Leadership And Management In Nursing Management Essay

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Todays radical restructuring led to techniques and new methods of management formation in the area of health care. There are powerful hierarchical organisations of superior position filled by doctors and health practitioner, leaving the nurses and physicians behind at various stages (Felfe & Schyns, 2010).

The way of managing the nurses through leadership in the nursing are often debated too, as reflected through various previous studies from Judd et al. (2010) through their research and analysis. Although there are huge gap in the nursing profession with others in the health care system between management and leadership, as it is time to fight for the nurses' superiority management role in the organization (Klanberg & Dirschel, 2009).

Through management and leadership perspective, there are claimed that the nursing profession have limitations by not having the skills and depth comprehension in medical knowledge which is requirement for managerial position (Marx, et al., 2009).


Management is the psychological procedure of gathering the people together and controlling other people to accomplish the organization's goal that has been set. Management helps the manager to acknowledge the missions in the organisation as well as to motivate people to work and achieve the company's goals. Sometimes, the managers do not lead. A manager is a person who is in charge and responsible to conduct and achieve the target mission (Clarkson, 2009).

There are four elements in management functions known as planning, organising, leading and controlling. Planning is the first stage where goals are defined and activities are coordinated strategically. The second stage is organising where things, people and task division are determined. The leading stage involves motivating and influencing all the related parties including the act of problem solver in any issues within the management. The final phase is controlling where performance are monitored to guarantee project missions are met (Marquis & Huston, 2008).


Leadership is a form of people management where a person guides a group of people called followers with respect, full of charisma, rational, patient, able to work in his or team and able to receive critics from other people. While leadership focuses on doing the things right, the leader also someone is who realistic in his or her actions by first defining their target missions (Clarkson, 2009).

A leader is more to guiding, coaching and influencing the followers by stating the goal, stating the opinion, discussing with the team mates and followers as well as make rational actions. In leadership, there are bonds between the leaders to the followers which relate the performance and achievements to the organizational goals such as increasing the client services and satisfactory level, helping people to find strengths and weaknesses. The leadership style is best used when there is need in long-term capabilities building (Donoghue & Castle, 2009).


The leadership is vital to be practiced in the health care and as practice based evidence as it shown to have a positive effect on one's career where ones who had good leader are more satisfied with the work performance, increase the clients' satisfactions and reached their positions faster (O'Brien, 2010).

Most commonly, there are two types of leadership being used in the health sector, known as the transformational leadership and the transactional leadership. These types of leadership have its pro and cons, as well as different application are required when dealing with different situations (O'Brien, 2010).


Transformational leadership is a leadership approach, causing changes in individuals and social systems. It creates valuable and positive change with the evolution of followers to become leaders through motivation, morale and performance of followers through various mediums. Elements of the transformational leadership include the individualized consideration, intellectual stimulation, inspirational motivation and idealized influence (Strapasson & RG, 2009).

The transformational leadership ensures the long term goals can be achieved through enhancing exceptional people skills in the organisation. New initiatives from charismatic leader are able to detect potential skills in the followers, developing each follower's potential and therefore task delegation is given to the right one (Salanova, et al., 2011).

The transformational leader spends time to discuss with the follower to make each task easier and create a stronger bond between employer and employee. Both leader and follower influence the growth and make decisions for the company. The inspiring leader creates higher satisfaction among the employees thus reducing the turnover and saves cost of new employees' training budget (Strapasson & RG, 2009).

The transformational leadership is proven positive and benefits the organisation in the long run as the strengths and weaknesses in every followers is identified the right task is handed to the right candidate (Wanga & Howellb, 2012). The positive minded towards every task has proven to be good and effective, not just in the work performance but also patients' satisfaction towards the service and care provided by my organisation (Felfe & Schyns, 2010).

Nevertheless, there are limitations when the manager applies the transformational leadership. The transformational leadership is very time consuming (Purvanova, 2009) as it is not easy to transform the typical management way into something fresh, especially when in an oversize organisation (Anderson, 2012). Other than that, the transformational leadership will not work when dealing with situational condition (Chuanga, et al., 2012). That is why sometimes transactional leadership is used to deal with certain conditions involving situational condition (Richie, et al., 2008).


The transactional leadership is another leadership style that is applied which focuses on the role of organisation and group performance. Transactional leadership emphasised on reward and punishment, rules and regulations as well as obeying the standards and instructions that have been stated (Harms, 2010).

Transactional leadership is a proven strategic concept of giving rewards based on employees' performance, thus increase workers' self motivation to perform well in the organisation. It is the most effective leadership style when dealing with simple and clearly-defined objectives to achieve (Krüger, et al., 2011).

There are four styles of transactional leadership overall which can be divided into two forms, the transactional and managerial style leadership and the avoidance leadership which includes the contingent rewards, active management by exception, passive management by exception and Laissez-faire. This type of leadership is more of a managerial style rather than emphasising leaders' ideal qualities.

The contingent rewards emphasises the goal to reward by providing reimbursement for the subordinates. There is less or no changes made in the task given but are required following the organisation's standard and procedure. The active management by exception is the followers' task monitoring by transactional leaders to prevent any error occurred.

Another form of transactional leadership is also known as avoidance leadership, the passive management by exception and the Laissez-faire style. The passive management by exception is where transactional leaders intervene only when the standards are not met their expectations which may include punishment. The Laissez-faire leadership style is where the transactional leaders give the alternatives of decisions to make and the leaders do not act as decision makers, which leads to poor direction to the group of people (Perkel, 2011).

Nevertheless, transactional leadership can be harsh as it emphasized on the rewards and punishment towards the workers to motivate people in the organization (Harms, 2010). The employees also cannot think out of the box due to the procedure they have to follow. It also assumes that every employee agrees to an assignment, thus everyone is 'forced' to work and obey their superior. Some workers may feel stressed about it and affect their overall performance with increasing turnover and burnout (Bono, et al., 2012).

This transactional leadership is applied to deal with situational condition where there is lack of motivation or the right person and skills to perform in the daily task in the organization (Krüger, et al., 2011).


Leadership and management are two different things, but to stabilize the goals and people in the organisation, they must go hand in hand as complementary and to achieve success. The major difference between leadership and management can be seen where a leader focuses on doing things right while a manager focuses on doing the right things (Gullatte, 2012).

A leader studies, develop principles and innovates people. Leadership focuses on people where there is a trust created among the stakeholders to support both leaders and followers. Leaders learn the strengths and weaknesses in their followers and assign task according to their skills. Leader looks forward to develop the followers' career strength and listen well to critiques to achieve the target goals (Zhua, et al., 2011).

On the other hand, a manager focuses on things and accepts the status quo and the system, not people as shown in leader. Managers copy the former management style where the employees only follow his instructions based on rules and standards and there is no way to be creative in completing tasks given (Gullatte, 2012).

They are definitely different although there is a lot of misconception that relates the manager being a leader of vice versa. The fact is that a leader can never become a manager, but a manager can become a leader (Ricketts, 2009).


I am currently attached to one of the private hospital in the county with four years experience as a nurse. In the private hospital where I am working in, I have been assigned to the surgical ward among the breast cancer and Ear, Nose and Throat (ENT) patients. My department consists of a nurse manager, 13 staff nurses and two care aides.

I have gained a lot of experience while working as a nurse, both positive and negative impact. Nonetheless, with the new restriction and alteration of the management structure in the organization has bring fresh transformation to the way the superior position to manage the nurses and helps to increase the client services.

One of the examples that portray the professional practice through transformational leadership in my organization is the nurse manager. The nurse manager is one who is responsible for the nurses in an organization (Flodgren, et al., 2011). My nurse manager determines and delegates the task to achieve the target goal, which is to increase client satisfactions. The nurse manager supervises the task of the nursing staff in the department including helping physicians with the patients' treatments and a list of equipment required for the patients (Naylor & Kurtzman, 2010) other than in charge of the medical supplies for the patient care for my surgical department.

As the leader of the nurses, my nurse manager helps to prepare training materials for the nurses to introduce techniques to ensure the task is performed correctly as well as to create highly competent nurses in the organization (Schmalenberg & Kramer, 2009).

The leadership style that has been reflected by my nurse manager never fails to inspire me with her idealistic character and the way she treats her followers. It is exceptional that she treats us as an individual by considering our dynamic capabilities and skills (Marshall, 2010) and listens well to positive critiques (Cummings, et al., 2010). For instance, my nurse manager discusses the strengths, weaknesses and the nurses' preference before delegating task to us. This makes me feel appreciated as I love my job and able to perform well. My nurse manager also sometimes empowered the nurses and appoints individuals to handle and lead in certain situation to improve our management skills. Most of the time, she is able to accept critics and always motivate me to perform well, this creates strong bond of the nurses and manager where I feel comfortable to discuss with her regarding my work issues. This creates high satisfaction towards my job and work performance (Sabina, et al., 2012).

My nurse manager always influence and motivates me to adapt with my new role of any given duty (Spear, 2010) which makes me feel more confident in performing my task. My manager often asks questions if I have any problem with the task assign and ready to be good listener as well. Sometimes the nurses are assigned in groups to find out the best evidence based practice to give our best service to the patients.


The practice based evidence have shown that leadership implementation in the health care sector does have a positive effect on one's career where ones who had good leader are more satisfied with the work performance, increase the clients' satisfactions and reached their positions faster. Leadership values also reduce turnover, increase transfer of knowledge and facilitates the social relationship between new comers into their organization with transformational and transactional leadership (O'Brien, 2010).

The nurses need to know their roles and responsibilities towards their patients and career. The nurses need to realize their chance and change the society's perception regarding their capabilities. Motivating followers is vital to evade less motivated which leads to poor performance to the client services and organisation (Zhua, et al., 2011).

The nurse manager in the organization needs to apply transformational leadership which changes the typical old school management technique to an innovative and pioneering (Li, et al., 2010) with the subsistence of charismatic, ideal, optimistic and an excellent motivator especially to the followers.

The transformational leadership application resulted in higher contentment of the patients. Satisfied client can be progressively rising with better understanding from leaders to followers (Heuston & Wolf, 2011) in the organisation.

Transactional leadership can be applied when there is clearly defined objectives and when there is an urgent task need to be completed. It is not conducive to apply this style as it fails to bring out the best from the followers. Most importantly, a true leader knows how to switch on between transformational and transactional leadership style in their routine to achieve target goals.