NUR 4102 Module 1 Leadership Styles Paper: Relational Leadership and Outcomes for Nurses and Patients Example

Fixing Problems or Building People: What Kind of Leader Is a New Charge Nurse

Student Name

Bachelor of Science in Nursing, Thomas Edison State University

NUR-4102: Leadership and Management in Nursing: Scholars Track

Mentor Name

Month Day, Year

Fixing Problems or Building People: What Kind of Leader Is a New Charge Nurse

Introduction

I took the charge role on our day shift two years ago, mostly because I could untangle a bad morning faster than anyone else. If a patient was sliding, a family was angry or a hospitalist was slow to return a page, I stepped in and handled it. Last spring two nurses in their first year asked to move to other floors. When the manager held exit conversations, both said something close to the same thing: they liked the team, but they had stopped learning. That comment stayed with me. This paper looks at what the leadership literature says about different ways of leading, what that evidence means for nurses and for patients and what it says about the way I run a shift.

Leadership Theories in Brief

Northouse (2021) defines leadership as a process through which an individual sways a group of people to reach a shared goal. Treating it as a process matters, because a process can be studied and practiced; it is not simply a trait someone is born with. Of the approaches he reviews, four help me think about the charge role. Transformational leaders raise the motivation of the people around them by offering a vision worth working toward, challenging them to think, setting an example and paying attention to how each individual is developing. Transactional leaders work through exchange, rewarding good performance and stepping in when something goes wrong. Servant leaders place the growth and well-being of followers ahead of their own position. A task-focused leader concentrates on getting the work finished, usually by directing and checking it closely. Most real leaders mix these approaches, and Northouse stresses that people can deliberately shift the mix.

Effects on Nurses

Cummings et al. (2018) pulled together 129 studies that examined how the style of nurse leaders relates to results for nursing staff and their work environments. The pattern across this large body of work was consistent. Relational styles, a group that includes transformational, resonant and authentic leadership, went along with staff who reported greater job satisfaction, more committed to their organizations, more likely to say they intended to stay, healthier and more productive. Styles centered on tasks, where finishing the work takes priority over relationships, went along with lower satisfaction and weaker results on several other measures. The review team recommended that hospitals invest in developing relational leadership among nurse managers and charge nurses, not only among executives.

Effects on Patients

An earlier review by Wong and Cummings (2007) asked whether nursing leadership reaches the bedside. Across the studies they located, leadership practices rated as positive were tied to patients reporting more satisfaction and to fewer adverse events and complications, and a few studies found lower mortality. The authors were cautious: only a modest number of studies qualified, and they used different designs and measures, so the findings could not be pooled. They suggested that leaders probably influence patient outcomes indirectly, by shaping how nurses feel about and carry out their work.

Assessing Myself

Read against these sources, my own pattern is mostly task-focused. When a newer nurse comes to me unsure about a patient, I tend to walk into the room and take care of it instead of talking it through. I make decisions about assignments and admissions without saying why. Most of my feedback arrives after a mistake, and very little of it after good work. These habits keep the board moving, but the findings Cummings and colleagues report suggest they may also be part of why two nurses felt stalled and left.

The Nurses Who Left

I asked one of the two nurses, now on a step-down unit, whether she would talk with me about her first year. She described a shift when a patient's blood pressure dropped and I took over the call to the physician while she stood in the doorway. She said she was grateful the patient was safe but never learned what I had noticed or why I chose the order of interventions I did. Her account matched what the reviews describe: the problem was not that the unit was unsafe, but that she was being managed rather than developed.

Learning From My Own Manager

The manager who promoted me offers a contrast. When I was new to charge, she rarely gave me answers. She asked what I saw, what I planned to do and what could go wrong, and then she let me try while staying close. I remember feeling trusted. Her approach looks a great deal like the transformational behaviors Northouse describes, and it shows me that relational leadership can coexist with high standards.

A Plan to Lead Relationally

Using transformational leadership as a guide, I have set four goals. First, I will coach instead of rescuing: when a nurse brings me a problem, I will ask what she thinks should happen next and back her plan unless it puts the patient at risk. Second, I will explain the reasoning behind the day's priorities during the morning huddle, so assignments stop feeling arbitrary. Third, at least twice each shift I will tell a nurse specifically what she did well and why it mattered for a patient. Fourth, I will meet once a month with each of our three newest nurses to talk about what they want to learn next.

When Task Focus Is Needed

Choosing a relational default does not mean giving up direction. During a rapid response or a cardiac arrest, a calm leader who assigns roles and gives clear instructions keeps patients safer than a discussion would. What I want is to fit the style to the moment, so that firm direction is reserved for emergencies and coaching becomes the norm for everything else.

Measuring Change

I have asked the unit manager to add two items to our quarterly staff survey, one on whether nurses feel supported by the charge nurse and one on whether they feel they are growing. I will also follow transfers and resignations for the next twelve months and have asked a senior nurse I trust to point it out whenever I slip back into rescuing.

Limits

Both reviews relied mostly on cross-sectional studies, which cannot establish cause. A leader rating her own behavior is likely to be generous. The unit, the nurses and the events in this paper are invented.

Conclusion

Northouse showed that leadership is a process people can learn, Cummings and colleagues linked relational styles to nurses who are satisfied and stay and Wong and Cummings connected positive leadership with better outcomes for patients. My habit of fixing everything kept shifts running but may have cost the unit two promising nurses. Coaching, explaining my reasons, recognizing good work and investing in newer staff give me a way to lead that develops people while still solving problems.

References

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19-60. https://doi.org/10.1016/j.ijnurstu.2018.04.016

Northouse, P. G. (2021). Leadership: Theory and practice (9th ed.). SAGE Publications.

Wong, C. A., & Cummings, G. G. (2007). The relationship between nursing leadership and patient outcomes: A systematic review. Journal of Nursing Management, 15(5), 508-521. https://doi.org/10.1111/j.1365-2834.2007.00723.x