What action by the nurse-manager best demonstrates servant leadership?

Today, nursing management is viewed as a profession of its own, requiring special training, skills, and characteristics (which typically come more naturally to some than others). As a fundamental component to drive a team’s motivation, performance, and job satisfaction, effective nurse management is of the utmost importance to hospitals and health systems. Building upon this logic, nurse managers with a solid understanding of their own nursing leadership style will be more successful in managing their team/unit, ultimately driving better patient care.

The most effective leadership styles in nursing management understand that both nursing staff and patients benefit from the unit acting as a team. Realizing that the success of the unit heavily relies on the strength of the nursing leader should implore nursing leaders to understand the different types of leadership styles in nursing management. Once a foundational understanding of the leadership styles in healthcare is established, nursing leaders can take personal inventory of how they fall into current styles, while also assessing which styles they might be more successful with in the future. The American Association of Nurse Assessment Coordination (AANAC) recognizes the following five nursing leadership styles as:

• Transformational
• Democratic
• Laissez-Faire
• Autocratic
• Servant

1. Transformational Leadership in Nursing

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. Sometimes called quiet leaders, they lead by example.

Pros of Transformational Leadership Style

Transformational leadership in nursing inspires and motivates employees to find better ways of achieving a goal, as these leaders excel at conflict resolution. They can mobilize people into groups that can get work done, raising the well-being, morale and motivation level of a group through excellent rapport.

Cons of Transformational Leadership Style

Transformational leadership in nursing may prove to be ineffective in initial stages of initiatives or ad-hoc situations. This type of leadership style requires an existing structure so that further development and growth can occur, meaning it’s not ideal for brand-new organizations.

2. Democratic Leadership in Nursing

The democratic leadership style welcomes and encourages input and communication from the team when making decisions. Relationships are highly valued by this type of leader, and it’s important to them that their team feels comfortable and willing to voice concerns, opinions, and ideas. A democratic leader also sees value in providing feedback to their team, truly viewing communication as a two-way street.

Pros of Democratic Leadership Style

Democratic leadership in nursing can work well to ensure the team feels valued and comfortable speaking up. High reliability organizations value transparency and input from team members with the most expertise, not necessarily seniority or highest rank, making this type of leader beneficial in creating a culture that promotes input from the entire team.

Cons of Democratic Leadership Style

Democratic leadership style in nursing can be detrimental to the team when a rapid response is required. In an environment where adverse events and emergencies occur, time is of the essence, and democratic leaders unable to make quick decisions independently and without input from the team might struggle to succeed.

3. Laissez-Faire Leadership in Nursing

Laissez-faire leadership in nursing is most often seen in new or inexperienced nurse leaders. Typically referred to as a “hands-off” approach, laissez-faire nursing leaders rarely provide direction or feedback to their team, but rather allow the team to function as they prefer, without strong supervision. These leaders are not thought of as strong decision makers.

Pros of Laissez-Faire Leadership Style

Because laissez-faire leadership in nursing does not micromanage or dictate how their team should function, a highly experienced and effective team may thrive under this type of leadership. This philosophy supports the theory that if something’s not broken, it doesn’t need to be fixed or changed, which a laissez-faire nursing leader wouldn’t take the initiative to do.

Cons of Laissez-Faire Leadership Style

Laissez-faire nursing isn’t necessarily a good fit for the healthcare industry, due to the constant state of change and need for quick decision making. With experienced nurses retiring and a surge in new nurse onboarding, it’s becoming increasingly unlikely that laissez-faire leadership in nursing will help the team succeed with being proactive vs. reactive to patient safety issues.

4. Autocratic Leadership in Nursing

As a stark contrast to the laissez-faire leadership style, autocratic leadership in nursing is extremely “hands on” and includes a great deal of decision making. Nursing leaders using the autocratic leadership style are comfortable making decisions without input from their team, and often withhold information from the team in general. This type of leader has little tolerance for mistakes.

Pros of Autocratic Leadership Style

Autocratic leadership in nursing will be effective in making quick decisions when necessary. This may serve the team well in emergency situations, or when implementing “zero occurrence” policies (e.g., driving for zero pressure ulcers, etc.).

Cons of Autocratic Leadership Style

Autocratic leadership in nursing does not promote trust or communication amongst a team, but instead creates a culture whereby team members’ valuable insights and knowledge go untapped. This type of leader stifles collaborative decision-making and transparency, which hinder an organization’s journey to high reliability.

5. Servant Leadership in Nursing

With a recent growth in popularity, servant leadership refers to leaders who influence and motivate others by building relationships and developing the skills of individual team members. Coined by Robert K. Greenleaf in 1970, the term refers to leaders that are drawn to serve first, which aspires them to lead. Servant leadership in nursing implies that a leader naturally cares about ensuring each team member has the resources and tools they need to succeed.

Pros of Servant Leadership Style

Servant leadership in nursing can be extremely beneficial when leading a multidisciplinary, diverse team. Servant leaders excel at meeting the needs of individual team members, regardless of their roles, specialties, and resource requirements.

Cons of Servant Leadership Style

A poor-performing team may continue to suffer under the servant leadership style, when overall, collective direction and guidance for the team would better move the needle. Servant leadership in nursing is not recommended when top-down decisions must be made with the goal of quickly aligning the entire team.

Interested in Learning More about Nursing Leadership?

As the national leader in holistic healthcare assessments, Relias Assessments empowers nurse leaders to leverage assessments to make informed hiring and placement decisions thereby helping them achieve better long-term nurse success, satisfaction, and retention. Assessment data helps nurse leaders identify developmental areas, continuously measure competencies, and cultivate future nurse leaders.

Additionally, CE Direct (known for its reputation as the leading provider in continuing education) offers a wealth of knowledge to nurse managers on management and leadership education, including:

• 100+ courses specific to management and leadership training for nurses, such as Developing Your Leadership Potential and Coaching: An Essential Skill for Nurses.
• Certification Review courses on nursing’s most popular topics to help nurse managers self-prepare for certification exams, prepare for recertification, and earn CE hours while improving knowledge.
• Focused CE Series on Nursing Preceptor Specialty Practice to maximize nurses’ knowledge in precepting concepts. Topics include boundaries between preceptor and preceptee, critical thinking, time management, evaluation of competency, goal-writing, constructive feedback, patient/family engagement, HCAHPS, NDNQI, and more.

Is your manager an autocrat or a servant?

You’re moving up in your career and about to assume a managerial role. Are you prepared? How do you want to lead? What are your leadership styles in nursing options?

Leadership and management styles notably affect nurse performance and job satisfaction. Effective nurse leaders directly impact quality of care and patient experience. Some of the best leaders ensure efficiency and proficiency while delivering mentorship. 

What type of nurse manager will bring out the best in you? What kind of leader do you, yourself, want to be? 

7 Common Leadership Styles In Nursing

Autocratic

Autocratic leaders make decisions with little input or consultation from their employees. These hands-on leaders are quick thinkers and are great at delegating tasks and giving directions. 

Strengths: Autocratic nurse leaders work well in emergency situations. It is also useful when enforcing legal policies and medical procedures that protect patient health and safety. 

Weaknesses: Because this leadership style can be associated with negative reinforcement, these leaders are less effective at building team camaraderie, developing trust, or having open communication. 

Autocratic nurse leaders should be sure they keep communication lines open with staff and be aware of their staff’s strengths and capabilities. They should allow team members to voice their opinion, concerns, and ideas without being condescending. 

Laissez-faire 

Laissez-faire leaders offer minimum amounts of supervision and take a “hands-off” approach. While they promote creativity and ingenuity, they typically don’t provide guidance or direction. You can often see this type of leadership style among new or inexperienced nurse leaders.

Strengths: Due to lack of micromanaging, highly-experienced or self-directed nurse teams can thrive under this type of leadership style. Laissez-faire leaders work well in home healthcare and hospice environments, where nurses are highly confident in their skills and can work independently. 

Weaknesses: The Laissez-faire leader encourages employees to set their own goals and solve any issues. New or inexperienced nurses and nurses who need more guidance or hand-holding don’t do well with laissez-faire nurse leaders. 

Laissez-faire leaders should ensure their employees practice safe and competent nursing. 

Democratic leader

A democratic leader encourages feedback, involvement, and communication from team members. Their style is collaborative. They encourage personal and professional growth and focus on team success. 

Strengths: Their style works well in improving quality and processes. This nursing leadership style works well in quality assurance and performance improvement roles and diversity and inclusion roles. 

Weaknesses: When a rapid response is needed in an emergency medical situation — like when a patient codes — these leaders may find it difficult to make quick, independent decisions. Democratic leaders need to be careful to maintain decision-making authority.

Nurses who enjoy getting in-depth feedback, want to grow professionally, and actively participate in decision-making and changes work well with democratic leaders. 

Transformational

Transformational nurse leaders are visionary. They build engaged teams and are beneficial in facilities where significant changes are needed, such as improving overall patient care. For example, a 2019 study of 17 hospitals in Pakistan showed gains in employee satisfaction may reduce rates of patient care errors. A recent Belgian study also demonstrated improvements in the safety performance of nurses due to transformational leadership.

Strengths: Transformational leaders work well with new nurses, as they are great at mentoring, instilling trust, building confidence, and encouraging teamwork while encouraging nurses to act independently. They listen to ideas and concerns and are usually highly respected leaders in an organization. Transformational leaders work well when a hospital, clinic, or other facility needs improvement.

Weaknesses: While studies have shown that transformational leadership skills drive high employee satisfaction and retention, it is less effective in facilities where the leader is responsible for day-to-day decision making.

Transformational leadership is one component of the American Nurses Credentialing Center’s (ANCC) Magnet Model. According to the American Nurses Association (ANA) transformational leaders, “must lead people to where they need to be to meet the demands of the future.”

Servant 

Servant leaders are relationship-oriented and focus on individuals’ needs. These leaders ensure employees have the skills, tools, and resources they need to achieve goals. They are highly involved in employee development. 

Strengths: Servant leaders create goal-driven environments, and nurses who like working with diverse teams and environments will do well. New nurses work well under servant leaders, as these leaders are patient and empathetic. Servant leaders work well in nurse educator, staff development, and clinical leadership roles.  

Weaknesses: Servant leaders put the team’s well-being over their individual needs or goals but should be sure they keep sight of the facility or organizations’ strategic objectives.

Servant nurse leaders are great listeners and prioritize empathy. They build trust and develop teams.

Though the term “Servant Leadership” was coined by Robert K. Greenleaf in 1970, the concept has existed for much longer. As someone who served a worthy cause for ‘the greater good’ and prioritized empathy and awareness, many associate Florence Nightingale with the servant leadership philosophy. 

Situational  

Healthcare is constantly changing. Situational leaders work well in healthcare because they are flexible and modify their leadership style based on an organization or individual nurse’s needs. These nurse leaders analyze the situation and then determine the appropriate approach. Situational leaders are among the most adaptable of the leadership styles in nursing.

Strengths: Situational leaders work well with nursing students in clinical settings.  

Weaknesses: Situational leaders often divert from an organization’s long-term strategies or goals. 

Situational leaders can freely change their management style. They work well in a flexible environment.

Transactional

Transactional leaders use a reward and punishment system. They focus on:

• Supervision
• Organization
• Performance

Efficiency is prioritized over building morale. Highly bureaucratic healthcare organizations have traditionally utilized transactional leadership strategies to meet short-term goals. 

Strengths: Transactional leaders do well with problem-solving. Their leadership style can lead to reduced errors and an evidence-based approach to care. It is a task-oriented style most useful for clarifying roles and responsibilities and working within tight deadlines and emergency situations.

Weaknesses: Transactional leaders pay more attention to mistakes made by staff rather than encouraging a teaching or inspirational environment. 

The relationship between these managers and their nurses entirely relies on the outcomes of the transitions. Employees must be motivated by rewards and discipline. These leaders work well in an environment where tasks should be completed in a specific manner. Transactional leaders only focus on the present. They are not concerned with the performance of the organization in the future. 

Overall Qualities of an Exceptional Nurse Leader

• Integrity. Integrity is vital for making the right decisions for patients and team members. Your leader should teach empathy and ethical practices. Leaders with integrity often show compassion and don’t put profits over people. They respect you as an individual and as an essential member of the team.
• Critical thinking. Critical thinking is an integral part of nursing. Leaders need to think on-the-spot and clearly explain their rationale. Critical thinking is key when deciding among the leadership styles in nursing. 
• Communication. Good nurse leaders know how to communicate and actively listen. They encourage open communication and don’t discourage you from expressing concerns or ideas. Communication and collaboration are critical to the healthcare system. Nurse leaders must promote communication between patients, nurses, and staff.
• Professionalism. Leaders should remain professional at all times, and other team members will hopefully reflect that same positivity. 

Train to Be a Nurse Leader

Here are steps you can take to demonstrate leadership:

• Education. Consider pursuing an MSN – Administration and Management degree to improve your abilities as a leader and craft your communication skills. Good nurse leaders have excellent decision-making, relationship-building, and performance management skills. If you do not yet have your BSN, you may choose — or be required — to pursue a BSN (RN to BSN).  
• Be proactive. Great leaders are visionary and take the initiative to take care of what needs to be handled. They develop education, design programs, and think outside the box. 

To be a great leader — and recognize effective leadership — don’t be afraid to adapt and change your strategy for your patients, colleagues, organization, and self. Use critical thinking to make those choices and never stop growing as a nurse. 

If you want to become a leader or move up in your nursing career, Aspen University offers online RN to BSN, specialized MSN, and DNP (Doctor of Nursing Practice) programs to help you get there.