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Print ISSN: 2735-3974 Menoufia Nursing Journal
Online ISSN: 2735-3982 Faculty of Nuring
DOI: -------------------- Menoufia University
Transformational Leadership Skills among Nursing
Managers
1Shimaa M. Salem, 2Manal Z. Ahmed, 3Mervat E. Aldahshan
1 2&3
Master in Nursing Administration, Professor of Nursing Administration, Faculty of
Nursing, Menoufia University, Egypt
Abstract: Background: Transformational leadership is an influential element in
achieving the quality of nursing care. Transformational nursing leaders are a source of
inspiration to nurses through their commitment for their healthcare organizations.
Transformational nursing managers' insistence to a mission and willingness to take risks
along with a strong desire to achieve and drives healthcare organizations to success.
Purpose: To identify the level of nursing managers' transformational leadership skills.
Methods: A descriptive research design was used. The study was conducted in Menoufia
University Hospitals. A convenience sample of sixty two nursing managers constituted
the study sample. Multifactor Leadership Questionnaire (MLQ) Form 6S was used to
identify the transformational leadership skills among nursing managers. Results: Nursing
managers in the hospital setting showed low level (27.7 ±3.1) of transformational
leadership skills. The highest mean score was for individual consideration dimension
whereas the lowest mean score was for Laissez‐faire leadership dimension Conclusion:
In-service training program about transformational leadership skills for nursing managers
is needed to improve Laissez‐faire leadership that increase their insistence to hospitals'
mission and desire for success.
Keywords: Nursing managers, transformational leadership, skills.
Introduction
Nursing by nature is an emotionally safe environment for patients. This
demanding and a highly stressful expanding role of nursing managers
profession as nurses has to deal with have contributed significantly to the
different people in various situations at stress experiences among nursing
different times of the day. During their managers. Moreover, nursing
everyday work, nurses have to cope managers have to deal with several
with extremely emotionally charged personalities both in the upper and
and rapidly changing circumstances. lower levels of management in the
These stressful situations resulting in organization or unit with different
harm to both nurses and patients. High perspectives and competing values. So,
levels of stress cause physiological and nursing managers experience
psychological illnesses, poor occupational stress and burnout from
occupational performance, low job various stressors such as role conflict,
satisfaction, high burnout and turnover, work and time pressure, job overload,
reducing quality of care and patient’s role ambiguity, inadequate social
satisfaction (Bakker & De Vries, support, inadequate leadership, and
2021). organizational constraints (Berger et
Also, nursing managers’ role have al., 2019).
been expanded to be responsible for So, nursing administration must take
creating and maintaining a professional into consideration that nursing
work environment for nurses and a managers are not created when they
MNJ, Vol. 7, No. 1, May 2022, PP: 83-92 83
Transformational Leadership Skills among Nursing Managers
graduate from any level of nursing morale, lead to rapid innovation,
education programs. Nursing improve conflict resolution, decrease
Managers need to grow in the turnover and foster a sense of
organization and additionally be ownership among nurses. So, it is
mentored in their specific roles to be transforming nursing work
effective for the unit and overall environments that lead to high level
healthcare organization. Therefore, this work performance for staff nurses
study is a vital step in identifying the (Jensen et al., 2019).
level of nursing managers' Also, Transformational leadership is
transformational leadership skills that characterized by four behaviors. These
increase their insistence to hospitals' specific behaviors of this leader are
mission and desire for success among classified into four dimensions are
nursing managers (Labrague et al., idealized influence, inspirational
2018). motivation, intellectual stimulus, and
In addition, the role of the nurse leader individualized consideration (Spies et
becomes critical in creating supportive al., 2018). The1st dimension “idealized
and positive work environment to help influence” is based on the nurses'
nurses cope with stress of managing belief in the leader’s ability to
their own and other’ emotions influence and is an attribution
concurrently. Effective nursing characteristic that indicates whether
leadership in organizations requires nurse managers hold nurses’ trust,
numerous talents, skills, competencies, maintain their faith and respect, show
types of knowledge, effective dedication to them, appeal to their
communication, self and social hopes and dreams, and act as their role
awareness (Noquez, 2019). model. The 2nd dimension
Transformational leadership style “inspirational motivation” involves
should be used by nursing managers to encouraging others to achieve the goals
improve leadership skills. and aspirations of the organization
Transformational leadership is an while also achieving their own aims
influential element in achieving the (Kroes, 2017).
quality of nursing services (Lan et al., Motivation is an important element of
2019). In addition, transformational healthcare, as motivation affects
nursing leaders are a source of performance and quality of patient
inspiration to others through their care. So, transformational nursing
commitment for those who work for managers should have the ability to
them. Their perseverance to a mission inspire and motivate their nursing staff.
and willingness to take risks, along Inspirational motivation empowers
with a strong desire to achieve, drives nurses to complete the task; it focuses
organizational success (Akkaya, 2020). on the good characteristics in them and
Transformational leadership, one of the avoids over-rotating towards focusing
most popular forms of leadership, has on the bad characteristics. Also,
been the focus by many researchers in transformational leaders provide a
recent years (Buila, Martínezb, & vision, use appropriate symbols and
Matutec, 2019). Transformational images to help others focus on their
leadership can be defined as, an work, and try to make others feel their
approach in which nursing leader work is significant. The 3rd dimension
inspires and motivates team of nurses “Individualized Consideration” within
to create positive changes within individualized consideration, nursing
healthcare organization. This managers support and encourage
leadership style can increase nurses' individuals to reach higher levels of
84 Menoufia Nursing Journal, Vol. 7, No. 1, May 2022
Transformational Leadership Skills among Nursing Managers
achievement and assisting them to problems (Brouer, Chiu, & Wang,
achieve full actualization (Schieltz, 2016).
2017). The key influence on culture is the
Transformational nursing managers transformational leadership of an
demonstrate important concern for the organization. Transformational
needs and feelings of their nurses leadership and organizational culture
which brings out the best efforts from hold the key to understand
each individual in achieving daily organizational effectiveness. In
work activity that is serving in addition to decisions taken by a
achieving organizational goals. manager are very important as they
Individual consideration is related to affect a large number of people. Thus,
how the transformational nursing the leadership skills of the manager
manager treats each nurse as an have to be very powerful in achieving
individual, acknowledges their needs, organizational goals, higher levels of
and it includes the recognition of productivity and enhance quality of
strengths as well as provides health care services (Ishii, Takemura,
demonstration of both care and & Ichikawa, 2021).
compassion toward their nurses, nurses Purpose
development, coaching, and mentoring
(David, Armanu & Afnan, 2017). To identify the level of
transformational leadership skills
The 4th dimension “Intellectual
among nursing managers in Menoufia
Stimulation” intellectual stimulation
encourages staff innovation and University Hospital.
challenging their nurses to be creative Research Question:
towards the purpose of fulfilling their What is the level of transformational
tasks and assigned responsibilities. leadership skills among nursing
Transformational nursing managers
also encourage creative thinking in managers in Menoufia University
Hospital?
their staff nurses, challenges nurses’
assumptions and create an environment Methods
that is tolerant of seemingly extreme
positions, and nurture staff to question Research Design:
their own values and beliefs of those of A descriptive research design was used
the organization (Suratno, Ariyanti, & to fulfill the purpose of this study.
Kadar, 2018).
Transformational leadership has a Setting:
positive impact on the organization’s This study was conducted at all units
performance. When transformational and departments in Menoufia
leaders create a strong entrepreneurial University Hospital. All medical,
culture, initiative taking, group surgical, general or specialized
learning and innovative approaches to departments and critical care units
problem solving are all enhanced, were included in the study. This
which in turn informs action in dealing hospital constitutes four buildings;
with patient safety issues. A strong General Hospital, Emergency Hospital,
emphasis on hierarchy, rules, policies Specialized Hospital, and Oncology
and control, they argue, potentially hospital. The bed capacity of the
inhibits a positive climate for safety hospital is 1200 beds. The study was
due to fear of negative outcomes and conducted in different general wards
blame for reporting safety-related and acute care units.
Menoufia Nursing Journal, Vol. 7, No. 1, May 2022 85
Transformational Leadership Skills among Nursing Managers
Sample: assign projects individually, and pay
A convenience sample technique was attention to those who seem less
used to select study's sample. The involved in the group. Contingent
Total number of nursing managers is reward shows the degree to which
92 only sixty two (67.4%) of nursing nursing managers tell others what to do
managers who returned the in order to be rewarded, emphasize
questionnaire and accepted to take part what leader expect from them, and
in this study constituted the study's recognize their accomplishments.
sample. Management by exception assesses
whether nursing managers tell others
Instrument: the job requirements, are constant with
Multifactor Leadership Questionnaire standards performance, and are a
(MLQ) Form 6S was used to identify believer in “if it isn't broke, don’t fix
the transformational leadership skills it”. Laissez faire leadership assesses
among nursing managers. This whether nursing managers require little
instrument is the most frequent, well of others, are content to let things ride,
validated leadership instrument, and it and let others do their own things
is applied to a wide range of (Suratno, Ariyanti, & Kadar, 2018).
organizational settings as well as with The instrument uses five-point Likert
leaders in different cultures. It is used scale (0= Not at all, 1= Once in a
to assess transformational leadership while, 2= Sometimes, 3= fairly often,
style systematically. MLQ consists of 4=frequently, if not always). Score for
21 items which assess nursing each factor is determined by summing
three specified items on the
managers’ leadership on seven factors questionnaire. For example, to
related to transformational leadership. determine score for factor 1, Idealized
Each factor was composed of three influence, sum responses for items 1,
items. Idealized influence indicates 8, and 15. Score categorizes as: low (0-
whether nursing managers hold 4), moderate (5- 8) and high (9 – 12).
subordinates’ trust, maintain their faith The grand total score for all the seven
and respect, show dedication to them, factors ranged between 0 -84. The total
appeal to their hopes and dreams, and score of each nursing manager was
act as their role model (Kroes, 2017). categorized into “Low level of TL”
Inspirational motivation assesses the ranging from (0 – 28), (<28 – 56) was
degree to which nursing managers
provide a vision, use appropriate considered as “Moderate level of TL”,
symbols and images to help others and (<56 – 84) was considered as
focus on their work, and try to make “High level of TL” (Avolio & Bass,
others feel their work is significant. 2004).
Intellectual stimulation shows the Cronbach alpha was used to test
degree to which nursing managers reliability for the overall Multifactor
encourage others to be creative in Leadership Questionnaire (MLQ)
looking at old problems in new ways, Form 6S was α = 0.92 (Brandt &
create an environment that is tolerant Laiho, 2013). For the current study
of seemingly extreme positions, and Cronbach alpha was estimated (α =
nurture people to question their own 0.90). All the dimensions of the MLQ
values and beliefs of those of the also have high internal consistency
organization (Schieltz, 2017). with idealized influence was α = 0. 82,
Individual consideration indicates the for inspirational motivation was α =
degree to which nursing managers 0.80, intellectual stimulation was α =
0.83, individual consideration was α
show interest in others’ wellbeing,
86 Menoufia Nursing Journal, Vol. 7, No. 1, May 2022
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