7 Nursing Leadership Styles

Is your manager a servant or an autocrat?

Do you want to climb up the career ladder and assume a management position? Are you ready? What leadership style do you want to adopt?

What leadership styles in nursing are there?

A skilled nurse will balance the patient’s needs and the technical aspects of performing their job as expected.

For instance, administering medication when a patient is sick will require good background knowledge and physical skills.

It also requires the ability to administer the medicine how the patient would require you to, and having the ability to educate the patient when need be.

Having a caring attitude and performing all the expected duties of a nurse is seen as the hallmark of nursing care.

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In the ongoing Covid-19 pandemic, nurses are the “frontline workers” who take care of the patients. A skilled nurse will balance the technical demands of the job and the patient’s needs.

Less visibly, nursing leadership is creating a way to incorporate various involvements in healthcare, whether in the boardroom or the bedside.

Nursing leaders act as indispensable guides to a profession that is facing rapid change. Even when the world healthcare system is stretching in response to the pandemic, one can visibly see the leadership roles.

Traditional instances show that nurse leaders include administrators, supervisors, managers, chief officers, directors, and any other managerial roles.

However, in recent times, nursing leaders are preceptors, educators, mentors, and researchers. They also perform as advocates, data analysts, financial consultants, case managers, or other functions.

Regardless of the title a nurse holds, there is an expectation to demonstrate leadership, and one must individually challenge themselves in developing effective leadership styles

All nurses have a responsibility to ensure they demonstrate competency and skill in their leadership.

7 Leadership Styles in Nursing

Nursing Leadership Styles

Today, management in nursing is a stand-alone profession, which requires special skills, training, and characteristics.

To increase the motivation of a team, job satisfaction, and performance, effective nursing management is fundamental in the health care system and hospitals

Building on the above logic, nurse managers who understand their nursing leadership style better manage a team/unit and ensure better patient care.

  1. Autocratic
  2. Transformational
  3. Free-Rein (Laissez-faire)
  4. Servant
  5. Democratic
  6. Situational
  7. Transactional

Autocratic Leadership in Nursing

Autocratic leaders choose to make their decisions with little consultation or input from their employees. These leaders are seen as quick thinkers and are good at giving the needed directions and delegating tasks.

These leaders are not tolerant of innovation and error. Some of their characteristics are being rapid decision-makers, independent and self-reliant, highly structured, authoritative, and definitely being “the boss.”

Autocratic leaders are helpful during emergencies in the healthcare setup, disaster management, or traumas. It is useful when clear, definite, rapid directions and decisions are benefiting all the people involved.

Some lead and some follow


Autocratic nurse leaders perform well in emergency response. The autocratic leadership style is functional when enforcing medical procedures and legal policies which protect patient safety and health.


The leadership style may be associated with negative reinforcement; these leaders lack a team-building spirit. They also find it challenging when it comes to having open communication or developing trust.

Thus, autocratic nurse leaders should ensure they keep open communication lines with their staff and be aware of their capabilities and strengths.

They should give room for the team members to voice their concerns, opinions, and ideas without showing a condescending attitude.

Transformational Leadership in Nursing

Transformational nurse leaders are visionary. They thrive in building engaged teams and are helpful in health facilities where there is a need for significant change.

Studies have shown that improvement in employee satisfaction will significantly reduce errors in patient care.

Transformational leadership will motivate employees to perform beyond the laid-out expectations and enable them to take ownership of their roles.

Rather than assigning roles from the top-down, transformational leaders teach employees how to think for themselves

They discourage them from only taking instructions. These leaders, also sometimes referred to as quiet leaders, lead by example.

Trans Leadership Style


Transformational leaders work well as mentors to new nurses, instilling trust, encouraging teamwork, and building confidence.

They encourage the nurses to learn to work independently, listen to ideas and concerns, and are regarded highly in the organization.

Transformational leaders work well in a health facility that requires improvement.


The leadership style is ineffective in a work environment where the leader makes day-to-day decisions.

Even though transformational leadership improves employee retention and satisfaction, the leadership style needs an already existing structure.

It helps to actualize more development and growth. Thus, it is not the best fit for health facilities that have been newly created

Free-Rein (Laissez-Faire) Nursing Leaders

Laissez-faire leaders fall into the category of inexperienced and new nurse leaders. A leadership style is a hands-off approach.

In this approach, leaders are seen not to provide feedback or direction to their teams. They typically allow the teams to operate however they like, with little or no supervision.

Laissez-faire leaders are perceived as a weak leader

Characteristics that depict these leaders include trusting, hands-off, tolerance, and encouraging error and innovation.

Free-Rein (Laissez-Faire) Nursing Leadership Style


Because there are a lack of micromanaging in this leadership style, self-directed and highly experienced nurses will thrive under this leadership style.

Laissez-faire leaders perform well in hospice and healthcare environments. The nurses, in this case, are highly confident and can work independently.


Laissez-faire encourages an attitude of setting your own goals and solving issues as they arise.

Inexperienced and new nurses who require guidance and someone to walk with them will not do well with these leaders.

Laissez-faire leadership is not the best leadership style for the healthcare industry. This is due to the continuous changes and always needing constant decision-making.

The laissez-faire leadership in nursing cannot help a team succeed in a reactive vs proactive to the issues of safety of the patients.

Laissez-faire leaders must ensure that their employees will practice competent and safe nursing.

Servant Leadership in Nursing

Servant leaders are seen as relationship-oriented and will put their focus on the needs of individuals.

The leaders, in this case, ensure that employees have the tools, skills, and resources needed to achieve laid-out goals. These types of leaders are involved in the development of the employee.

Servant leaders will share power, conceptualize problems, listen actively, prioritize others rather than themselves and empathize with others.

They support and encourage employees through service and actions to meet the goals of their job exceptionally

Servant leaders will continually assess the needs of the team to facilitate work and provide the required resources.

In healthcare, these leaders are most valuable when a system is in place to align workers who already possess expert skills. They provide support and resources to create an effective work unit.


Servant leaders are known to create goal-driven kind of environments. Nurses who love working in diverse backgrounds and teams will work well in this type of leadership.


Servant leaders prioritize the needs of their teams over their individual goals or needs.

They should ensure that they have kept sight of the health care facilities’ strategic objectives. Servant leadership in nursing may not be appreciated, especially when decisions from the top align with an entire team quickly.

Servant leaders are good listeners, and they prioritize being empathetic. They develop trust and build teams.

Democratic Leadership in Nursing

A democratic leader will engage in shared leadership. They take advantage of the member participation to give a guide to management and in making decisions.

Sometimes, it is also participative leadership. Democratic leaders depict collaborative, mutually respecting, empowering, encouraging, and supporting innovation

In the health care system, democratic leaders will best fit in situations where new relationships between a group and the leadership come up.

For instance, when a process or a system needs improvement in the health care system, a democratic leader will be required to take action.

It will be necessary for directing a team of nurses in identifying amendments to a guideline or policies.

A democratic leader acknowledges the importance of communication and feedback in their team and sees communication as two-sided.


The style works at improving processes and quality. It works well in performance improvement and quality assurance roles and inclusion and diversity roles.

Democratic leadership in nursing will work at ensuring the teams feel valued and can comfortably speak their minds

Highly reliable organizations value input and transparency from members of their groups who have the most expertise in an area. And this has nothing to do with their ranks. Thus, this promotes input from the whole team.


If there is a need for a rapid response to an urgent medical situation, democratic leaders may find it difficult to make independent and quick decisions.

Democratic leaders have to be conscious of maintaining a decision-making authority.

Nurses that appreciate in-depth feedback want to grow professionally. They wish to participate actively in changes and decision-making

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Situational Leadership in Nursing

Health care is constantly changing. Situational leaders perform well in healthcare because of their flexibility and can modify their leadership style.

It depends on the circumstances in the organization or the individual needs of the nurse. The nurse leaders will analyze the current situation and determine the best approach. Situational leaders adapt best.


Situational leaders perform well with nursing students in clinical-type settings.


Situational leaders will often change from the long-term goals or strategies of an organization.

They will freely choose to change their management style. These leaders perform best in flexible environments.

Transactional Leadership in Nursing

Transactional leaders use a reward and punishment approach to leadership. Their focus is mainly on:

  • Organization
  • Supervision
  • Performance

They focus mainly on efficiency than building the morale of the employees. The highly bureaucratic health care organizations utilize this type of leadership style to achieve short-term goals.


Transactional leaders are the best performers in problem-solving. Their kind of leadership style will lead to minimal errors as well as an evidence-based method of care.

It’s a task-oriented approach that clarifies roles and responsibilities and the ability to work in emergencies and tight deadlines.


Transactional leaders will focus on the mistakes committed by the staff as opposed to encouraging an inspirational or teaching environment.

There is uniqueness in every leadership style. Leaders need to show different types of leadership as they respond to different situations in the line of work.

A nurse leader will find it appropriate to become a democratic leader in a process improvement or a new system implementation.

The same nurse leader may want to use laissez-faire leadership when they generate policies. The leader will support his nursing team while allowing them to steer continuing updates and improvement.

Other leadership styles are pace-setting and strategic. Pacesetters are generally highly motivated and always lead others to follow. They set the expectations, and team members follow for a rapid turnaround.

Nurse leaders will use the pace-setting leadership style to achieve faster healthcare results, but they should be cautious about overworking their team members.

Strategic nurse leaders focus on achieving quality goals and the employers’ growth. The strategic leadership style will push a medical team in transitory periods.

Strategic leaders help the team members sail through change without forgetting that they need to remain accountable and keep the mentorship in place.

Significance of Nursing Leaders

Nursing leaders establish the tone to be adapted or create a culture for change. Nurse leaders give perspective, vision, as well as expertise for strategic improvements. They foster good quality care for patients and a healthy and safe environment to work in.

Nurse leaders are invaluable for three fundamental reasons:

  • They guarantee the safety of patients, the work environment, together with the entire nursing occupation.
  • A successful nurse leader will establish, support, as well as generate evidence-based practices.
  • Practical nurse leaders will keep high-quality administration of healthcare at all levels. It will also involve taking care of patients to management and systems facilitation.

Behaviours and Qualities of an Outstanding Nurse Leader

Valued and successful nurse leaders will nurture and demonstrate plenty of dynamic behaviours and qualities. They consist of the following:

  • Emotional Intelligence –

    It involves managing their emotions and responding to other people’s emotions appropriately.

  • Interactive Communication –

    Language should be appropriate, articulate, precise, and written intelligently. Oral language should be formal. It should correspond with practical, professional, and relevant personal interactions with other people.

  • Teamwork and Mutual Respect –

    An outstanding nurse leader will foster trust and efficient and effective large group and small group interactions.

  • Critical Thinking –

    It involves the ability to create informed and reasonable decisions and observations.

  • Adaptability –

    It is the ability to thrive and cope with change.

  • Commitment to Safety and Quality –

    It is a never-ending dedication to deliver the highest safety and quality outcomes for the community and the patients, not forgetting the nursing staff.

  • Demonstrate Professionalism –

    One’s conduct, behaviour, and formal attitude should reflect integrity in character and fully commit to the occupation.

  • Technical Proficiency –

    This is when one can maneuver the technical aspects of the healthcare system. They include information technology, medical devices, and equipment required for specialty areas and equivalent administrative roles.

  • Politically Pragmatic Mindset –

    Centre your attention on the right thing and what is best for the profession or the organization.

  • Global Mindset –

    Openness towards other cultures and respect for different diversities.

How to Train To Be a Nurse Leader

Here are the steps you can follow to demonstrate your leadership ability:

  • Education –

    Consider pursuing relevant courses to improve your leadership ability and your communication skills continually. Excellent nurse leaders possess exceptional decision-making ability, performance management, and relationship-building skills.

  • Be Proactive –

    Great leaders are visionaries and will take the initiative in taking care of all that needs proper handling. They design programs, develop education, and think outside the box.

To be great in your leadership and to have the ability to recognize effective leadership, you need to have the ability to adapt and change the strategy used.

You will also need to change the plan for your colleagues, patients, and the organization. Make use of critical thinking in making your choices and never stop flourishing as a nurse


Nurses can precept, advocate, mentor, investigate, educate, and initiate change in all roles. In developing their skills formally, nurses should pursue their studies at the baccalaureate, master’s, or doctorate level.

Apart from studies, nurses can get recognition and certification of a higher level of knowledge in what they wish to specialize in. It will enable them to demonstrate leadership in the community.

Most importantly, nurses can develop their skills in leadership by learning to embrace the challenges they face in their current roles every day.

In pursuing opportunities for decision-making, influencing change, nurturing the occupation, and improving care, the nurses can take that as a challenge. They can become better leaders.

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