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Leadership in Nursing

Leadership plays a crucial role in effectively developing and implementing healthcare policies, and nurse leaders face unique challenges. When creating and implementing policy, a particular type of leadership stands out as best suited for the task. Transformational leadership is widely regarded as the most effective approach for driving policy changes in healthcare settings (Specchia et al., 2021). This leadership style empowers individuals, fosters innovation, and inspires a shared vision, all essential for navigating healthcare policy’s complex and dynamic landscape.

Transformational leadership is characterized by its ability to inspire and motivate followers to achieve extraordinary outcomes. Nurse leaders who adopt this approach empower their team members by encouraging autonomy, creativity, and critical thinking (Ferreira et al., 2020). In healthcare policy, this involves stakeholders at every level, including frontline nurses, administrators, patients, and other relevant parties, in the policy development process. By giving them a voice and a sense of ownership, transformational leaders create an environment that encourages the generation of innovative ideas and solutions.

Transformational leaders excel at creating a shared vision and aligning the efforts of diverse individuals towards a common goal. This is especially crucial in healthcare policy, as policy changes often require collaboration among various stakeholders with different perspectives and interests. Nurse leaders who adopt a transformational approach can articulate a compelling vision of improved healthcare outcomes and engage others in working towards it (Collins et al., 2020). By fostering a shared understanding of the desired policy objectives and the potential benefits, these leaders can rally support and build momentum for policy implementation.

The dynamic and ever-changing nature of healthcare policy necessitates a leadership style that can adapt to new challenges and foster continuous improvement. Transformational leaders are known for embracing change and inspiring others to do the same (Ferreira et al., 2020). Policy development and implementation means being responsive to emerging evidence, technological advancements, and evolving healthcare needs. By encouraging a culture of learning and adaptation, transformational leaders can guide their teams through the complexities and uncertainties inherent in healthcare policy, ensuring that policies remain relevant, effective, and responsive to the population’s needs.

Transformational leadership also promotes a culture of trust and collaboration. These elements are essential for successful policy development and implementation in healthcare. Trust enables open communication, facilitates sharing of ideas and concerns, and encourages constructive feedback (Collins et al., 2020). In policy, nurse leaders can foster an environment where stakeholders feel safe to voice their opinions and participate actively in policy-making. Collaboration, on the other hand, ensures that diverse perspectives are taken into account and that decisions are made with the input and consensus of relevant parties. Nurse leaders can create an environment conducive to effective policy development and implementation by prioritising trust and collaboration.

While transformational leadership is the most suitable style for healthcare policy creation and implementation, nurse leaders may encounter challenges. These challenges often stem from the complex nature of the healthcare system, which involves multiple stakeholders, competing interests, and a rapidly changing landscape (Ferreira et al., 2020). Nurse leaders may face resistance to change, limited resources, and bureaucratic hurdles that can impede policy progress. However, nurse leaders can navigate these challenges more effectively by adopting a transformational leadership approach. Transformational leadership’s empowering and inspirational nature can help overcome resistance to change by fostering a culture of engagement and collaboration. Nurse leaders can find creative solutions to resource constraints and bureaucratic obstacles by encouraging innovation and creativity, ultimately driving policy changes forward.

One notable example of policy development that exemplifies transformational leadership is the implementation of electronic health records (EHRs) in an extensive hospital system. The nurse leader responsible for this initiative demonstrated transformational leadership by inspiring and engaging the nursing staff (Collins et al., 2020). Through regular communication and active involvement, the leader created a shared vision of the benefits and importance of EHRs, addressing potential concerns and resistance among the nurses. This leadership style fostered a sense of trust and commitment among the nursing staff, resulting in their active participation and cooperation throughout the implementation process.

The success of this initiative can be attributed to the transformational leadership approach employed. The nurse leader provided clear guidance and encouraged the nursing staff to contribute their ideas and suggestions. By valuing their input, the leader empowered the nurses to take ownership of the project, which enhanced their motivation and commitment (Kiwanuka et al., 2021). The transformational leader also facilitated the necessary training and support, ensuring the nurses were adequately prepared for the EHR implementation. As a result, the hospital system successfully transitioned to electronic health records, improving efficiency, patient safety, and overall quality of care.

Another example of policy change that illustrates transformational leadership is implementing a new pain management protocol in a healthcare organization. The nurse leader leading this initiative adopted a transformational leadership style by involving multidisciplinary teams of nurses, physicians, and pharmacists. Through open and transparent communication, the leader created an environment where ideas and perspectives were valued, developing a comprehensive pain management protocol that incorporated best practices and evidence-based guidelines.

The success of this policy change can be attributed to the transformational leadership style employed by the nurse leader. The leader promoted a shared commitment to improving pain management practices by fostering collaboration and teamwork among the various stakeholders. The transformational leader provided mentorship and support to the nursing staff, encouraging them to embrace and implement the new protocol consistently (Collins et al., 2020). Through ongoing education and training, the leader ensured that all healthcare providers were well-informed and equipped with the necessary knowledge and skills to implement the new pain management protocol effectively.

Effective leadership is crucial in the development and implementation of healthcare policies. Transformational leadership, in particular, has shown to be successful in driving policy development and change. Through the examples of implementing electronic health records and a new pain management protocol, we have seen how transformational leaders inspire, motivate, and empower their teams. By fostering collaboration, trust, and innovation, transformational leaders create an environment supporting healthcare policy implementation. These examples highlight the importance of leadership in navigating challenges and achieving positive outcomes in policy development and change within healthcare organizations.


Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nurs Stand35(5), 59-66.

Ferreira, V. B., Amestoy, S. C., Silva, G. T. R. D., Trindade, L. D. L., Santos, I. A. R. D., & Varanda, P. A. G. (2020). Transformational leadership in nursing practice: Challenges and strategies. Revista Brasileira de Enfermagem73.

Kiwanuka, F., Nanyonga, R. C., Sak‐Dankosky, N., Muwanguzi, P. A., & Kvist, T. (2021). Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review. Journal of Nursing Management29(2), 133-142.

Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership styles and nurses’ job satisfaction. Results of a systematic review. International journal of environmental research and public health18(4), 1552.


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