What is Transformational Leadership in Nursing? (With Pros VS. Cons, Key Traits, & How to Apply)

Written By: Darby FaubionDarby Faubion BSN, RN

Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Darby lives in Louisiana and loves exploring the state’s rich culture and history. Darby has a passion for caring for veterans and a special interest in those affected by post-traumatic stress disorder. In her quest to make a difference for veterans, she founded a non-profit called “Operation Battle Buddy.” Read Full Bio »» BSN, RN

In his book Leadership, James MacGregor Burns described transformational leadership as the event that occurs when “two or more persons engage with others in such a way that the leader and followers raise one another to high levels of motivation and morality.” As healthcare organizations continue to evolve to meet the demand for high-quality patient care, many have adopted transformational leadership. If you are a nurse or nurse leader, you may have asked how to apply transformational leadership in nursing. In this article, I will share some information about transformational leadership, including key elements of transformational leadership in nursing, traits of successful transformational leaders, and examples of how to implement transformational leadership into nursing practice.

What is Transformational Leadership in Nursing?

Transformational leadership in nursing is a management style that motivates nurses to take ownership of their roles and perform beyond minimum expectations. This leadership style motivates team members by appealing to their desire to demonstrate higher moral values and integrity in practice. Transformational leadership in nursing encourages teams to work toward the greater good of an organization and the people in the organization instead of considering self-serving interests.

What are the 4 Key Elements of Transformational Leadership in Nursing?

Transformational leadership in nursing can significantly impact professional relationships and promote positive patient and organizational outcomes. While there are several characteristics associated with transformational leadership, the following are four key elements related to transformational nursing leadership.

1. Inspirational Motivation:

Effective transformational nurse leaders articulate a clear vision and communicate with a sense of commitment and passion. Their belief in themselves and others inspires others to do their best.

2. Individual Consideration:

Transformational leadership in nursing involves having a leader who takes the time to know each team member. They learn about their team members' strengths, weaknesses, and motivations and dedicate themselves as mentors and leaders to those in their charge.

3. Intellectual Stimulation:

Transformational nurse leaders value the ideas of team members who think outside the box and search for better ways of accomplishing things. These leaders encourage creativity and welcome ideas and input.

4. Idealized Influence:

Transformational leadership in nursing includes the act of idealized influence, which means setting a good example for others to follow and doing so in a manner that makes them want to be better.

5 Advantages of Transformational Leadership in Nursing

1. Transformational leadership in nursing creates an atmosphere that fosters higher job satisfaction.

Healthcare organizations adopting and implementing transformation leadership have shown gains in staff satisfaction and overall outlook about their roles. Happy employees have higher retention rates which is also beneficial for employers.

2. Transformational leadership in nursing is associated with higher levels of employee morale.

According to the American Psychological Association, employees with low morale are less engaged and have higher incidences of heart disease, anxiety, and depression. Conversely, employees with high morale are motivated, efficient, and engaged.

3. Transformational nursing leadership has a significant, positive impact on patient safety and overall patient outcomes.

When nurses are satisfied and engaged in their jobs, it reflects in the quality of care they provide. Nursing staff who are guided by transformational nurse leaders have an increased likelihood of seeing improved patient outcomes with positive long-term health benefits.

4. Transformational leadership in nursing stimulates creativity and encourages learning.

Successful transformational nurse leaders understand when an employee’s growth is stunted, it directly affects the healthcare organization. Therefore, they are careful to encourage their employees to face new challenges by creating opportunities for growth and development.

5. Transformational nurse leaders help bring motivation and enthusiasm to the workplace.

Transformational nurse leaders are typically good at analyzing gaps in an organization's vision and formulating new plans when needed. Their excitement and charisma help motivate team members to get involved.

3 Disadvantages of Transformational Leadership in Nursing

1. Employees may experience higher rates of burnout.

When nurse leaders implement transformational leadership, it shows management has long-term plans. Employees feel hopeful and inspired to work toward and attain goals. While this can be beneficial for business, if employees work longer hours or feel obligated to work beyond their normal tasks to achieve the organization's goals, it can result in emotional fatigue, job dissatisfaction, and burnout.

2. In some cases, transformational leadership can lead to overlooking reality.

Transformational nurse leaders are motivators and movers of change. They are passionate about goals and find effective ways to communicate goals and expectations to their subordinates and team members. While this is important, their enthusiasm and belief that things will "come together" if everyone is on board with their ideas often leads transformational leaders to overlook the reality of situations, resulting in barriers to communication or obstruction of achieving goals.

3. Transformational leadership in nursing is sometimes considered unidirectional.

When transformational leadership is practiced, it is not uncommon for employees to be influenced to do what is in the best interest of an organization, not the other way around. When the benefit is a one-way street, employees can grow tired of working to accomplish goals they believe do not benefit them.

7 Key Traits of Successful Transformational Leaders in Nursing

Transformational leadership in nursing involves a commitment to improved team morale and patient care outcomes. The following are seven key traits of successful transformational nurse leaders.

1. Effective Communication:

A key trait of successful transformational leadership in nursing is effective communication. A study by Harvard Business Review suggests companies with disengaged employees have a 34% turnover rate versus an 11% turnover rate at companies with engaged employees. Transformational nurse leaders understand the importance of communicating goals and expectations, which makes implementing improvement efforts easier.

2. Creates inspiration for a shared vision:

Transformational nurse leaders inspire a shared vision for the future of their organization by effectively envisioning it for themselves and describing it to others in a way that creates excitement about the possibilities. The leader’s passion for making a difference becomes evident, making it possible to elicit the help of others willing to align in purpose and action.

3. Becoming a model for the change you want to see:

Nurse leaders model the way they wish to see change occur by setting an example for others to follow. They demonstrate behavior that others can follow, including being visible on the nursing unit, making timely rounds on patients, and offering consistent follow-up with subordinates to show their concern.

4. Allowing others to become actively involved:

Transformational nurse leaders understand how important it is for their team members to participate in activities and opportunities. They engage the nurses on their teams to engage in collaborative activities, fostering a sense of empowerment and trust.

5. Willingness to challenge the process:

Transformational leadership in nursing involves having a strong will to exceed the status quo. Transformational nurse leaders are not afraid to take risks, try new ideas, learn from mistakes, and support positive change.

6. Sets high expectations and demonstrates measures to achieve goals:

When leaders exercise transformation leadership concepts, they set high expectations and demonstrate their attainability by working alongside team members to accomplish goals.

7. Demonstrating competence in nursing practice:

Successful transformational nurse leaders are competent, hard-working nurses. Their ability to demonstrate safe, effective, high-quality patient care inspires others to work hard, as well.

How to Apply Transformational Leadership in Nursing?

Transformational leadership in nursing is a powerful tool if used correctly. Nurse leaders dedicated to seeing positive change must first be the change they want to see in their organizations. The following are some transformational leadership in nursing examples and some of my personal experiences from my nursing career.

1.Transformational Leadership Action: Offering Support and Recognition

It is no secret that being recognized for a job well done feels awesome. Successful transformational nurse leaders understand the importance of making others feel appreciated. The simplest effort such as openly acknowledging someone in front of peers can make a significant difference in employee morale and work ethic.

Real-Life Example:

Ms. Williams was the Director of Nursing at the local community hospital where I did clinicals as a nursing student. I remember arriving to clinicals one morning just in time to see Ms. Williams placing a bouquet of flowers and balloons at the nurse’s desk. My first instinct was to find out which patient they should be delivered to and offer to make the delivery. Ms. Williams thanked me and told me the flowers and balloons were for a nurse, not a patient. I later discovered the gift was Ms. Williams’ way of showing appreciation for to the nurse who worked extra hours for sick team members. I also learned that was not the first time she had offered recognition to her team. Several employees made a habit of going the extra mile because they felt like nursing management appreciated their hard work.

2. Transformational Leadership Action: Practicing Integrity

Integrity is the decision to do right, even when you think no one is watching. The truth is, there is almost always somebody watching. Nurses who demonstrate transformational leadership in nursing successfully have one thing in common: integrity.

Real-Life Example:

Mr. Calhoun was the director of employee education at a university hospital where I used to work. A few of Mr. Calhoun's job duties were to verify the continuing education hours of nursing staff and to arrange learning opportunities for nurses who had not achieved their required hours. One day I overheard a few charge nurses talking about Mr. Calhoun and how picky he was about the nurse's CEUs. One of the nurses said, "No one checks that stuff but him. He could give the nurse a break and just sign off on it." I suppose I could have followed their way of thinking because what they said was true. It did not make it right, though. Mr. Calhoun demonstrated transformational leadership in nursing to me by using integrity in his practices. His honesty inspired me, and probably others, to act with the same level of honesty and integrity on the job.

3. Transformational Leadership Action: Inspiring Others to Look Beyond Self-Interest

The most effective nurses are those who remember the significance in looking beyond self-serving interest to find what is most beneficial to patients, their teams, and the organizations for whom they work. Transformational nurse leaders demonstrate this characteristic by modeling behavior that supports others first, even if it means feeling inconvenienced at times.

Real-Life Example:

When I graduated nursing school and started my first job, Ms. Alice was the first nurse I worked with. She was old enough to be my grandmother and had been a nurse longer than I was alive. I remember being nervous about working with such a seasoned nurse. Ms. Alice was patient and kind to me. She taught me how to perform physical assessments and calm agitated patients. She poured her wealth of knowledge and experience into me every chance she could. Instead of rushing through the day and thinking of ways to make her day easier, she took the time to educate a new, anxious, young nurse. Of all the things I learned from Ms. Alice, perhaps one of the most important was the importance of looking beyond the things that benefit me to find a way to help others.

4. Transformational Leadership Action: Inspiring Motivation

It doesn’t take a lot of skill to find things to complain about. Being an inspiration, on the other hand, sometimes takes effort. Transformational leadership in nursing sometimes means being the inspiration that motivates others, even if we don’t feel like it. Demonstrating confidence in others’ abilities and showing appreciation for their efforts is a win-win for everyone.

Real-Life Example:

Mr. Whittington was the administrator of a local nursing home. He had one of the most pleasant, upbeat personalities of anyone I have ever met. His enthusiasm for the simplest things seemed contagious to everyone. Whether we rearranged furniture in the employee lounge, discussed resident outings, or planned staff luncheons, Mr. Whittington always had something positive to say about how confident he was in our abilities to make things happen. His attitude about our efforts made everyone involved want to work hard to make sure things ran smoothly.

5. Transformational Leadership Action: Celebrating the Small Wins

Strong transformational leaders understand the importance of finding the good in every situation. When transformational nurse leaders acknowledge even the smallest efforts by their team to succeed, team members feel appreciated and empowered to do more. As a result, they work harder and more efficiently.

Real-Life Example:

Mrs. Ott was the Director of Nursing Education at the technical college where I earned my first nursing degree. I remember the day I had to go to her office and discuss my horrible mid-term average in chemistry. I was mortified trying to decide how I would justify my poor performance and what I could say to ask her to help me. I will never forget the smile on her face when she winked at me and said, “Well, the good thing is, you’re only halfway through the semester. You’ve got plenty of time to turn this ship around.” I wasn’t sure if I wanted to laugh or cry, and I’m pretty sure I actually did both. Mrs. Ott looked at my grades and, instead of telling me how terribly miserable my average was, she pointed out the good grades I made and asked me what I did differently on those tests than other exams. She helped me realize celebrating the small wins is important. Her willingness to celebrate them with me made me want to do better. I’d like to tell you I pulled the proverbial rabbit out of the hat and aced chemistry, but I did not. I did make it out of the class with a passing grade, though. That collection of small wins ended up making a difference for me and became a turning point in my academic endeavors. Three degrees later, I still remember Mrs. Ott and the way her leadership transformed my outlook.

6. Transformational Leadership Action: Helping Others Find Their Voice

Confident leaders are not only comfortable speaking up and doing what they feel is right; they also feel comfortable helping others do the same. Transformational leadership in nursing sometimes means being the person you want others to become.

Real-Life Example:

When I first met Ms. Myrtle, I was not sure what I thought of her. My grandmother would have called her “brassy,” meaning she was outspoken or opinionated, and she was. To be honest, she terrified me. The more I worked with Ms. Myrtle, I began to realize her willingness to be outspoken and stand up for what she believed gave me the courage to do the same. While effective nursing leadership requires give and take and humility, strong leaders understand the importance of having team members who can speak up for themselves and their patients. Ms. Myrtle taught me that attitude is not always a bad thing, but when used correctly, it can significantly impact all aspects of personal and professional relationships and positively influence patient and team outcomes.

7. Transformational Leadership Action: An Attitude of Servant Leadership

Servant leadership is demonstrated by a leader’s willingness to work alongside their team to help achieve the best possible outcomes. It is an essential part of transformational leadership in nursing, as this behavior inspires others to have the same mentality.

Real-Life Example:

Ms. Martin was the nursing supervisor for a busy university hospital outpatient clinic. The outpatient clinic comprised several specialty clinics, including ophthalmology, pediatrics, orthopedics, family practice, surgery, and rheumatology. Each morning, Ms. Martin made rounds to each clinic to verify if their appointment register matched hers and to see if additional help was needed in any clinic. It was not uncommon to find Ms. Martin's office door closed as she spent a great deal of time working alongside the nursing staff in clinics that were overwhelmed by large patient loads.

5 Ways to Know if Transformational Leadership in Nursing is the Right Leadership Style for You

All leaders tend to lean toward one leadership style more than another. Personal preference, role models, and abilities influence the leadership style we are best suited for. If the following applies to you, transformational leadership in nursing could be the right style for you.

1. You know how to keep your ego in check.

Transformational nurse leaders work to control their egos, focusing on the best interests of their teams and organizations instead of personal gain.

2. You are comfortable making tough decisions.

Successful transformational leaders in nursing face their fears and make tough decisions, even in the face of adversity. They never lose sight of their organization's vision, values, goals, and objectives and work to accomplish those goals.

3. You love to inspire others.

Transformational nurse leaders motivate others to work hard and give their all. Their way of inspiring includes treating team members as valued individuals and taking the time to understand what motivates each member of the team.

4. You are comfortable taking a proactive approach.

Being proactive helps transformational nurse leaders mitigate risk and avoid potential problems by identifying potential problems. Being proactive means demonstrating a willingness to address and solve problems before they become an issue to others.

5. You don’t have a problem with self-management.

Transformational leadership in nursing involves having the ability to prioritize and plan and a willingness to be held accountable for the outcome or results. Transformational nurse leaders understand the importance of internal motivation to inspire others.

Useful Resources to Guide You in Becoming a Transformational Leader in Nursing

There are several resources to guide you as you take on the role of transformational leadership in nursing. The following are resources from YouTube, podcasts, and books focused on transformational leadership.

YouTube Videos

• What is Transformational Leadership in Healthcare? This video provides three steps to begin practicing transformational leadership in healthcare. In three minutes, learn what a transformational leader does, how to get started, and how to be effective as a transformational leader.
• Transformational Leadership at the Bedside This forty-five minute YouTube webinar discusses how transformational leadership strategies can make significant changes within a business or healthcare organization. Dr. Jen Jackson discusses why transformational leadership is more important than ever for nurse leaders.

Podcasts

• Transformational Leadership in Action Your Next Shift: Dan Weberg, RN, MHI, Ph.D., discusses how active transformational leadership can transform your nursing career. This podcast teaches how transformational leadership can help end nurse burnout and how negative teammates can teach you to engage staff more effectively.
• Transformational Leadership with Dr. Jen Jackson: Dr. Jen Jackson is a transformational nurse leader with over fifteen years of leadership experience in academic and community medicine. In this podcast, Dr. Jackson discusses the power of transformational leadership in nursing with Jeremy Brewer of ShiftWizard.

Books

• Transformational Leadership in Nursing: This award-winning book guides nursing graduate students and seasoned nurses in developing the necessary skills to become effective transformational nurse leaders. Readers will discover chapters addressing transformational leadership regarding emerging contexts for healthcare and changing healthcare perspectives.
• Transformational Nursing Leadership- A Vision for the Future: In this book, author Anne Barker discusses how transformational leadership in nursing can transform the nursing industry. She addresses dissatisfaction with practice settings, attitudes and behaviors of nurse managers, and organizational structures and their effects on effective nursing practices.

My Final Thoughts

Transformational leadership covers a broad range of aspects. Nurses who want to have an active role in leading by example may ask how to apply transformational leadership in nursing? This article's resources, examples, and insight are a few ways to implement and develop transformational leadership in nursing.