The Application of Transformational Leadership Within Nursing Practice, Essay Example

The application of transformational leadership within nursing practice – based on the previously reviewed related theories and studies – have a positive impact on employee commitment, role clarification, and personal relationships within the organization. Below, the author would like to attempt implementing the theory in their practice using the main assumptions of the theory of transformational leadership, and the elements of implementation highlighted in previous literature review.

Case Analysis

In a busy clinical practice with 80 beds, mostly serving acute cardiovascular patients, there are several challenges the leader faces. Staff shortages, multicultural teams and patient populations, increased training requirements, and regulation are among the many issues that need to be handled. In my practice, the most important problem is staff retention and lack of commitment towards change projects. As change is constant in health care in general, as well as within my unit, it is important to increase commitment among team members. Some of the team members are over-qualified to do the job, and are looking for career progression opportunities. As there are not enough internal leadership roles available, many are seeking opportunities outside of the organization, and this results in a higher than average staff turnover. This, in turn, increases the cost of recruitment, training, and administration. The budget allocated for team training is limited, and this means that newly recruited nurses (often straight out of college) will start the job without relevant practical training.

The workload of the nursing leader is high, and there is little time to engage with colleagues apart from providing guidelines, targets, and instructions. There are 12 full time nursing team members working within the unit. Some team members feel overworked and undervalued. After a discussion with one particular team member, a senior nurse with 12 years clinical experience has revealed that there is currently a conflict between the two groups of nurses in the unit. New nurses are looking to try new practices and seek new, evidence-based intervention procedures that would improve the overall performance of the unit. Senior staff, however, looks at these initiatives as attempts to change the current power relations and find the new methods too risky, unbalanced, and lacking foundation. Nurses who have been working within the unit for several years believe that their skills and experience are not fully valued by the management, and are not satisfied with the situation. They believe that the gaps in younger nurses’ experience and training increase patient risks, and endanger the entire organization’s reputation.

Newly recruited, recently trained nurses, on the other hand, believe that current practices are ineffective, and nurses with experience are not supporting them in learning. They also believe that the structure of the team is highly hierarchical, and they have to do the administrative and lower level jobs, while experienced nurses deal with patients. Further, some of the newly recruited nurses attend part time college courses on clinical leadership, and are planning to pursue a career in nursing management upon graduation. They believe that they would not have “space to grow” within the health care organization, and are planning to move on after obtaining a degree.

Situational Analysis

In the above situation, it is evident that nurses (both newly recruited and those who have been in the unit for many years)  feel like they are undervalued, and cannot see opportunities for personal and professional development. Staff retention rates are lower than average,  and this indicates that engagement among colleagues is low. Training is scarce, and many nurses are looking to move on to new career paths to feel valued and gain further experience. The main issue, however, is that the organization’s vision is not fully aligned with personal missions of employees. The management has not made a decision whether or not they should embrace the implementation of evidence-based practice in the acute cardiovascular unit. Patient satisfaction surveys show that relatives do not feel that they receive enough information about the available treatment options, and they do not believe that the staff is effectively managed. Due to staff shortages, postponing of appointments and treatments is common. Further, recent statistics show that absenteeism increases the costs of running the unit.

The Implementation of Transformational Leadership

The above described busy acute nursing unit could benefit from the implementation of transformational leadership approaches in several ways. Below, the author would like to use two approaches to assess the potential impact of transformational leadership on employee commitment, performance, and communication: the first analysis will cover the 4I-s of transformational leadership (Bass & Bass, 2008), and the other one would look at various processes of transformational leadership, defined by Tafvelin (2013), such as clarifying vision, roles, and increasing commitment.

Individualized consideration, intellectual stimulation, inspirational motivation, and idealized influence can improve the working conditions, culture, and commitment level of employees in the nursing team.

Individualized consideration of the leader could be based on personal interviews, and appraisals should include not only performance review, but also the discussion of professional development goals. Once the leader created a vision, they can communicate this with followers, and help them align with it through finding personal and professional development opportunities. It is, however, important that personal goals are created based on a consensus between the nursing team leader and the employee.

Individualized consideration looks at personal missions and aspirations in order to align them with the vision and mission of the organization. Further, once each team member is assessed and strengths/development areas are identified, it is important to assess training opportunities that would serve the interest of the team member, as well as the entire unit. Intellectual stimulation can be manifested in coaching, training programs, or the development of special teams that focus on particular challenges the team is facing. One particular challenge, for example, can be low satisfaction level of patients and their relatives. To solve this issue, the team leader could create working groups to research the sources of problems and potential solutions. Team members who are particularly trained on or experienced in dealing with patient representative groups could be assigned the job to research evidence in related literature, and propose changes that would increase patient satisfaction and communication with relatives. Another issue that has been identified is postponing appointments based on staff shortages. A patient and staffing level administration team could be created and initiated by the nursing team leader, in order to identify the shortcomings of the current administration system and offer solutions to reduce the number of cancellations and postponed appointments. It is important that both working teams reach a consensus related to realistic targets.

Inspirational motivation within the team can be achieved in various ways. As the engagement level of both new and experienced staff is low, it is important to make individual members feel valued and respected for the benefits they deliver for the team as a unit. Inspirational motivation involves the clear communication of organizational mission and vision, and gaining commitment from individual members of the team by listening and offering coaching. Newly recruited nurses who feel that they are overqualified for the job might be motivated to learn new aspects of the work, and offering coaching from senior team members would increase the motivation level of both groups. Senior nurses would feel valued, with their experience and knowledge appreciated by the leader. Newly recruited members of the team, however, would value the opportunity to learn more about the job, and develop their skill set. Mentoring is another way of implementing inspirational motivation, and is an effective way of providing opportunities for personal and professional growth.

Idealized influence would be based on the leader acting as a role model, and clearly communicating their personal vision. This would help clearly defining organizational objectives, as well as clarifying roles within the team. Without regular meetings and collaboration sessions involving both newly recruited team members and experienced nurses, however, aligning the leader’s vision with organizational objectives, communicating goals and the culture would not be possible. Therefore, there is a need for holding weekly meetings, during which special teams would report on the progress they made researching new ways of improving patient outcomes, performance, and collaboration.

Clarifying vision on the unit and system level is an important task that the leader of the above described unit is facing. For this, effective communication and collaboration methods need to be implemented. Team meetings held weekly would help the nursing team leader engage with individuals.

Increasing commitment could be the result of clear communication of organization goals and vision. However, it is important to align the vision with personal cultures, and change the culture of the team in a way that it encourages an open flow of information. Motivation through coaching and mentoring would increase job satisfaction, and consequently commitment. It has been found that many team members are planning to leave (or have already left) the team because they felt that there was no “space to grow” within the unit. The leader, therefore, should communicate clearly that those looking for leadership opportunities within the unit would be provided the opportunity to learn and make positive contributions. This would, in turn, decreased the workload of the leader, and free up time for coaching, mentoring, and team discussions.

The last issue the leader needs to deal with is the clarification of roles. There is currently a competition among newly recruited and experienced nurses. By clearly defining the roles of each individual, and assigning experienced team members the task of coaching newly qualified nurses, collaboration would improve, and all members of the team would feel valued, with a clearly defined place in the organization.

References

Bass, B. M., & Bass, R. (2008). The Bass handbook of leadership: Theory, research, and managerial applications. Simon and Schuster.

Tafvelin, S. (2013). The Transformational Leadership Process: Antecedents, Mechanisms, and Outcomes in the Social Services.