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LWW/NAQ NAQ200189 February 29, 2012 14:7
Nurs Admin Q
Vol. 36, No. 2, pp. 147–154
c
Copyright 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
TheTransformative Power of
Personal and Organizational
Leadership
KarenDrenkard,PhD,RN,NEA-BC,FAAN
Transformational leadership has both personal and professional domains. Key concepts and re-
search related to transformational leadership are explored, as well as a framework for personal
and professional leadership, in relation to leadership of self, leadership in relation to others, and
leadership in relation to systems. A review of the issues and trends facing nurse executives results
in identification of the research gaps in personal and professional leadership as it impacts nursing
practice, and suggestions about potential research agenda items for executive nurse leadership in
practicearediscussed.Keywords:nursingadministration,researchagenda,transformational
leadership
HE PACE AND fundamental shifts in 3. Identification of the research gaps in
Thealthcaredelivery models and systems personal and professional leadership as
that are currently facing health care providers it impacts nursing practice
call for increased focus and emphasis on ex- 4. Suggestions about potential research
ecutive nursing leadership. Executive nurses agenda items for executive nurse lead-
and administrators will need evidence-based ership in practice
leadership methods and processes to meet
future needs of patients across the contin-
uum of care. This article recaps the remarks KEYCONCEPTSANDRESEARCH
presented at the June 16, 2011, North Star RELATEDTOTRANSFORMATIONAL
Summit held at the University of Pennsylva- LEADERSHIP
nia School of Nursing about transformational
leadership and the personal and professional The Great Man theory of leadership was
domains of leadership. The article shares in- the primary concept guiding all leadership
sights about 4 key points: literature prior to the 1900s and was based
1. Key concepts and research related to on the thought that the masses were led
transformational leadership by a superior few leaders.1 These leaders
2. A framework for personal and profes- shapedtheinstitutionsandorganizationsthey
sional leadership, in relation to leader- led, and it was only through their high de-
shipofself,leadershipinrelationtooth- gree of intelligence, energy, and moral force
ers, andleadershipinrelationtosystems that the masses were led. As a response to
(Figure 1) Great Man theories, trait and behavioral the-
ories began to emerge, followed by theorists
analyzing situational and environmental fac-
AuthorAffiliation: American Nurses Credentialing 2,3
Center, Silver Spring, Maryland. tors in leadership. More recently in the
The author declares no conflict of interest. latter half of the 1900s, integrative theories
Correspondence: Karen Drenkard, PhD, RN, NEA-BC, that include goal attainment, change theory,
FAAN, American Nurses Credentialing Center, Silver contingency theories, and people and situ-
Spring, MD 20910 (karen.drenkard@ana.org). ations have been developed.4,5 This article
DOI: 10.1097/NAQ.0b013e31824a0538 focuses on the transformational leadership
147
Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
LWW/NAQ NAQ200189 February 29, 2012 14:7
148 NURSING ADMINISTRATION QUARTERLY/APRIL–JUNE 2012
Figure 1. Conceptual framework for personal and professional leadership. Copyright 2011 American
Nurses Credentialing Center. All rights reserved.
theory, an integrative theory that is transfor- where an exchange of incentives occurs for
6 8
mational and value-based. Burns and later desired accomplishments. This movement
7
Bass and Avolio are considered the semi- from transactional leadership to transforma-
nal theorists of transformational leadership. tional leadership is based on an exploration
Burns defined transformational leadership of characteristics that move beyond the trans-
as a “process whereby leaders and followers actional mode of relationship. Transactional
raise one another to higher levels of morality leadership was defined by Burns as having
and motivation.”6(p19) anemphasisonworkstandards,assignments,
Burns was one of the first leadership the- task orientation, and task completion. Trans-
orists to further the notion that true trans- actionalleadershipstyleincludedrewardsand
formative change occurred as a result of the punishments based on this compliance-based
relationship between the leader and a fol- form of working. While Burns proposed that
lower. “The genius of leadership lies in the leadership is both a transactional and trans-
manner in which leaders see and act on formational process, it was Bass, followed by
their own and their followers’ values and 6 whoidentifiedthecharac-
otherresearchers,
motivations.”6(p19) The evolution of transfor- teristics of transformational leadership. Trans-
mational leadership emerged from an under- formational leadership is formally defined
standing of leadership based on transactions, as “a leadership process that is systematic,
Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
LWW/NAQ NAQ200189 February 29, 2012 14:7
The Transformative Power of Personal and Organizational Leadership 149
consistingofpurposefulandorganizedsearch 12 andthe
LeadershipQuestionnaire(MLQ-5X)
13
for changes, systematic analysis, and the AnticipatedTurnoverScale. Astratified,ran-
capacity to move resources from areas of dom sample of 1500 RNs across the United
lesser to greater productivity to bring about States was surveyed. Data analysis included
a strategic transformation.”8(p34) Burns de- a 28% response rate. The only demographic
scribestransformingleadershipas“transcend- variable that was statistically significant was
ing leadership that is dynamic leadership in whether the organization was Magnet desig-
the sense that the leaders throw themselves nated or seeking Magnet status, as the nurses
into a relationship with followers who will in those work settings had a lower antici-
feel ‘elevated’ by it and often become more pated turnover rate than those organizations
activethemselves.”6(p20) Thequalitiesoftrans- that were not Magnet designated or seek-
formational leadership, as described by re- ing Magnet status. The transformational lead-
searchers, include the following: ership characteristic that had the strongest
1. Individualized consideration—the correlation to reduced anticipated turnover
ability of a leader to treat each person score was idealized influence (r =−0.39,
equally, but differently, to give personal P < .0001), the ability of the leader to pro-
attention; functioning as a coach or vide vision and a sense of mission, instilling
9
mentor. pride, respect, and trust in the workplace.
2. Intellectual stimulation—the ability of Anticipated turnover decreased as the pres-
the leader to ask questions and find ence of transformational leadership charac-
waystoproblemsolve,toencouragefol- teristics increased. The higher the score on
lowers to create solutions and try new the leadership assessment of the nurse man-
ideas; questioning assumptions, refram- ager,thelesslikelythestaffnursewastothink
ing problems, and approaching old situ- aboutleaving.Inpractice,theimplicationsin-
10
ations in new ways ; including the fol- clude screening and coaching and mentoring
lowers in the generation of solutions. leaderstodemonstrateskillsofidealizedinflu-
3. Charisma—a leader’s ability to gener- ence, including acting in ways that build re-
ate excitement and provide vision and a spect, talking about values and beliefs about
sense of direction. patient care, emphasizing the importance of
4. Inspirational motivation—the com- the mission in daily work, and considering
munication of the shared vision on the moral and ethical consequences of decision
part of the leader to the follower; mo- making. In this study, staff nurses were less
tivating and inspiring others by provid- likely to leave when they had more trans-
ing meaningandchallengetofollowers’ formational leadership styles evident in their
11
tasks. nurse manager, providing evidence that the
5. Idealized influence—a leader’s ability leadership style of nurse managers is an im-
to behave as a role model and emulate portant factor in reducing staff turnover.
high ethical standards.
In an unpublished research study con- FRAMEWORKFORPERSONALAND
ducted in 2005 (K.D., unpublished data, PROFESSIONALLEADERSHIP
2003),therelationshipofthetransformational
leadership variables of idealized influence, Personal leadership: Leadership of self
intellectual stimulation, individualized con-
sideration, and inspirational motivation was Socrates said “Know thyself.” Without
examined in inpatient nurse managers to de- knowledgeofones’ownleadershiptraitsand
termine the impact of leadership characteris- behaviors, it is difficult to understand what
ticsonanticipatedturnoverofRNstaffnurses. gaps or complementary skill sets might be
Thetoolsusedtoassesstransformationallead- neededtocreateahighlyeffective leadership
ership characteristics were the Multi-Factor style. In this context, to “knowthyself”means
Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
LWW/NAQ NAQ200189 February 29, 2012 14:7
150 NURSING ADMINISTRATION QUARTERLY/APRIL–JUNE 2012
recognizinganddistinguishingbetweenwhat In addition to managerial partnerships,
you know and what you do not know. There mentorship and succession planning are key
are many assessment tools in the literature components of leadership in relation to oth-
that can adequately help nurse leaders assess ers. There are multiple leadership roles that
their skills and strengths, as well as personal- canbetakenonbothtoserveasamentorand
ity characteristics. Whether it is the Meyers- to create a system that supports succession
Briggs or some other assessment tool, hav- planning. For example, an individual nurse
ing data about personal leadership traits and executive can serve as a role model, could
behaviors is essential to being an effective demonstrate coaching behavior, or serve as
leader. aninformalmentor.Thedemonstrationofap-
preciation and recognition can range from in-
Professional leadership: Leadership in formal support to the creation and develop-
relation to others mentofmoreformalrecognitionprogramsin
organizations. The role of serving as a formal
6
Burns was the first theorist to link the mentor is a possibility that would assist the
traits and behaviors of a leader to those of next generation of nurse executives in plan-
the follower, and it was this partnership be- ning career transitions more carefully.
tween the two that is the basis for under-
standingleadershipinrelationtoothers.Lead- Professional leadership: Leadership in
ership of organizations takes place both in relation to systems
relation to others and in relation to the sys- The ultimate outcome of strong personal
tem.Oneofthemostinterestingperspectives leadership is the ability of the leader to work
about leadership of organizations in relation within a system to create transformational
to others is the concept of managerial part- change. This transformative power is un-
nerships. In “The Psychodynamics of Organi- leashed only through the partnership of the
14
zations,” Krantz shares the concept of the leader with the team, and moving large sys-
managerial partnership. Krantz suggests in- tems through change is critical to creating a
cluding the superior-subordinate relationship transformed practice environment. Nurse ex-
as a unit of analysis. He shares that both mem- ecutivesmustbecomeeffectivechangeagents
bers of the managerial couple must accom- and create a space where innovation can oc-
plish a job, but neither can control that job cur. We need to move to demonstrating ac-
individually. Therefore, each must trust each tual effectiveness through improved patient
other while coping with feelings of depen- and organizational outcomes based on lead-
dence on the other. Krantz suggests that the ership characteristics. It is no longer enough
managerialcoupleasaunitofanalysisisgener- to work within the system as it is; in health
ally underrepresented, understudied, and not care today, transformative changes need to
well understood. Krantz explains characteris- happen for the future requirements of qual-
tics of successful managerial couples, as well ity, cost, and service excellence. Nurse exec-
asfactorsthatinfluenceandimpactsuccessof utives must have the skills and capability to
this 2-person field within an organization. We transform the system, to take it to a place
knowthishasimplicationsfornursemanagers where it may not want to go. One system
and their effectiveness on improving patient change that many hospital nurse executives
outcomes. Only through a strong managerial have taken on is to transform their nursing
unit will shared objectives be achieved. This services through the process of the Magnet
should be a consideration in developing a re- Recognition journey.
search agenda within the world of nurse ex-
ecutives, and the often-times neglected role Becoming a transformational leader requires
of the number 2 spot in nursing executive thoughtfulness, inclusivity, good listening skills,
practice. flexibility, and resiliency. Whether convincing
Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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