Effective leadership in nursing has never been more critical. In the midst of a nurse shortage that has reached crisis levels, and at a time when the healthcare landscape is changing drastically, nursing leadership must be able to guide nurses through their daily tasks and provide them with the support needed to grow their careers.
By understanding the organizational structure in nursing leadership, new and experienced nurses may better navigate the current healthcare industry and learn how to advance their own careers.
What Are the Foundations of Nursing Leadership?
At the core of any leadership position in nursing is the fundamentals of nursing practice. Nurse leaders must be effective nurses who know how to prioritize patient care and provide all patients with responsible, personalized treatment plans. Beyond that, however, nurse leaders also should have a diverse range of skills, including business acumen and leadership skills. According to the American Nurses Association, nurse leaders must be committed to ongoing education and professional development in order to continually improve their leadership approach over time.
The Evolution of Nursing Leadership Roles
Not that long ago, nurses and their supervisors operated with limited collaboration within the healthcare field. Nursing was generally considered a secondary form of care, with the doctors and physicians taking the lead on developing patient plans — often without nurse input.
According to the Cleveland Clinic, nursing leadership roles have evolved significantly in the past several decades. Rather than keeping nurses out of the conversation, nurse leaders have been invited to have a seat at the table; they often work collaboratively with physicians and other providers in the care team to ensure patients receive the personalized care they need. By bringing nurses into the fold, healthcare administrators and other members of the care team have been able to substantially improve patient satisfaction ratings and overall outcomes.
Key Theories Underpinning Nursing Leadership
According to the Nursing Times, the key theories that underpin nursing leadership include two distinct leadership styles:
- Transactional – Nurses with a transactional leadership style focus more heavily on completing work or tasks in order to receive a reward or to check an item off the list. While it is an efficient leadership style, it is not always ideal for nurse leaders.
- Transformational – Nurses with a transformational leadership style focus on motivating nurses to complete their tasks in a way that benefits the greater good and, in particular, enhances the patient experience. Transformational nurse leaders consider the individual needs of each patient, come up with innovative solutions, model effective behavior in the clinical setting, and seek to motivate and inspire nurses to continue to grow in the profession.
Organizational Systems in Nursing Leadership
Organizational systems for leadership in nursing have been developed to ensure that there is a hierarchy within a healthcare facility. The organizational structure of an individual facility may vary slightly based on the following factors:
- The type of facility
- The size of the facility
- The size of the staff
- The scope of the nursing staff
Ultimately, the organizational structure in nursing leadership exists to help ensure that nurses receive necessary support and professional guidance. In addition, the hierarchy works to protect patients and ensure they are receiving safe, effective, and personalized care.
Structural Frameworks in Healthcare Organizations
Structural frameworks in healthcare organizations may vary based on the type of facility, location of the facility, services provided at the facility, and size of the staff. According to NurseJournal.org, a typical nursing hierarchy is as follows:
- Chief nursing officer – Oversees the entire nursing staff and the overall nursing operations within the facility.
- Nursing director or administrator – Reports to the CNO and manages the charge nurses and advanced practice nurses (APRN).
- Charge nurse and APRN – Report directly to the Nursing Director or Administrator and oversee the day-to-day operations and nursing staff.
- Registered nurses (RNs) – Report to the Charge Nurse and APRN, but may also receive instructions from the Nursing Director or Administrator.
- Licensed practical nurses (LPNs) – Work alongside RNs and report to the Charge Nurse, but may also take direction from the Nursing Director or Administrator.
- Certified nurse assistants (CNAs) – Provide basic patient care and assist LPNs and RNs. They report directly to the Charge Nurse but may also receive tasks from the Nursing Director or Administrator.
The Role of Nursing Leaders in Organizational Design
Nurse leaders often have input when it comes to creating or restructuring the organizational systems for leadership in nursing. When developing organizational structure, nurse leaders should always work to optimize the efficiency of the nursing staff and ensure nurses receive the support they need from leadership. Naturally, the patient experience should be a high priority when developing the organizational structure in nursing leadership, and the structure should be created in a way that ensures all nurses have as much time as possible to spend with their patients.
Leadership Styles and Their Impact on Nursing Practice
In every position, including those outside of the healthcare field, leadership styles have an impact on how a professional approaches a management position. In the field of nursing, leadership styles influence workplace culture as well as the patient experience, making it important for nurse leaders to focus on professional development and adopt a leadership style that makes a positive impact on those around them.
Transformational Leadership in Nursing
Transformational leadership in nursing has the potential to be powerful and highly effective. It revolves around the “four I’s,” which include:
- Individualized consideration – Transformational leaders take a personalized approach to patient care, ensuring that every patient is receiving care based on their personal beliefs, traditions, and preferences as well as their physical and emotional needs.
- Intellectual stimulation – Transformational leaders in nursing recognize that the status quo is not always the best solution for all patients, and they strive to devise new and innovative solutions to the complex challenges of today.
- Inspirational motivation – Transformational leaders in nursing have a vision for what they think their facility could attain, and they provide their staff with the resources and support needed to reach those goals. They help motivate the nurses who report to them to provide better patient care.
- Idealized influence – Transformational leaders in nursing model the behavior they expect from their direct reports, highlighting the importance of working as a team in order to provide all patients with the best possible outcomes.
Servant Leadership and Its Relevance to Nursing
According to a Nurse Leader article titled “The Case for Servant Leadership,” servant leadership can be a particularly powerful leadership style within the nursing profession. Servant leaders are described as those who are empathetic, attentive, and aware, and they often seek out leadership positions as a way to serve others. Within the nursing profession, servant leaders are impactful because they recognize that they are working with patients and nurses for the greater good of society.
Communication Strategies for Effective Nursing Leadership
Effective communication rests at the core of nursing leadership. Nurse leaders must be able to communicate clearly and effectively with nurses who report to them as well as patients receiving care at the facility. In order to provide nurses and patients with the information and instruction they need, nurse leaders must also be compassionate and empathetic and recognize the weight that their words carry throughout the day.
Enhancing Interprofessional Collaboration
Nurse leaders who are adept communicators are able to interact and collaborate more effectively with members of the care team. According to American Nurse, enhanced communication helps build strong relationships in the workplace. Nurse leaders may improve their communication and collaboration skills by following this six-step effective listening model:
- Stop
- Look
- Listen
- Ask questions
- Paraphrase content
- Paraphrase feelings
Navigating Challenges in Nurse Communication
Communication in the healthcare field can be complex, particularly for nurse leaders who are working to communicate directly with patients. One of the most common challenges in nurse communication is relaying complex or in-depth health information to patients. Nurse leaders must work directly with the nurses who report to them to find a way to relay information to patients in a way that is understandable and relevant.
Developing Leadership Competencies in Nursing
Leadership skills are not inherent; all leaders, regardless of the field they are in or the area in which they specialize, have to be intentional about developing the core leadership competencies for their field. The most essential leadership competencies in nursing are:
- Communication and collaboration
- Educational skills and practice skills
- Environmental health and resource utilization skills
- Ethics
- Professionalism
- Compassion and empathy
Continuous Professional Development for Nursing Leaders
For many nurses, acquiring a leadership or management position is a professional goal. However, it is worth noting that this is not a stationary goal. Once a nurse is practicing in a leadership position, professional development becomes even more important. Nurse leaders should constantly work to enhance their leadership style, improve their management approach, and adopt the latest trends influencing the development of the healthcare field.
Mentorship Programs and Their Importance
Mentorship programs are particularly valuable in the field of nursing, especially for nurse leaders. Mentors in healthcare may provide nurse leaders with ongoing guidance and personalized advice. For many nurse leaders, their mentor is the person they go to when facing a complex challenge they need help navigating. Typically, mentors have significant experience in a leadership position and are able to provide developing nurse leaders with actionable, relatable advice.
Implementing Change Within Nursing Organizations
Change can be difficult to navigate, especially in the field of nursing. The reality is that the practice of nursing never stops, so nurse leaders and all nurses who report to them are required to continue to maintain a high level of patient care even amid organizational change. The responsibility of managing that change falls on nurse leaders, who must be able to provide staff with assurance while simultaneously ushering in the change.
Strategies for Effective Change Management
Below are some of the most effective strategies for change management:
- Actively working to create a climate that is welcome to change. Nurse leaders could do this by preparing in advance and collecting data to help support the concept of the change.
- Know that some will be excited about change, while others will be resistant to it.
- Clearly communicating the need for and benefits that will result from the change.
- Creating a supportive environment during the implementation phase — one in which nurses may express their concerns, questions, or feedback without fear of reprimand.
The Role of Technology in Nursing Leadership
Technology continues to play a pivotal role in the field of nursing, and nurse leaders must remain aware of the latest technology trends in order to implement them effectively at their individual healthcare facilities.
Leveraging Digital Tools for Better Healthcare Outcomes
Advanced digital tools could help streamline tasks for nurse leaders and administrators while simultaneously improving patient outcomes. Some of the top digital tools in nursing include:
- Electronic health records
- Cybersecurity solutions
- Telehealth solutions
- Customer relationship management software
Future Trends in Nursing Technology and Leadership
Advancements in technology will continue to impact the nursing profession. Nurse leaders need to adapt and adjust to new technology to streamline operations and deliver the best possible patient outcomes. Recent advancements in artificial intelligence, virtual reality, and augmented reality are expected to have the most significant impact on the nursing profession, particularly as patients seek more virtual and remote healthcare treatment options.
Addressing Challenges in Nursing Leadership
The nursing field is currently facing several unique and monumental challenges, which have presented those in leadership positions with a range of issues to address.
According to the American Hospital Association, some of the most considerable challenges facing nurse leaders include:
- Financial resource allocation
- Staff recruitment and retention
- Improving workplace culture
Nurse leaders are beginning to work collaboratively at all levels of the healthcare field to innovate solutions addressing these challenges, all while prioritizing patient care at their facilities.
Burnout and Resilience Among Nursing Leaders
The burnout rate among nurses at all levels of the profession is rising. While many professionals often talk about the burnout experienced by registered nurses and other nurses who are working directly with patients, it is crucial to recognize that nurse leaders are also facing similar burnout rates. According to the American Organization for Nursing Leadership, nurse leaders experience the same levels of stress as their front-line reports, and many have found themselves working long hours to protect and accommodate the nurses who work for them.
Ethical Decision-Making in Nursing Leadership
Nurse leaders are frequently forced to make difficult decisions within their facilities, highlighting the importance of ethical decision-making. Nurse leaders must account for the personal needs of the patient as well as the needs of their nurses to ensure the decisions they make are as beneficial as possible for all parties involved.
Explore Organizational Structure in Nursing Leadership at Post University
As organizational systems and leadership in nursing shift with the ever-evolving times, it is imperative that today’s nurses understand how to grow their professional skill sets.
At Post University, our nursing degree programs focus on developing the nursing competencies of the future in order to face the complex challenges of the modern healthcare landscape. We offer a Registered Nurse to Bachelor of Science in Nursing, a Master of Science in Nursing, and a Doctor of Nursing Practice, allowing nurses at all career levels to advance their industry knowledge and improve their practical skills.
Please note jobs and/or career outcomes highlighted in this blog do not reflect jobs or career outcomes expected from any Post program. To learn more about Post’s programs and their outcomes, please fill out a form to speak with an admissions advisor.
