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Clinical leadership styles

The complexities of the modern organizations are increasing and there is no one particular leadership style that is ideal to be followed in every situation. There are many different types of leadership that the nurses should follow as per the clinical situation. No one type of leadership style can be made mandate to be followed because the leadership is to be chosen according to the requirements of the situation. This article will shed light on the different types of leadership styles, the introduction to each type of leadership style, which leadership style is commonly followed. The nurses follow the different leadership styles so this article will also cover different situations that demand the specific leadership style. This article will use different theories and leadership styles to examine the statement that states “with increasing complexities of the modern organizations, there is no one particular leadership style that should be followed”. 

One leadership style cannot be followed as a model for every situation in the clinical practice. There are many different types of leadership styles that are to be followed in a clinical practice such as democratic leadership, affiliative leadership, transformational leadership, situational leadership, authoritarian leadership, autocratic leadership and so on (Norwich university, 2019). The adoption of the leadership styles results in the job satisfaction and the retention. Each leadership style has its own unique characteristics that are followed according to the suitable situation in the clinical practice. The leadership is performed by the nurses by the role modeling and the communication which carried out at all the levels. The reason behind the nurses entering into the leadership styles is the knowledge gap of organizing the nursing leadership.

The nurses that adopted the clearer leadership style such as transformational leadership faced less of the management problems than the nurses who adopted the composite style of leadership (Azaare & Gross, 2011). Transactional leadership is the leadership style that offers the rewards to the people in return for their compliance. Transactional leadership should never be used in the situation of the cardiac arrest because it is task oriented in which the deadline has to be met but using this in cardiac arrest will promote the nurses to deliver the non- holistic care approach and they would focus on completing the work rather than focusing on the patient as a whole (Giltinane, 2013). The situational leadership style is the leadership style that encourages the adoption of different leadership styles as per the situation because the health care settings face the constant change and effective leaders are required at that particular situation.  

The impact of the nurses’ leadership style on the patient outcome can be examined using an organizational framework that is Path – Goal leadership theory and it can be used to examine the influence of the nurses on their job satisfaction and the retention in the health care setting. The Path – Goal Leadership theory is based on the expectancy theory that states that that the medical personnel will act in a specific manner that will be based on the expectation of the positive desired patient outcome (PIMS, 2015). It is a process in which the nursing managers select that specific behaviour that will be the most appropriate for the needs of the patients and the workplace environment. Using the Path – Goal Leadership theory, it was found that the nurse managers to use the situational leadership style the most because different situations demands for different types of leadership styles (Asamani, Naab & Ofei, 2016).

Autocratic leadership style is the leadership style in which the decision making skills of the nurses is tested because it requires the immediate decision making for the welfare of the patient and the nurse is not allowed to put the blame on others for the case of the patient. The autocratic leadership style can be best used in the case of emergencies like the burnt case where there is a need to make the decision on the spot as there is no time for the nurse to take into account the opinion of the staff members (Sfantou et al., 2017). The leadership grid is the next theory that can be used to define the use of appropriate theory in regards to the situation in the clinical practice. As per the leadership grid theory, the task versus the person preference grid is made in which the concern of the nurse about the work is grid with the nurses’ concern for their patients. 

The democratic leadership style involves the professionals in the decision- making process and at last they are allowed to take the final decision. The nurses in this case generally get confused with varied opinions that make them difficult to reach to a particular decision. Democratic leadership style can be used in the case when there is a plenty of time to decide the best source of action for the patient’s care. This will involve the contribution of various nurses and creativity by them will help in reaching to a decision. The democratic leadership style can be achieved when taking care of a child who is suffering from chronic illness. The same care pattern may not be effective in this case and the nurse may require some other innovative techniques to take care of the patient that is child. Democratic leadership style can be best used in this case.

Laissez- faire leadership style is the leadership style that uses a hands- off approach in which there is no requirement of direct supervision and the guidance. It can have the negative contribution to the unit socialization and can lead to the creation of the culture of blame in the health care setting. This leadership style should only be used when there is no such severity related to the patient case and when the nurse using this leadership style is sure that it will not harm the patient. In case the patient gets harmed, then the nurses and the higher medical professionals will start to blame the nurse so this leadership style is not very favorable to be used in the health care setting. This leadership style is known as the absence of the leadership and the adoption of this style has led to the reduction in the extrinsic job satisfaction levels of the nurses (Konstantinou & Prezerakos, 2018). 

The situational leadership is the style that is preferred by maximum number of nurses in any health care setting because it enables to use the appropriate nursing style and the management style according to the situation. The role of the nurse as a situational leader is to diagnose the performance, analyse the commitment that is made by the follower and its competency also, guides the follower to improve the performance and is flexible to choose any kind of the leadership style (Lynch, 2015). The situational leadership style is used in maximum number of cases because the situational leaders aims to deliver the person centered care. They partner their followers for the performance that refers to the process of the situational leader nurse to facilitate in developing their followers by supporting the continuous learning process within the healthcare environment.

The situational leader nurses adopt the self- reflection approach that gives the insight to the self practices and develops better continuous learning skills in the nurse. The reflexivity process is followed by them that make them practice better learning onto the patients. The situational leadership style has very positive outcome on the patients because it aims to deliver the person – centered care and is successful in the job satisfaction and retention of the nurses in the health care setting. Situational leadership is the framework of Hersey and Blanchard that is inclusive of four different types of leadership styles such as delegating, coaching, directing and supporting (Andrigue, de Lima Trindade, Amestoy & Beck, n.d.). The situational leadership is adopted by the nurses who are more mature than their team members, and is also dependent on their willingness of their duty of directing the self- behavior. 

The conclusion drawn is that there are many different types of leadership styles that exists in the health care setting. The nurse plays the role of the leader and they have the flexibility to choose their own leadership style that they find suitable. The most followed leadership style is the situational leadership because it gives the flexibility of the using reflexivity process and choosing the appropriate nursing style. The other important types of leadership styles include the transformational leadership style, autocratic leadership style, Laissez- faire leadership, democratic leadership style and so on. Each leadership style has unique characteristic which makes them preferable and any one of them can be used depending on the situation in the clinical setting.There in no one leadership style that is the ideal or should be followed as the model because there are a lot of complexities growing up within the modern organization. The nurses have the flexibility to choose the particular nursing leadership style according to the situation. Every situation in the clinical setting is different and demands for the different types of nursing leadership style. 


Andrigue, K. C. K., de Lima Trindade, L., Amestoy, S. C., & Beck, C. L. C. (n.d.). Situational leadership style adopted by nurses in the hospital field.

Asamani, J. A., Naab, F., & Ofei, A. M. A. (2016). Leadership styles in nursing management: implications for staff outcomes. Journal of Health Sciences.

Azaare, J., & Gross, J. (2011). The nature of leadership style in nursing management. British Journal of Nursing, 20(11), 672-680.

Giltinane, C. L. (2013). Leadership styles and theories. Nursing Standard, 27(41).

Konstantinou, C., & Prezerakos, P. (2018). Relationship Between Nurse Managers' Leadership Styles and Staff Nurses' Job Satisfaction in a Greek NHS Hospital. American Journal of Nursing Science. Special Issue: Nursing Education and Research, 7(3-1), 45-50.

Lynch, B. (2015). Partnering for performance in situational leadership: a person-centred leadership approach. International Practice Development Journal, 5.

Norwich University. (2019). Five leadership styles for clinical nurse leaders. Retrieved from https://online.norwich.edu/academic-programs/resources/5-leadership-styles-for-clinical-nurse-leaders

PIMS. (2015). Path Goal Leadership Theory. Retrieved from http://www.nwlink.com/~donclark/leader/lead_path_goal.html

Sfantou, D., Laliotis, A., Patelarou, A., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017, October). Importance of leadership style towards quality of care measures in healthcare settings: a systematic review. In Healthcare (Vol. 5, No. 4, p. 73). Multidisciplinary Digital Publishing Institute.

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