Becoming a Transformational Nurse Leader

By Rose O. Sherman, EdD, RN, FAAN

“A leader is best when people barely know he exists, when his work is done, his aim fulfilled, they will say: we did it ourselves.”

Lao Tzu

All of us have probably had a leader or coach who was able to bring out the very best of everyone on their team and achieve results that seemed impossible. If you have had this experience, you were probably witnessing transformational leadership. It is one of the key characteristics of Magnet designated organizations and is considered essential to solve some of the complex problems that we see in health care today. But the truth is, many current nurse leaders are not transformational leaders. They may not even be sure what a transformational leader does or how to develop their skills to become one.

Key Attributes of Transformational Leaders

Transformational leadership theory was first introduced in 1978 by James McGregor Burns. He described it as leadership that occurs when the leader engages with followers in a way that raises their level of performance and motivation. Those influenced by transformational leaders find meaning and value in their work, are able to make significant contributions to their organizations and are more likely to become leaders themselves. There are four key attributes of transformational nurse leaders:

1. The leader serves as a role model and “walks the talks”.

2. They inspire motivation in their followers by having a strong vision about their work.

3. They are concerned about the individual and demonstrate genuine concern for their needs and feelings.

4. The leader challenges and develops the followers to be innovative and creative nurturing independent thinking.

Transformational Leadership Skill Development

Nurse researchers who study transformational leadership have found that nurse leaders who use transformational leadership principles create environments that promote higher levels of job satisfaction, well being and organizational commitment. Wong & Cummings (2009) also found in their work that there were significant associations between transformational leadership practices, increased patient satisfaction and reduced adverse events.

Developing transformational leadership skills requires that nurse leaders be honest and reflective about their current practices. Dr. Ronald Riggio, an expert in leadership development, advises leaders to ask themselves the following key questions to determine whether they demonstrate transformational leader qualities: (Agree or Disagree)

1. I would never require a follower to do something that I would not do myself.

2. My followers would say they know what I stand for.

3. Inspiring others has always come easy to me.

4. My followers would say that I am attentive to their needs and concerns.

5. My followers have told me that my enthusiasm and positive energy is infectious.

6. Even though I could easily do a task myself, I delegate it to expand my followers skills.

7. Team creativity and innovation are the keys to success.

8. I encourage my followers to question their most basic way of thinking.

Your Leadership Journey

You probably were not able to answer yes to each of the above questions. Leadership is a journey of self-development. It is important to turn your areas of weakness around using these statements in situations to ask yourself for example – am I being attentive to the needs and concerns of my team members? An even stronger test would be to ask members of your team how they would rate you on each of the eight statements.

Every nurse who assumes leadership (CNO, nurse manager, charge nurse, preceptor) can and should practice transformational leadership. You will find that most of your followers are visionary, passionate and committed. They have great innovative ideas about how to transform health care that need to be unleashed through transformational leadership.

Read to Lead

Burns, J.M. (1978). Leadership. Harper & Row Publishers.

Riggio, R. (2009). Are You a Transformational Leader?

Transformational Leadership – You Tube

Wong, C.A. & Cummings, G.G. (2009). The relationship between nursing leadership and patient outcomes: A systematic review. Journal of Nursing Management. 15, 508-521.