DQ: Discussion 1: Leadership Theories in Practice

NURS 6053 Discussion 1 Leadership Theories in Practice Walden

DQ: Discussion 1: Leadership Theories in Practice

Formal leadership theories focus on the principles of good management and the official aspects of the organization (Doherty & Hunter Revell, 2020). Formal leadership styles have strong similarities with the initiating structure. Xu (2017) discussed leadership theories in clinical practice as transformational, participative, transactional, situational, and autocratic. According to Xu (2017), transformational leaders motivate others with their vision and cooperate with the team towards shared values. Participative leadership is an administrative style that invites contributions from employees to organizational decisions (Xu, 2017).

A leadership theory that I have identified recently in practice is the transformational style used by a nurse leader in the hospital where I worked earlier. The nurse leader used to: Idealize influence to build confidence, practice inspirational motivation to articulate a clear

DQ Discussion 1 Leadership Theories in Practice
DQ Discussion 1 Leadership Theories in Practice

vision for the organization, encourage people within the facility to question and challenge assumptions, to look at old problems in new ways, and gave individualized consideration to each follower. The nurse leader was always open to criticism or ideas that would enhance the quality of working conditions. For example, the nurse leader once accepted ideas to reduce the working hours and proposed to the management to employ more nurses. One of the vital behaviors I have identified is that leaders’ influence and motivation have an impact on commitment to work and job satisfaction among nurses (Choi et al., 2016). Another peculiarity is that openness to new ideas improves the quality of nurses’ working lives (Ferreira et al., 2018). The openness and transformational leadership qualities were essential since it helped improve the quality of nurses’ working lives (Giddens, 2018). All the nurses are happy due to the traits of the nurse leader and thus remained committed to their job, and they were always satisfied.

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Choi, S. L., Goh, C. F., Adam, M. B. H., & Tan, O. K. (2016). Transformational leadership, empowerment, and job satisfaction: the mediating role of employee empowerment. Human resources for health, 14(1), 73.

Doherty, D. P., & Hunter Revell, S. M. (2020, March). Developing nurse leaders: Toward a theory of authentic leadership empowerment. In Nursing Forum.

Ferreira, V. B., Amestoy, S. C., Silva, G. T. R., Felzemburgh, R. D. M., Santana, N., & Trindade, L. D. L. (2018). Transformational leadership in nurses’ practice in a university hospital. Acta Paul. Enferm.[Internet], 31(6), 644-50.

Giddens, J. (2018). Transformational leadership: What every nursing dean should know. Journal of Professional Nursing, 34(2), 117-121.

Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4), 155-157.

RE: Discussion – Week 4


How competing needs may impact the development of polices to address that issue 

For years the healthcare system in the United States has relied on a fee-for-service payment system whereby each medical service and procedure is paid for separately. However, this payment model created several limitations, including fueling health care costs, overtreatment, and overutilization at the same time leaving others underserved and undertreated. In an attempt to counter these perverse incentives, the legislation of payment reforms which focuses on methods that reflect providers’ performances, primarily quality, safety, and patient experience, has been put in place to replace the traditional system of fee-for-service (Palumbo et al., 2017). The new healthcare payment reform has been designed to spur provider efficiency, reducing unnecessary spending subsequently reducing healthcare costs. However, competing needs such as the use of 12-hour shifts as employees’ retention strategy, workforce, and resources have affected the development and adoption of this critical policy following the necessity that surrounds competing needs to align with the agenda of payment reform.  

Payment reforms such as Medicare, which pushes for bundled payment, whereby patients are required to use only one payment method covering all episodes of care, have to address nursing shortages. With the aging population steadily rising, Medicaid has been burdened with being the primary payer of healthcare for many Americans. Nurses play a critical role in driving system change because of their sheer numbers (Miller et al., 2017). It is estimated that as of 2019, over 3.8 million registered nurses were integrated into the American workforce, a lower number compared to the health care needs of the American people. As a result, the available nursing workforce is forced to register more hours in their workplaces, reducing quality, safety, and quantity of care service (Rivers & Glover, 2008). There are numerous severe ramifications associated with shortages of nurses, such as work overload of available healthcare personnel, which results in burnout and subsequently compromise patient safety and long waiting, which may cause more harm, including preventable deaths.  


Miller, B., Ross, K., Davis, M., Melek, S., Kathol, R., & Gordon, P. (2017). Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care. American Psychologist, 72(1), 55-68. 

Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation?. Journal Of Professional Nursing, 33(6), 400-404. 

Rivers, P., & Glover, S. (2008). Health care competition, strategic mission, and patient satisfaction: research model and propositions. Journal Of Health Organization And Management, 22(6), 627-641. 

Leadership skills begin with understanding one’s self. Leadership leaders “demonstrate self-confidence and are able to trust and empower others” (Sherman & Pross, 2010). Their communication and actions impact others and creates a healthy working environment. The art of leadership within healthcare organizations involve managing relationships with patients, coworkers, nurses and influencing their behaviors.

An example of a good leader was my previous manager who I had the pleasure to work with for four consecutive years. I witnessed a strong leadership characteristics such as setting certain directions, strategies, having a vision for the unit, and her ability to connect with her coworkers/nurses on both personal and professional level. She was considered an informal leader; as described in the Laureate Education (2014) “displayed charisma and willingness to help others be successful because of the vision they see for their unit which can be perceived as a leader with personal power”. A good example of leadership, when my manager implemented pressure ulcer prevention strategies on the unit. She created a daily list of patients who required frequent turning every 2 hours and set up a worksheet with times with nurses names to turn patients at the assigned times. Options were offered for nurses on a preferred time depending on their patients’ workload.

Overall, this particular practice helped recognize team members’ strengths to help create a positive workplace environment and ensure tasks get completed. Also, made quality of care to be a vital element for achieving high productivity levels within healthcare organizations (Sfantou et al., 2017). In the process of conducting skills; leaders are establishing the methods of collaboration, innovation, and communication. These methods will help set the healthcare organization for success. In conclusion, it is important for leaders to ensure they develop the skills and competencies needed to be successful. The development of healthy work places are responsive to the changing healthcare environment.


Laureate Education (Producer). (2014). Leadership [Video file]. Baltimore, MD: Author.

Sherman, R., & Pross, E. (2010). Growing Future Nurse Leaders to Build and Sustain Healthy Work Environments at the Unit Level. OJIN: Online Journal of Issues in Nursing, 15(1), Manuscript 1. Doi: 10.3912/OJIN.Vol15No01Man01. Retrieved from

Sfantou, D.F., Laliotis, A., Patelarou, A.E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare, 5(4), 17. DOI:10.3390/healthcare5040073

Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.


Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.


To Prepare:

  • Review the Resources and examine the leadership theories and behaviors introduced.
  • Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
  • Reflect on the leadership behaviors presented in the three resources that you selected for review.

By Day 3 of Week 4

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

By Day 6 of Week 4

Respond to at least two of your colleagues on two different days by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described.