Leader Behaviors that Contribute to Nurse Satisfaction

By Rose O. Sherman, EdD, RN, NEA-BC

We know from a wide range of research studies that the relationship with one’s immediate supervisor plays a critical role in satisfaction and retention. Research done by the Gallup corporation indicates that the four most valued qualities in leaders are trustworthiness, compassion, stability and the ability to foster hope. Although these qualities matter, an important question is what specific behaviors can a nurse leader demonstrate that will lead to higher levels of staff satisfaction. A study published in this month’s Journal of Nursing Administration authored by a research team at Massachusetts General Hospital provides some important clues.

The aim of the study was to explore staff nurse and nurse directors’ perception of leadership on units with high nurse satisfaction levels. Nine nurse leaders and nine staff nurses were interviewed using an appreciative inquiry (looking at why things go right) approach to help identify the characteristics of nursing directors that contribute to nurse satisfaction on these units. The four themes identified by the staff nurses included the followin

Theme 1 – The leader empowers staff and uses reflective practice strategies to enhance nurse autonomy.

RNs identified empowerment as a key leadership behavior – leaders who delegate decisions and trust staff. When staff does make a decision, they appreciate a leader who uses reflective practice strategies in a nonjudgmental way to assess outcomes.

Theme 2 – The leader is visible and promotes interpersonal connections in a safe and caring environment.

RNs on units with high satisfaction report that their directors are visible, accessible and look for ways to connect to staff. They take an interest in each of their nurses both professionally and personally. They use a strengths-based leadership approach to assess for opportunities to promote development. They make sure that their staff are doing okay.

Theme 3 – The leader demonstrates passion and vision to foster a quest for excellence.

Leaders who have high rates of staff satisfaction on their units are passionate about their work and their passion for excellence is contagious. They are transparent in sharing data as a way of looking for ways to improve.

Theme 4 – The leader role models high expectations and professional behaviors for staff.

Nurse leaders on units with high RN satisfaction lead by example. They are professional in how they look, speak and behave. They work hard to control their own stress levels. They expect their nurses to be certified and give regular feedback on professional performance.

When the nursing directors were interviewed, their responses were similar to those of their staff. They recognize their is a delicate balance between encouraging autonomy and providing support. They resist Monday Morning Quarterbacking decisions that were made in their absence. They understand the importance of authentic presence to come to know staff and closing the loop on staff concerns. Balancing visibility with boundaries was acknowledged to be a challenge but visibility matters. They understand the importance of creating a culture of learning where professional development is highly valued. They describe fairness and equity as key leadership behaviors.

This study has important findings for nurse leaders. Drilling down on key behaviors that matter in nursing leadership is critical for the development of our current and future nurse leaders.

Read to Lead

Burke, D., Flanagan, J., Ditomassi, M. & Hickey, P.A. (2017). Characteristics of Nurse Directors that Contribute to Registered Nurse Satisfaction. Journal of Nursing Administration. 47(4), 219-225.

Gallup (2016). First Break All the Rules: What the World’s Greatest Managers Do Differently. New York: Gallup Press