Servant Leadership in Nursing

By Rose O. Sherman, EdD, RN, FAAN

“The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.” –Max De Pree

One of my neighbors is fighting an aggressive cancer, and recently spent three weeks in the hospital receiving chemotherapy. Happily, she has been discharged and appears to being doing well. In my conversations with her about her hospitalization, she was very complimentary of the nursing care that she had received. What she found even more remarkable was the incredible leadership provided by the nurse manager on the unit. This neighbor had been in leadership positions outside of health-care almost her entire working life. She told me that she was amazed watching this nurse leader interacting with staff. She exemplified servant leadership. Her comments were not surprising to me. I have known this beloved nurse manager for years. What was surprising is that her leadership was clearly visible to a very sick patient.

What is Servant Leadership?

Servant leadership as a leadership philosophy was first defined by Robert K. Greenleaf. He described servant leaders as those who achieve results for their organizations by attending to the needs of those they serve. A nurse servant leader looks to the needs of his/her staff and continually asks how they can help them solve problems and promote their personal development. The manager described by my neighbor as a servant leader worked with her staff to help them meet the needs of patients, while coaching them in their professional practice. The ability to provide service is their primary motivator for seeking a leadership role. Larry Spears describes 10 characteristics that are key to the development of a servant leader:

1. Listening – the servant leader actively listens to the needs of staff and helps to support them in their decision making.

2. Empathy – the servant leader seeks first to understand the needs of others and empathize with them.

3. Healing – the servant leader helps staff to resolve their problems, negotiate their conflicts and encourage the formation of a healing environment.

4. Awareness – the servant leader has a high degree of emotional intelligence and self-awareness. He or she views situations from a holistic, systems perspective.

5. Persuasion – the servant leader does not use coercive power to influence or persuade but rather their personal powers of persuasion.

6. Conceptualization – the servant leader sees beyond the day to day operations of their unit or department. They are able to focus on the bigger picture and build a personal vision.

7. Foresight – the servant leader is able to envision the likely outcome of a situation and is proactive in attempts to create the best consequences.

8. Stewardship – the servant leader is a good steward of the resources and staff that they are given. They feel an obligation to help and serve others without focusing on their own rewards.

9. Commitment to the Growth of People – the servant leader is inclusive of all staff and sees value in everyone. They attempt to maximize the strengths of all who work with them.

10. Building Community – the servant leader recognizes the importance of building a sense of community among staff.

Servant leadership has been embraced by many nurse leaders as the philosophy that guides their practice. Servant leadership is caring leadership and helps to build trust because followers believe that their leader genuinely cares about their welfare. This psychological safety leads to a higher level of employee engagement. Through their work, nurse servant leaders like the nurse manager described by my neighbor naturally build healthy work environments that attract and retain staff.

Read to Lead

Greenleaf, R.K. & Spears, L.C. (2002). Servant Leadership: A Journey into the Nature of Legitimate Power and Greatness 25th Anniversary Edition. Paulist Press.

The Greenleaf Center for Servant Leadership