This document discusses various styles of nursing leadership. It begins by defining leadership and describing its importance in nursing. It then outlines 10 common leadership styles used in nursing including democratic, transformational, laissez-faire, servant, affiliative, and autocratic leadership. For each style, the advantages and challenges are summarized. Overall, the document provides an overview of key leadership concepts and different approaches nurse leaders can take to guide their teams.

1. NURSING LEADERSHIPAND CHANGE PROCESS
INTRODUCTION
Leadership is a process by which an executive can direct, guide and influence
the behaviour and work of others towards accomplishment of specific goals in a
given situation. Leadership is the ability of a manager to induce the
subordinates to work with confidence and zeal.
Leadership is the potential to influence behaviour of others. It is also defined as
the capacity to influence a group towards the realization of a goal. Leaders are
required to develop future visions, and to motivate the organizational members
to want to achieve the visions.
According to Keith Davis, “Leadership is the ability to persuade others to seek
defined objectives enthusiastically. It is the human factor which binds a group
together and motivates it towards goals.”
Strong leaders in nursing are vital to help navigate the constant evolution of
health care. Nurse leaders do more than balance costs, monitor productivity, and
maintain patient and staff satisfaction. They serve as role models and influence
health care organizations at all levels. A strong nurse leader motivates their
colleagues, setting the tone for a safe, civil workplace with a culture of high
morale and job retention.
DEFINITION
Leader:
A leader is the one in the charge, the person who convinces other people to
follow. A great leader inspires confidence in other people and moves them to
action.
Leadership:
Leadership is the ability of an individual or a group of people to influence and
guide followers or members of an organization, society or team. Leadership
often is an attribute tied to a person's title, seniority or ranking in a hierarchy.

2. Nursing leadership:
Nursing leadership is "the ability to inspire, influence and motivate nursing staff
and other health care workers to work together to achieve their highest potential
and collective organizational goals."
IMPORTANCE/ FUNCTIONS OF LEADERSHIP
Leadership is an important function of management which helps to maximize
efficiency and to achieve organizational goals.
The following points justify the importance of leadership in a concern.
1. Initiates action- Leader is a person who starts the work by
communicating the policies and plans to the subordinates from where the
work actually starts.
2. Motivation- A leader proves to be playing an incentive role in the
concern’s working. He motivates the employees with economic and non-
economic rewards and thereby gets the work from the subordinates.
3. Providing guidance- A leader has to not only supervise but also play a
guiding role for the subordinates. Guidance here means instructing the
subordinates the way they have to perform their work effectively and
efficiently.
4. Creating confidence- Confidence is an important factor which can be
achieved through expressing the work efforts to the subordinates,
explaining them clearly their role and giving them guidelines to achieve
the goals effectively. It is also important to hear the employees with
regards to their complaints and problems.
5. Building morale- Morale denotes willing co-operation of the employees
towards their work and getting them into confidence and winning their
trust. A leader can be a morale booster by achieving full co-operation so
that they perform with best of their abilities as they work to achieve
goals.
6. Builds work environment- Management is getting things done from
people. An efficient work environment helps in sound and stable growth.
Therefore, human relations should be kept into mind by a leader. He
should have personal contacts with employees and should listen to their

3. problems and solve them. He should treat employees on humanitarian
terms.
7. Co-ordination- Co-ordination can be achieved through reconciling
personal interests with organizational goals. This synchronization can be
achieved through proper and effective co-ordination which should be
primary motive of a leader.
FUNCTIONS OF LEADERSHIP
Following are the main roles of a leader in an organization:
1. Required at all levels- Leadership is a function which is important at
all levels of management.
In the top level, it is important for getting co-operation in formulation of
plans and policies.
In the middle and lower level, it is required for interpretation and
execution of plans and programmes framed by the top management.
Leadership can be exercised through guidance and counselling of the
subordinates at the time of execution of plans.
2. Representative of the organization- A leader, i.e., a manager is said to
be the representative of the enterprise.
He /She has to represent the concern at seminars, conferences, general
meetings, etc.
His /Her role is to communicate the rationale of the enterprise to outside
public. He /She is also representative of the own department which he
leads.
3. Integrates and reconciles the personal goals with organizational
goals- A leader through leadership traits helps in reconciling/integrating
the personal goals of the employees with the organizational goals.
A Leader is trying to co-ordinate the efforts of people towards a common
purpose and thereby achieves objectives. This can be done only if he can

4. influence and get willing co-operation and urge to accomplish the
objectives.
4. He /She solicits support- A leader is a manager and besides that he is a
person who entertains and invites support and co-operation of
subordinates. This he can do by his personality, intelligence, maturity and
experience which can provide him positive result.
In this regard, a leader has to invite suggestions and if possible,
implement them into plans and programmes of enterprise. This way, he
can solicit full support of employees which results in willingness to work
and thereby effectiveness in running of a concern.
5. As a friend, philosopher and guide- A leader must possess the three-
dimensional traits in him. He can be a friend by sharing the feelings,
opinions and desires with the employees.
A Leader can be a philosopher by utilizing his intelligence and
experience and thereby guiding the employees as and when time requires.
He /She can be a guide by supervising and communicating the employees
the plans and policies of top management and secure their co-operation to
achieve the goals of a concern.
At times he can also play the role of a counsellor by counselling and a
problem-solving approach. He can listen to the problems of the
employees and try to solve them.
CHARACTERISTICS OF LEADERSHIP
1. It is an inter-personal process in which a manager is into influencing and
guiding workers towards attainment of goals. It denotes a few qualities to
be present in a person which includes intelligence, maturity and
personality.
2. It is a group process. It involves two or more people interacting with each
other. A leader is involved in shaping and moulding the behaviour of the
group towards accomplishment of organizational goals.
3. Leadership is situation bound. There is no best style of leadership. It all
depends upon tackling with the situations.

5. EMOTIONAL INTELLIGENCE FOR LEADERS
An organization is made up of people and when people are involved, emotions
automatically come into play, and a workplace is no different. It would be
unwise to assume that a workplace is all objective, no-emotion only
performance kind of a packed room where hormones have no scope to creep in
however the fact is that emotions alone are the biggest motivator or de-
motivator of an employee.
The emotions alone, govern the performance and efficiency of a worker and had
it not been the case, we would have never talked about the importance of work-
life balance and for the present context, the need of emotionally intelligent
leaders.
The current times are very dynamic not just economically but also socially
where the social fabric is rapidly evolving due to globalization and other
influences. The average age of the workforce is reducing and the leaders now
look forward to managing people belonging to different cultures and
backgrounds. In such a situation, it is important for a leader to be highly
sensitized to the emotional aspects of his/her transactions with people.
Emotional Intelligence is basically the ability to recognize and understand one’s
own feelings and emotions as well as those of others and use that information to
manage emotions and relationships. The four important aspects of Emotional
Intelligent as proposed by Daniel Goleman are:
 Self- Awareness
 Self- Management
 Social Awareness
 Relationship Management or Social Skills
A leader tends to have a huge influence on the thoughts and motivation of
people. He/she has the capacity to enthuse optimism and confidence in the
followers and lead them to constructive endeavours which is called resonance
and on the other hand they can negatively influence them to destruct, e.g. of
such leaders being Hitler and d Osama Bin Laden which is opposite to
resonance called dissonance.
Leaders are closely observed in terms of their body language, facial expressions
etc. So, it is important for a leader to consider the non-verbal form of

6. expressions as well, which may positively or negatively influence followers.
Therefore, if a leader is talking about ethics in business with a slightly
unconvinced and bemused look on his face, the followers make a note of it and
the message is not received by them. A leader has to act as a role model too,
supporting his statements, ideologies and values with appropriate actions.
As a leader one also has to be aware of one’s own capabilities and weaknesses,
it is difficult to accept guidance from a leader who is not self-aware. As
managers, leaders have to empathize as well with the situations, emotions,
aspirations and motivations of the subordinates.
A decreasing performance of a team member might be because of a number of
reasons, a disruptive worker might be facing motivation issues and a
subordinate who uses abusive language with others might be lacking confidence
in his own abilities. A leader needs to discern facts and try and reach to deeper
levels and understand things beyond obvious.
Apart from the above reasons, Emotional Intelligence is also important because
the followers or subordinate expect it from their leaders. A subordinate working
closely with the manager would expect the manager to understand his situation
and priorities. And not surprisingly, whether manger does so or not, affects his
level of commitment and performance at work.
A leader has to suitably know and understand when he/she needs to be
directive and when he needs to delegate. He/she needs to be aware, when the
team members are acting as one unit and when there are differences.
It is sometimes awkward to address emotional aspects of transactions between
people but leaders need to understand the importance and relevance of it as it
has a huge impact on the performance outcomes.
While conducting reviews and development dialogues, the feedback has to be
delivered in a manner which is acceptable. The leader needs to be sensitive to
the insecurities and apprehensions of the subordinates which sometimes
might be expressed and sometimes kept undisclosed. At the senior level it is
all the more important as the senior executives find it hard to clearly outline
their anxieties and differences and the leader has to anticipate some of them.
So, to be able to attract and retain talented subordinates and keep them
motivated, a leader needs to brush up on his people skills and emotional

7. intelligence, as all of them are not born with the charisma to hold people.
Fortunately, emotional intelligence with practice and carefully directed efforts
can be increased.
An organization is made up of people and when people are involved, emotions
automatically come into play, and a workplace is no different. It would be
unwise to assume that a workplace is all objective, no-emotion only
performance kind of a packed room where hormones have no scope to creep in
however the fact is that emotions alone are the biggest motivator or de-
motivator of an employee.
The emotions alone, govern the performance and efficiency of a worker and had
it not been the case, we would have never talked about the importance of work-
life balance and for the present context, the need of emotionally intelligent
leaders.
The current times are very dynamic not just economically but also socially
where the social fabric is rapidly evolving due to globalization and other
influences. The average age of the workforce is reducing and the leaders now
look forward to managing people belonging to different cultures and
backgrounds. In such a situation, it is important for a leader to be highly
sensitized to the emotional aspects of his/her transactions with people.
LEADERSHIP STYLES/TYPES
While there are many ways to lead, here are 10 styles that can help nurses
decide where their strengths as leaders lie and which methods work best for
them.
1. Democratic leadership
2. Transformational leadership
3. Laissez-faire leadership
4. Servant leadership
5. Affiliative leadership
6. Autocratic leadership
7. Coaching leadership

8. 8. Transactional leadership
9. Situational leadership
10.Visionary leadership
Style 1: Democratic leadership
Democratic leaders encourage staff to participate in decisions and are known for
open and honest communication. Democratic leaders are natural delegators and
empower their teams to be responsible and accountable for their actions.
Beyond this, democratic leaders always provide feedback, as they value
continuous improvement. They also avoid dwelling on the individual mistakes
of their team members.
Democratic leadership advantages and challenges
Perhaps the most important advantage of democratic leadership in nursing is
that it makes honesty and accountability real priorities and as such, team
members have a high level of trust in their leaders. They are also more likely to
understand the bigger picture when it comes to their work and be highly
satisfied in their roles.
There are some disadvantages to democratic leadership in nursing, however. It
can cause leaders to delay decision making. Also, in some circumstances, it may
not be possible to reach a consensus, so team members may feel like the
consultation was a waste of time.
Style 2: Transformational leadership
Another style that nurse leaders can apply is transformational leadership. This
style is heavily focused on building relationships with staff, motivating team
members and enabling them to buy into a shared vision and mission. Typically,
transformational leaders are charismatic, confident and inspirational. Staff
members are usually loyal to transformational leaders and look up to them.
Transformational leadership advantages and challenges
Transformational leadership can be very beneficial in several ways. First,
employees feel united around the common purpose of the nursing unit. In

9. addition, there is generally less staff attrition under transformational leaders.
Transformational nurse leaders can also manage change effectively.
Like any nursing leadership style, there are downsides to transformational
leadership. Transformational leaders can be known to be risky and disruptive,
and employees under transformational leaders may burn out quickly.
Style 3: Laissez-faire leadership
Laissez-faire leaders provide very little direction to the nurses on their teams
and instead empower them to manage themselves.
Laissez-faire leadership advantages and challenges
This type of leadership can be advantageous for many reasons. With a loose
style of management, staff can experience personal growth; when leaders are
hands-off, it gives employees room to be hands-on. Related to this, laissez-faire
leadership encourages innovation, as employees are free to experiment. With
this type of leadership, fast decision making is also possible, as decisions rest
wholly with employees.
Laissez-faire leadership in nursing is certainly not ideal for everyone or in every
situation. Usually, it is inexperienced leaders or leaders at the end of their
careers who use this style, as it is not focussed on problem-solving. When issues
do occur, they are solved reactively, which in a clinical situation can be less
than ideal.
Style 4: Servant leadership
Servant leadership is exemplified by leaders who influence those around them,
building positive working relationships and focussing on developing their
teams’ skills. Servant leaders are very attentive to the needs of their teams and
are known for listening, committing to team growth and accepting others. They
are also persuasive and build a positive sense of community within their teams
and healthcare environments.
Servant leadership advantages and challenges
Under servant leadership, team morale is generally high and team members feel
their leaders genuinely care about them and their needs. In addition, the

10. collaborative style of decision making increases employee engagement,
meaning that nurses will be less likely to leave. Servant leadership is also a
strong example of ethical leadership.
On the flip side, this leadership style can have disadvantages. It takes time to
build the trust required, and in some situations where nurse leaders need to
make quick decisions, it might not work. Furthermore, a team may lose sight of
the healthcare organisation’s goals if a leader is too focussed on the staff.
Style 5: Affiliative leadership
Nurse leaders who consider themselves transparent may like to consider the
affiliative leadership style. With this style, leaders are completely honest at all
times. They are wholly invested in the healthcare setting they work in and the
staff who report to them. They become a moral compass for everyone to follow.
They are also known for their exceptional communication skills and enjoy
giving positive feedback.
Affiliative leadership advantages and challenges
There are many benefits to this style. First, feedback is critical in the workplace,
and positive feedback can help employees feel more motivated. Also, under this
type of leadership, employees will feel as if they are more highly valued. They
will also be less stressed and know that their interests will be considered in all
situations.
However, affiliative leaders typically avoid conflict and may struggle to solve
complex problems. Also, productivity may decrease under affiliative leaders, as
they rely too much on their team’s self-direction to achieve success.
Style 6: Autocratic leadership
Another nursing leadership style is autocratic leadership. This style, however, is
quite different from the styles described above.

11. Autocratic leadership, often used in the past but less popular these days,
involves a nurse leader making all decisions about the nursing unit, typically
without consulting staff. Autocratic leadership is a command-and-control style,
where leaders use negative reinforcement and punishment to ensure compliance
with rules. Under this type of leadership, mistakes are not tolerated, and
individuals are blamed if they do make them.
Autocratic leadership advantages and challenges
Despite this style of leadership sounding, on the surface, less than ideal,
autocratic leadership in nursing does have some benefits. These include
effectiveness in emergency or stressful situations in which nurses can find
themselves. Quick decisions can be made under this leadership style, which
may be required.
This style of leadership also has many downsides. It is inflexible, and employee
engagement and motivation may suffer.
Style 7: Coaching leadership
As the name suggests, there is one unique characteristic that nurses who follow
this leadership style need: the ability to coach nurses in their teams. Instead of
showing direct reports on how to do something, nurses who apply coaching
leadership encourage them to try it on their own.
More than this though, coach leaders are known for the exceptional feedback
they give. They help nurses see how their work fits into the bigger picture of the
healthcare setting and take a personal interest in helping others succeed.
Coaching leadership advantages and challenges
Nurse leaders who follow this style will notice it has many advantages. It
produces a positive and uplifting work environment where everyone knows
what is expected of them. Nurses under a coach leader also feel confident that
they will experience personal and professional growth.
An unwavering focus on coaching alone, however, may not be ideal for every
person or every situation. Coaching takes time to be effective, and it may not
always be the right approach if there are tight deadlines. Nurse leaders who

12. follow this style must be aware of when it can work, and when their focus must
be elsewhere.
Style 8: Transactional leadership
Transactional leaders, also known as managerial leaders, are focussed on
controlling and organising their staff and workload. They specialise in short-
term planning and reward good behaviour. They also punish poor behaviour.
Transactional leaders give nurses clear structures and rules to work within, and
give their teams precise directions on what to do.
Transactional leadership advantages and challenges
Structure is almost always essential in nursing, so transactional leadership can
have its advantages. Employees, when given a clear set of rules and either a
reward or a punishment, understand what is expected of them and are usually
productive in achieving goals.
Yet the very structure that can be advantageous for this nursing leadership style
can also be a disadvantage. Transactional nurse leaders can be inflexible and too
formal in their approach, which may hurt employee morale. Inflexibility on
behalf of a nurse leader also does not encourage creativity or out-of-the-box
problem-solving.
Style 9: Situational leadership
One advantage for nurse leaders is that they do not need to apply a single
leadership style all the time. In fact, they can – and should – use different styles
in different situations. This approach is called situational leadership. As the
name suggests, it is where nurse leaders adapt their style to suit a situation or
work environment.
Nurse leaders who adopt this style are skilled in how they read a work situation
and adjust their approach. They are known to excel at giving direction, being
flexible, encouraging participation, delegating and being open and honest.
Situational leadership advantages and challenges
Given the flexibility of this style, it has many advantages. These include the
ability to react to situations differently and provide the leadership needed at the

13. moment. This leadership style is also comfortable for most employees, as they
know their leader will provide them with what they need.
The flexibility of this style, though, is also its downfall. Situational leadership
can be confusing to nurses and in different settings, as people never know what
to expect. This type of leadership also does not work as well with repetitive
tasks.
Style 10: Visionary leadership
Visionary leadership is where a nurse leader provides a compelling vision and a
clear and inspiring direction for everyone in the team. Visionary leaders
understand the big picture and excel at articulating a long-term path for those
around them. Visionary leaders are also great communicators and marketers.
People feel inspired by them and like to be around them.
Visionary leadership advantages and challenges
There are many benefits to being a visionary leader. First, nurses who work
with visionary leaders understand the goals that everyone is working toward.
They are inspired by their leaders’ energy and, as such, are more likely to
overcome temporary setbacks. Visionary leaders are also great at
acknowledging the achievements of their teams and making them feel valued.
There are disadvantages to this nursing leadership style, however. Visionary
leaders place such great emphasis on the future that they can sometimes forget
immediate operational concerns. They are leaders of personality more than
organisation, so they can also forget to plan and execute important tasks
THEORIES OF LEADERSHIP
There are several different types of leadership theories that have been developed
over the years to explain and understand leadership styles and behaviours. Here
are some of the prominent leadership theories:
1. Trait theory/ Great Man theory:
This theory suggests that leaders have some inborn traits. They have
certain set of characteristics that are crucial for inspiring others towards a

14. common goal. A successful leader is supposed to have the following traits
– good personality, tirelessness, capacity to read other’s mind, ability to
make quick decision, courage, persuasion, intelligence, reliability,
imagination, etc.
The trait theory arose from the “Great Man” theory as a way of
identifying the key characteristics of successful leaders. It was believed
that through this theory critical leadership traits could be isolated and that
people with such traits could then be recruited, selected, and installed into
leadership positions. This theory was common in the military and is still
used as a set of criteria to select candidates for commissions.
Advantages of trait theory:
 It is naturally pleasing theory
 It serves as a yardstick against which the leadership traits as of an
individual can be assessed
 It gives a detailed knowledge and understanding of the leader element in
the leadership process
Limitation of the trait theory:
There is bound to be some subjective judgement in determining who is
regarded as a good or successful leader. There is also a disagreement over
which traits are the most important for an effective leader.
2. STYLE THEORY
This focuses on what leaders do in relational and contextual terms. The
achievement of satisfactory performance measures requires supervisors to

15. pursue effective relationships with their subordinates, while comprehending
the factors in the work environment that influence outcome
3. SITUATIONAL THEORIES
Situational theories suggest that effective leadership is contingent upon the
specific situation or context. These theories argue that different leadership styles
should be adopted based on the characteristics of the followers and the demands
of the situation.
4. CONTINGENCY THEORY
The next type of leadership theory is contingency theories that expand on
situational theories by proposing that various factors, such as the leader's traits,
behaviours, and the situation, interact to determine effective leadership. These
theories highlight the importance of adapting leadership styles to match the
specific circumstances.
5. TRANSFORMATIONAL THEORY
Transformational leadership theory emphasizes the leader's ability to inspire and
motivate their followers to exceed their own self-interests for the greater good
of the organization. Transformational leaders inspire their teams through vision,
charisma, intellectual stimulation, and individualized consideration.
6. TRANSACTIONAL LEADERSHIP
Transactional leadership theory focuses on the exchange relationship between
the leader and their followers. Transactional leaders motivate their team
members through rewards, recognition, and a system of rewards and
punishments based on performance.
7. BEHAVIOURAL THEORY
It is based on the belief that great leaders are made, not born. Rooted in
behaviourism, this leadership theory focuses on the actions of leaders not on

16. mental qualities or internal states. According to this theory, people can learn to
become leaders through teaching and observation.
8. PARTICIPATIVE THEORY
It suggests that the ideal leadership style is one that takes the input of others into
account. These leaders encourage participation and contributions from group
members and help group members feel more relevant and committed to the
decision-making process. In participative theories, however, the leader retains
the right to allow the inputs of others.
IMPORTANCE OF LEADERSHIP THEORIES:
Theories of leadership describe how and why particular people develop to be
leaders. They lay emphasis on the actions and character characteristics that folks
might adopt for improving their leadership skills. Top qualities that leaders cite
as essential to effective leadership include: Strong moral principles and ethics
It is not necessary to overemphasize the importance of leadership. Any
organization's success may be a result of its leadership. Due to its leadership,
even the state has achieved independence, expansion, prosperity, and power.
Effective leadership is another thing about the success and expansion of a
business or industrial organization.
APPLYING LEADERSHIP THEORIES AT WORKPLACE
10 methods to point out leadership at the office include:
 Become a thought leader
 Join a corporation for professionals
 Consider the large picture
 Think proactively and with positivity
 Listen to others and pick up tips from them

17.  Connect with a goal in mind
 Look for a mentor
 Accept diversity
LEADERSHIP STRATEGY
Without an effective leadership strategy, it is believed, that the organizational
strategies do not work.
Best players in a team do not guarantee success without a great coach,
similarly, work teams may not function effectively if leaders do not follow an
appropriate leadership strategy.
To understand leadership styles here are three scenarios:
Scenario 1 - A Teacher gives a question to the class full of students, however,
solves it for them;
Scenario 2 - A Teacher gives the question to the students and observes how
students solve them;
Scenario 3 - A Teacher gives a question to the students and moves around the
class, observes the students, and helps wherever required.
Scenario 1 was “Leading from the Front”, Scenario 2 was “Supportive
Leadership Style”, and Scenario 3 was “Interactive Leadership Style”.
Besides this the leadership styles/strategies could be based on personality traits
like Directive Leadership, Structured Leadership, Intuitive Leadership, or
Process Driven leadership.
Some tips while selecting leadership strategy/style:
 A leader must be aware of his/her personality traits and those of his team
members/followers to understand which leadership style will be most
effective.
 A leader may not adopt a consistent leadership all through his/her career.

18.  Situational Leadership helps addressing varied needs/expectations of the
followers as the leader adopts a strategy based on a situation, he/she is in.
In case a leader has a self-reliant team, he/she needs to be using a
directive leadership style or lead form the front.
 He / She could instead delegate and provide inputs where necessary.
 A common mistake especially a lot of new leaders make is to copy
established/well know leaders. Remember, each situation is unique and so
are the followers. A leadership style which may be suited to a well-
known leader may not be appropriate for your team. Make no mistake
here - do not try and imitate other leaders.
 A leader will never be afraid of trying new approach to solve a work
problem or address a conflicting situation. It is quite a possibility that a
leader adopts a style that is not by the book.
 A leader must keep enhancing his/her leadership skills. While on the
job experience matters a lot, getting enrolled into leadership courses after
detailed evaluation of the program and feedback of the participants will
help implementing a leadership style more effectively.
 It is often said that good leaders are born and not made; however, good
leaders are those who are aware of their personality traits and also of their
followers. They know which leadership style is to be adopted in a
particular situation. Once this is done, there is a little challenge left for a
leader to become a “good/great” leader.
 An ideal organizational leader should not dominate over others. He / She
should guide the individuals under him, give them a sense of direction to
achieve organizational goals successfully and should act responsibly. He
/She should be optimistic for sure. He / She should be empathetic and
should understand the need of the group members.
 An organizational leader should not only lead others individually but also
manage the actions of the group.
 Individuals who are highly ambitious, have high energy level, an urge to
lead, self-confidence, intelligence, have thorough knowledge of job, are
honest and flexible are more likely to succeed as organizational leaders.
 Individuals who learn the organizational leadership develop abilities and
skills of teamwork, effective communication, conflict resolution, and
group problem solving techniques.
 Organizational leaders clearly communicate organizational mission,
vision and policies; build employees morale, ensure efficient business

19. operations; help employees grow professionally and contribute positively
towards organizations mission.
LEADERSHIP ETHICS
Ethics refer to the desirable and appropriate values and morals according to an
individual or the society at large. Ethics deal with the purity of individuals and
their intentions.
Ethics serve as guidelines for analysing “what is good or bad” in a specific
scenario. Correlating ethics with leadership, we find that ethics is all about the
leader’s identity and the leader’s role.
Ethical theories on leadership talk about two main things: (a) The actions and
behaviour of leaders; and (b) the personality and character of leaders. It is
essential to note that “Ethics are an essential to leadership”.
A leader drives and influences the subordinates/followers to achieve a common
goal, be it in case of team work, organizational quest, or any project. It is an
ethical job of the leader to treat his subordinates with respect as each of them
has unique personality.
The ethical environment in an organization is built and developed by a leader as
they have an influential role in the organization and due to the fact that leaders
have an influence in developing the organizational values.
An effective and ethical leader has the following traits/characteristics:
1. Dignity and respectfulness: He respects others. An ethical leader should
not use his followers as a medium to achieve his personal goals. He
should respect their feelings, decision and values.
Respecting the followers implies listening effectively to them, being
compassionate to them, as well as being liberal in hearing opposing
viewpoints. In short, it implies treating the followers in a manner that
authenticate their values and beliefs.
2. Serving others: He serves others. An ethical leader should place his
follower’s interests ahead of his interests. He should be humane. He must
act in a manner that is always fruitful for his followers.

20. 3. Justice: He is fair and just. An ethical leader must treat all his followers
equally. There should be no personal bias. Wherever some followers are
treated differently, the ground for differential treatment should be fair,
clear, and built on morality.
4. Community building: He develops community. An ethical leader
considers his own purpose as well as his followers’ purpose, while
making efforts to achieve the goals suitable to both of them. He is
considerate to the community interests. He does not overlook the
followers’ intentions. He works harder for the community goals.
5. Honesty: He is loyal and honest. Honesty is essential to be an ethical and
effective leader. Honest leaders can be always relied upon and depended
upon. They always earn respect of their followers. An honest leader
presents the fact and circumstances truly and completely, no matter how
critical and harmful the fact may be. He does not misrepresent any fact.
It is essential to note that leadership is all about values, and it is impossible to
be a leader if you lack the awareness and concern for your own personal values.
Leadership has a moral and ethical aspect. These ethics define leadership.
Leaders can use the above-mentioned traits as yardsticks for influencing their
own behaviour.
CORE TIPS OF EFFECTIVE LEADERSHIP
1. A leader must lead himself, only then He/ She can lead others. A leader
must be committed on personal and professional front, and must be
responsible. He/ She must be a role model for others and set an example
for them.
2. A leader must boost up the morale of the employees. He/ She should
motivate them well so that they are committed to the organization. He/
She should be well acquainted with them, have concern for them and
encourage them to take initiatives. This will result in more efficient and
effective employees and ensure organizational success.
3. A leader must work as a team. He/ She should always support his team
and respect them. He/ She should not hurt any employee.
A true leader should not be too bossy and should not consider him as the
supreme authority. Leaders should realize that they are part of the
organization as a whole.

21. Organizational leadership involves all the processes and possible results that
lead to development and achievement of organizational goals. It includes
employees’ involvement, genuineness, effective listening and strategic
communication.
CHANGE PROCESS BY LEADER NURSE
Change is constant in the health care environment. Change is defined as the
process of altering or replacing existing knowledge, skills, attitudes, systems,
policies, or procedures.
The outcomes of change must be consistent with an organization’s mission,
vision, and values. Although change is a dynamic process that requires
alterations in behaviour and can cause conflict and resistance, change can also
stimulate positive behaviours and attitudes and improve organizational
outcomes and employee performance. Change can result from identified
problems or from the incorporation of new knowledge, technology,
management, or leadership. Problems may be identified from many sources,
such as quality improvement initiatives, employee performance evaluations, or
accreditation survey results.
Nurse managers must deal with the fears and concerns triggered by change.
They should recognize that change may not be easy and may be met with
enthusiasm by some and resistance by others. Leaders should identify
individuals who will be enthusiastic about the change (referred to as “early
adopters”), as well as those who will be resisters (referred to as “laggers”).
Early adopters should be involved to build momentum, and the concerns of
resisters should be considered to identify barriers. Data should be collected,
analysed, and communicated so the need for change (and its projected
consequences) can be clearly articulated. Managers should articulate the reasons
for change, the way of the change will affect employees, the way(s) the change
will benefit the organization, and the desired outcomes of the change process.
CHANGE THEORIES
There are several change theories that nurse leaders may adopt when
implementing change. Two traditional change theories are known as Lewin’s
Unfreeze-Change-Refreeze Model and Lippitt’s Seven-Step Change Theory.

22. LEWIN’S CHANGE MODEL
Kurt Lewin, the father of social psychology, introduced the classic three-step
model of change known as Unfreeze-Change-Refreeze Model that requires prior
learning to be rejected and replaced. Lewin’s model has three major concepts:
driving forces, restraining forces, and equilibrium. Driving forces are those that
push in a direction and cause change to occur. They facilitate change because
they push the person in a desired direction. They cause a shift in the equilibrium
towards change. Restraining forces are those forces that counter the driving
forces. They hinder change because they push the person in the opposite
direction. They cause a shift in the equilibrium that opposes change.
Equilibrium is a state of being where driving forces equal restraining forces, and
no change occurs. It can be raised or lowered by changes that occur between the
driving and restraining forces.
 Step 1: Unfreeze the status quo. Unfreezing is the process of altering
behaviour to agitate the equilibrium of the current state. This step is
necessary if resistance is to be overcome and conformity achieved.
Unfreezing can be achieved by increasing the driving forces that direct
behaviour away from the existing situation or status quo while decreasing
the restraining forces that negatively affect the movement from the
existing equilibrium. Nurse leaders can initiate activities that can assist in
the unfreezing step, such as motivating participants by preparing them for
change, building trust and recognition for the need to change, and
encouraging active participation in recognizing problems and
brainstorming solutions within a group.[8]
 Step 2: Change. Change is the process of moving to a new equilibrium.
Nurse leaders can implement actions that assist in movement to a new
equilibrium by persuading employees to agree that the status quo is not
beneficial to them; encouraging them to view the problem from a fresh
perspective; working together to search for new, relevant information;
and connecting the views of the group to well-respected, powerful leaders
who also support the change.[9]
 Step 3: Refreeze. Refreezing refers to attaining equilibrium with the
newly desired behaviours. This step must take place after the change has
been implemented for it to be sustained over time. If this step does not
occur, it is very likely the change will be short-lived and employees will
revert to the old equilibrium. Refreezing integrates new values into

23. community values and traditions. Nursing leaders can reinforce new
patterns of behaviour and institutionalize them by adopting new policies
and procedures.[10]
Example Using Lewin’s Change Theory
A new nurse working in a rural medical-surgical unit identifies that
bedside handoff reports are not currently being used during shift reports.
Step 1: Unfreeze: The new nurse recognizes a change is needed for
improved patient safety and discusses the concern with the nurse manager.
Current evidence-based practice is shared regarding bedside handoff
reports between shifts for patient safety. The nurse manager initiates
activities such as scheduling unit meetings to discuss evidence-based
practice and the need to incorporate bedside handoff reports.
Step 2: Change: The nurse manager gains support from the Director of
Nursing to implement organizational change and plans staff education
about bedside report checklists and the manner in which they are
performed.
Step 3: Refreeze: The nurse manager adopts bedside handoff reports in a
new unit policy and monitors staff for effectiveness.
LIPPITT’S SEVEN-STEP CHANGE THEORY
Lippitt’s Seven-Step Change Theory expands on Lewin’s change theory by
focusing on the role of the change agent. A change agent is anyone who has the
skill and power to stimulate, facilitate, and coordinate the change effort. Change
agents can be internal, such as nurse managers or employees appointed to
oversee the change process, or external, such as an outside consulting firm.
External change agents are not bound by organizational culture, politics, or
traditions, so they bring a different perspective to the situation and challenge the
status quo. However, this can also be a disadvantage because external change
agents lack an understanding of the agency’s history, operating procedures, and
personnel.[12]
The seven-step model includes the following steps[13]
:
 Step 1: Diagnose the problem. Examine possible consequences,
determine who will be affected by the change, identify essential

24. management personnel who will be responsible for fixing the problem,
collect data from those who will be affected by the change, and ensure
those affected by the change will be committed to its success.
 Step 2: Evaluate motivation and capability for change. Identify
financial and human resources capacity and organizational structure.
 Step 3: Assess the change agent’s motivation and resources,
experience, stamina, and dedication.
 Step 4: Select progressive change objectives. Define the change process
and develop action plans and accompanying strategies.
 Step 5: Explain the role of the change agent to all employees and
ensure the expectations are clear.
 Step 6: Maintain change. Facilitate feedback, enhance communication,
and coordinate the effects of change.
 Step 7: Gradually terminate the helping relationship of the change
agent.
Example Using Lippitt’s Seven-Step Change Theory
Refer to the previous example of using Lewin’s change theory on a
medical-surgical unit to implement bedside handoff reporting. The nurse
manager expands on the Unfreeze-Change-Refreeze Model by
implementing additional steps based on Lippitt’s Seven-Step Change
Theory:
 The nurse manager collects data from team members affected by
the changes and ensures their commitment to success.
 Early adopters are identified as change agents on the unit who are
committed to improving patient safety by implementing evidence-
based practices such as bedside handoff reporting.
 Action plans (including staff education and mentoring), timelines,
and expectations are clearly communicated to team members as
progressive change objectives. Early adopters are trained as
“super-users” to provide staff education and mentor other nurses in
using bedside handoff checklists across all shifts.
 The nurse manager facilitates feedback and encourages two-way
communication about challenges as change is implemented on the

25. unit. Positive reinforcement is provided as team members
effectively incorporate change.
 Bedside handoff reporting is implemented as a unit policy, and all
team members are held accountable
APPLICATION OF LEADERSHIP IN NURSING
Nurses are leaders who influence and inspire others to achieve optimal health
outcomes for all. Nurses demonstrate leadership in a variety of ways, including
advocating for clients, promoting quality practice settings and by building and
sharing knowledge.
Advocating for clients
 Nurses advocate for and support clients in accessing timely health care
that meets clients’ needs.
 Nurses participate and advocate for culturally safe and inclusive practice
environments.
 Nurses take action to prevent discrimination and when they observe or
identify discrimination against a client.
 Nurses respond and are available to clients in their care.
 Nurses modify client care plans, together with clients and the health care
team.
 Nurses assess clients to determine their risk for health inequities and take
steps to ensure the best client outcomes.
 Nurses strive to protect clients from any type of harm, neglect or abuse.
This includes taking action to stop and refrain from unsafe, incompetent,
unethical or unlawful practice.
Promoting quality practice settings
 Nurses participate and advocate for improving the quality of their practice
setting to support safe client care.

26.  Nurses promote healthy relationships with clients, their caregivers,
advocates and members of the health care team by managing and
resolving conflict for best client care.
 Nurses fairly divide and advocate for resources. Nurses objectively
arrange care, based on health-related needs.
 Nurses contribute to a safe organizational culture.
Building and sharing knowledge
 Nurses assess the learning needs of health care team members they are
teaching, supervising and/or assigning.
 Nurses determine whether individuals have the proper knowledge, skill
and judgment to perform safe nursing care.
 Nurses support, mentor and teach health care members.
 Nurses provide and accept feedback from the health care team to support
positive client outcomes and effective team performance.
These accountabilities are outlined in Principle 4 of the Code of Conduct.
Reflect on your leadership
To enhance your ability to provide safe, client-centred care, you can reflect on
your leadership abilities by asking yourself
 How does my practice align with the leadership expectations outlined in
the entry-to-practice competencies and the Code of Conduct?
 What does nursing leadership mean to me?
 How am I developing as a leader?
 How can I maximize my leadership potential?
 What are the opportunities for leadership in my practice setting?
 What sources of feedback can I seek to inform my nursing practice?

27. Whether in a formal or informal leadership role, nurses demonstrate leadership
by fostering continued self-growth to meet the challenges of an evolving health
care system.
REFERENCES
 https://www.managementstudyguide.com/leadership-styles.htm
 https://online.jcu.edu.au/blog/leadership-styles-nursing
 https://www.simplilearn.com/top-leadership-theories-every-
manager-should-know-article
 https://www.nursingworld.org/practice-policy/nursing-
excellence/leadership-in-nursing/
 https://wtcs.pressbooks.pub/nursingmpc/chapter/4-3-
implementingchange/#:~:text=Change%20is%20constant%20in%2
0the,mission%2C%20vision%2C%20and%20values
 Deepak.K, Sarath Chandran.c, Mithun kumar. B.P, A
comprehensive text book on nursing management , 2019, 2nd
edition, EMMESS medical publisher. 401-448