasing population provoked the rising need for services that will provide greater demands on the already challenged health delivery system and many current nurse leaders will be retired soon (Dyess, Sherman, Pratt, & Chiang-Hanisko, 2016). Hence, young nurses have a great chance to be the critical stakeholders in partnering with other healthcare providers as well as to lead the health system design and ensure improvements. Therefore, efficient succession planning, the merging of nurse leader development, and identification are the critical business strategies that the organizations should incorporate. It is predicted that nurse managers with have experienced a great shortage by 2020 (Dyess, Sherman, Pratt, & Chiang-Hanisko, 2016). Hence, younger nurses should consider such professional opportunities. Leadership developmental activities and strategies that ensured the good performance of other generations are not efficient for the new nurse's generation (Arruda et al. 2015). The turnover during the first employment years among the new generation is the greatest problem in many organizations. This generation is less accepting and more critical regarding workplace practices as compared to the previous organizations. According to the research, 31% of new graduates leave the first work within the first two years and around 73% do not receive guidance to gaps in practice or how to respond as the professional team member with the practice environment improvement initiatives (Dyess, Sherman, Pratt, & Chiang-Hanisko, 2016). Thus, the situation is critical and dangerous.

The research of Dyess, Sherman, Pratt, & Chiang-Hanisko (2016) focuses on the Generation Y nurses before establishing the coursework as part of their Master's Degree program directed at providing support to the future nurse leaders. Hence, according to the presented information, nurse leaders can inadvertently sabotage the planning efforts succession when they are not conscious regarding their leadership attempts, or send negative verbal and non-verbal messages regarding the leadership roles (Dyess, Sherman, Pratt, & Chiang-Hanisko, 2016). Regarding staff nurses, they have reduced possibilities to observe their managers and are often not aware of their role scope. The limited understanding of leadership provides an adverse effect because the nurses with the exposure to leader roles build the greatest respect for the challenges that the current leaders face. The author's experience with the research stated that when emerging leaders start to work with their nurse manager preceptors as part of practice coursework, they develop different perceptions regarding the leadership role that was expended on the focus group (Dyess, Sherman, Pratt, & Chiang-Hanisko, 2016). Therefore, many young nurses can decide against becoming the leader without role-modeling, formal coaching, and intentional guidance, grounded on their experience in the practice environment. The nursing leadership's future could be in danger in case they decide to reject this opportunity. Therefore, it is critical to understand the ways of leadership skills development among nurses.

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Leadership Development

Nurses are expected to take the leading positions to positively influence future outcomes. Nonetheless, there are many challenges that they can address through education. In general, the baccalaureate degree for registered nurses was obligatory. Moreover, these future healthcare professionals have the potential possibility to learn the concepts of leadership as their basic underground education part. However, they may not have a chance to practice these skills during their education and to build confidence in their leadership abilities upon graduation (Prentice, 2015). Moreover, the nurses in the health care system remain silent, and this problem occurs due to their inability to develop leadership skills. It is critical to understand that in the current environment, nurses have to work to their full practice scope directed at the improvement of patient outcomes (Prentice, 2015). Hence, this healthcare area faces significant problems that one can manage through education, which plays a critical role.

The research of Prentice (2015) focuses on the influence of leadership education programs in the registered nurse's practice. He states that the nurses felt empowered due to the leadership sessions because they could discuss prevalent issues in their practice setting. Despite the existence of the Nursing Practice Council with representatives from every nursing unit, nurses underscored the value of having a dialogue with their leaders at the facility. Therefore, research participants emphasized the need for more possibilities to discuss different issues they experience in practice and asked for future in-service regarding leadership skill development. Also, he stated that such a strategy served as a tool aiding in conflict management (Prentice, 2015). It is possible that the workshops representing information regarding conflict resolution would provide nurses with strategies for addressing the conflict and delegation issues.

Also, another research provided evidence of the critical educational role. In the case of the leadership training influence, several great changes in the relation to this competency development were already mentioned in the research that provided the leadership pilot program for students in the fourth semester of the course and it was found that participants have expanded their influence skills, motivation, persuasion, construction teamwork and communication (Lanzoni, Meirelles, & Cummings, 2016). Hence, when the right stimulus appears in the educational institution for skills development, it is possible to gain the specific powers, involving leadership (Lima et al., 2016). Therefore, education plays a great role in leadership skills development.

In the case of leadership exercise intervening conditions, they were considered as positive about the professional experience and regarding building the trust between the community and professionals. The elements that negatively impact the leadership exercise were identified according to the percent of professionals with a different orientation from the policies recommended by the public, insufficient employee number, and inadequate working conceptions (Lanzoni, Meirelles, & Cummings, 2016). In this research nurses' leadership actions, reduction to the tasks, supervision were mentioned by participants to execute orders without appropriate reflection and to apply to public policies with emphasis n gaining institutional goals (Lanzoni, Meirelles, & Cummings, 2016). Nursing leadership oriented to fulfill the corresponding task presets less critical relation to the patient's health outcomes (Reeves, 2016). Therefore, in the research, the leadership strategies applied by nurse leaders included planning actions, stimulating self-organization of the group, and individual potential through motivation, dialogues, and management support.

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Moreover, according to the research, the nurses who finished student education programs tend to improve patient care outcomes, involving reduced post-surgical infection rates, fewer patient falls, reduced length of stay for a patient with heart failure, and readmission rates decrease. It is critical to teach leadership in practice and with intensive socialization, involving modeling and coaching by nurse educators, healthcare, and nurse leaders (Ailey, 2015). It is possible to divide the cognitive process of leadership learning in the practice professions into five main elements, such as leadership at organizational levels and above, leadership in teams, leadership with colleagues, families, and patients, integration of clinical leadership in action, and clinical leadership awareness (Ailey, 2015). At the same time, education offers leadership strategies that involve promoting students to analyze their own and others' leadership styles, whereas the developers change the projects to practice leadership skills and shadow the leaders in healthcare. Moreover, in compliance with the statements presented in the research, it can be beneficial to provide projects so that successive student groups build on the work of the previous cohort since the health care improvement usually requires ongoing efforts that address multiple issues (Ailey, 2015). Moreover, situated learning in leadership can be critical in a community setting, when used in the improvement of chronic disease management and developing sustainable programs for health promotion. Thus, education is a great contributor to leadership development.

At the same time, the efficient approach to leadership development is also extremely important. Hence, the executive-level nurses working in business-oriented and complex healthcare organizations face challenges connected with the competing demands (Leggat, Balding, & Schiftan, 2015). In particular, there is a need to shape the leadership capacity of the advanced nurse practitioners and the service demand to raise access to quality clinical service and decrease waiting time for a significant number of patients (Elliot, 2017). The main issue for any program aimed at leadership development involves creating the leadership capacity as the main priority within the strategic plan of the organization (Center for Creative Leadership, 2016). It demands the long-term approach and the sustained commitment of the healthcare facility in the form of providing appropriate support structures and resources that will assist nurse leaders beyond the initial start-up either of the new leadership posts or new practice development projects.

The countries, such as the US and UK, provide great investments in the development of leadership areas using competency guidelines and education courses that serve to raise the leadership ability of individual nurses across all grades. Hence, the position of advanced nurse practitioners is perfect to act as a professional and clinical leader as they have clinical expertise in the specialist practice area and they are educated at a minimum Master's degree that usually involves research projects and change management (Elliot, 2017). The strategic plan for leadership development has to include the emphasis on leadership capacity building within the advanced practitioner-level nurses as well as to establish appropriate support structures and mechanisms that will enable them to fulfill their potential as leaders.

It is worth noting that there are several support mechanisms and structures that facilitate nurse practitioners to perform their leadership roles. One of them is the defined leadership role to gain clarity on the nurse role and function both in nursing and multi-disciplinary team. Therefore, their leadership role is clear, and they are considered practice development initiative leaders within the healthcare organization (Elliot, 2017). The next issue is the administration and information technology support aimed at the nurse clinical work resourcing to free the role for research activities, practice development, and leadership (Elliot, 2017). The other element includes formal healthcare-university connections because building these links for the research can raise the application number of nurses and the success rates of the respective outcomes (Elliot, 2017). Moreover, the nurse clinical research function can add value through supporting evidence-based practice and disseminating best practices and innovation.

The next issue is networking because it enables nurses to shape strategic alliances within the external work of the organization to collaborate with others and act as change agents, addressing key issues in advancing practice. Moreover, the basic element is the strategic committee's membership, because being nominated by the organizational level management to strategic and clinical committees at international, national, and local levels can influence the decision-making regarding the service delivery and nurses can become leaders beyond their immediate clinic practice area (Elliot, 2017). The next element is leadership mentoring, which can guide nurses to apply or develop specific skill-sets that are critical to successful innovation and practice changes implemented in business-directed and multi-disciplinary healthcare organizations (Elliot, 2017). Leadership mentoring for nurses can influence their profile in the areas external to the organizations and promote the alliance's establishment with international and national excellence centers. The last issue is the director-level accountability because hacking the nurse position within the organization's management structure at the reporting level to the director means that they have direct access to executive decision-makers and budget-holders. Moreover, it implies that they are accountable for gaining their performance aimed at demonstrating the result about the improved patient care delivery quality, practice development, and evidence-based innovation (Elliot, 2017). Hence, such an attitude to leadership development can be efficient among nurses.

Another study also emphasized the importance of the right approach to leadership. In the research, manager nurses have implemented five exemplary leadership practices with moderate frequency providing others the possibility to practice (Silva et al., 2016). The nurses were the moderate leaders that encouraged teamwork, assisted in trust environment creation, shared the power, and valued the colleagues (Silva et al., 2016). From this perspective, there is a need for the professional and personal development of manager nurses proving strategies or tools for efficient leadership (Balsanelli, & Cunha, 2015). Moreover, the managers had to develop the work environment that promoted leaders to meet their needs (Silva et al., 2016). Therefore, the appropriate approach plays a critical role in leadership building.

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Another critical tool that can assist in leadership development is social media. There are four strategies for managing communication, such as custom, content, audience, and openness (Weiner, 2016). Nowadays, it is critical to use online platforms for communication and critical leadership. Social media is a valuable platform for professionals to encourage two-way communication. It helps to share perspectives and messages as well as provides the possibility to listen and solicit ideas and feedback from others at an unprecedented level (Flury, 2017). It assists in humanizing to a larger audience and promotes the ability to change while simultaneously saving time. Significant social media growth was noticed in the healthcare area. Organizational stakeholders prefer to obtain their information online, and social media changes the way people communicate and impact their approach to meet health care needs (Flury, 2017). Social media can be a critical tool for establishing relationships with other leaders. Moreover, it allows simultaneous and rapid engagement with the customer, colleagues, and employees. Expressing gratitude is critical for leaders and social media providers, which is an efficient basis for emphasizing employees (Flury, 2017). Moreover, social media can assist in learning which is highly critical for nursing in the fast-changing healthcare area. Hence, it provides different information that is vital for building an effective leadership strategy.


Overall, leadership development is a highly critical issue for nurses. With the expected retirement, the new generation will overtake the nursing leadership. Nonetheless, nowadays, nurse leader-staff relations are not positive for providing a healthier work environment. The focus on costs and unrelenting change in health care contributed to the formed perceptions. Hence, there is a need for promoting leadership among nurses. In addition to a more cohesive relationship with the staff, the leaders should ensure more efficient communication with staff regarding the leadership roles and responsibilities. The happening shifts in the healthcare environment demand the leaders challenge their practices and consideration to recognize and realize the critical leadership role and power in the relationships. Therefore, building leadership requires a long-term strategic approach and sustained commitment from the organization in the form of supporting resources and systems. Given that nurses are ideally positioned within the healthcare organizations to act as professional leaders, the organization's strategic plan for building leadership should involve them as part of the targeted leadership development initiative. It is critical to organize the appropriate education courses aimed at leadership development among nurses. It is important to understand that leadership skills are basic for efficient practice in the healthcare area. Therefore, the development and building of these skills have to be the main priority for the nurses. The patient's outcomes are in direct relation to the leadership skills among nurses, which means the leader can influence the professional lives of nurses and the patients. Hence, the aforementioned initiatives will help in encouraging leadership development in the nursing area, due to which the nurses will have the opportunity to build and develop their skills as effective leaders.

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