Exploring Leadership Styles in Nursing: Strengths, Challenges, and Best Practices

It’s no secret that leadership can make or break an organization or team. Leadership development is a growing concern in healthcare, and in nursing specifically, leadership styles should be given special consideration. How a nurse chooses to lead their team directly influences team performance, organizational success, and, ultimately, patient outcomes. 

Across developed nations, nurses account for 37% of a hospital’s staff and are typically set squarely at the intersection of patient care, team efficiency, and treatment execution. With so many hands in so many pots, the way nurses approach leadership will affect the success of their hospital or clinic. Let’s take a closer look at these different leadership styles to discover how they empower nurses to lead with confidence and create better outcomes for teams and patients.

The 7 Most Common Leadership Styles in Nursing

Nursing leadership requires flexibility, empathy, and strategic thinking. Every leadership role has its own strengths and challenges, so understanding and developing your approach based on your personality, strengths, and team needs is crucial.

Here are the seven most common types of leadership styles in nursing:

1. Transformational Leadership

Transformational leaders in nursing focus on inspiration and personal growth. This type of leader motivates their teams to exceed expectations by creating a compelling vision of the end goal: patient wellness and healthcare excellence. They must deeply invest in their team members as individuals to spur development, mentoring them to see beyond their current capabilities and strive for continuous improvement.

Strengths

• Promotes innovation and creative problem-solving
• Builds strong, motivated, and engaged teams
• Encourages personal and professional development
• Creates a positive and supportive work environment

Challenges

• Requires significant emotional and mental energy
• May lead to leader burnout due to said emotional investment
• Can be difficult to maintain consistency across large healthcare teams
• May not be effective in emergency situations

2. Transactional Leadership

Transactional leaders operate on a system of clear expectations, rewards, and consequences. Nursing leaders using this approach establish clear, specific goals, protocols, and performance metrics. They focus on maintaining order, ensuring compliance with established procedures, and providing direct feedback based on measurable outcomes.

Strengths

• Provides clear performance expectations and accountability
• Establishes consistent standards of patient care
• Simplifies performance evaluation processes
• Reduces ambiguity in role responsibilities

Challenges

• Can stifle creativity and individual initiative
• May create a rigid work environment
• Potentially demotivating for self-driven professionals
• Limits adaptability in complex healthcare scenarios

3. Democratic Leadership

Democratic leaders in nursing emphasize collaborative decision-making and team input. These leaders actively seek new perspectives from their team members, creating a sense of shared responsibility and collective ownership of patient care strategies. They appreciate open communication and believe that diverse viewpoints lead to better healthcare solutions.

Strengths

• Increases team engagement and job satisfaction
• Promotes open communication and mutual respect
• Values collective expertise and individual perspective
• Enhances ownership of each team member’s role

Challenges

• Can slow down decision-making processes
• May create challenges in time-sensitive medical situations
• Can cause decision-making paralysis during critical moments
• Requires significant time, communication, and coordination

4. Laissez-Faire Leadership

Laissez-faire leaders provide maximum autonomy and self-actualization to nursing professionals. These hands-off leaders trust their team members’ expertise and deliberately shy away from direct supervision. The laissez-faire leadership style works best with highly skilled, self-motivated teams who value lifelong learning, require minimal guidance, and can operate effectively without much intervention.

Strengths

• Empowers experienced professionals
• Allows for maximum individual creativity
• Reduces micromanagement with a hands-off approach
• Supports continuous learning through independent problem-solving

Challenges

• Can lead to a lack of accountability
• May result in inconsistent patient care
• Can create confusion about duties and expectations
• Team members may feel unsupported

5. Servant Leadership

Servant leaders prioritize the growth, well-being, and development of their team members. Nursing leaders who wish to adopt this approach must focus on supporting their colleagues and staff, removing obstacles, and creating environments where individuals can thrive professionally and personally.

Strengths

• Builds strong, supportive team relationships
• Promotes individual and collective professional growth
• Creates a compassionate workplace culture
• Enhances team member satisfaction and retention

Challenges

• Requires significant energy and can lead to burnout
• Can result in leaders putting others’ professional development above their own
• May blur personal and professional boundaries 
• May be perceived as less authoritative

6. Autocratic Leadership

Autocratic leaders provide direct, decisive direction with minimal team input. In nursing, this approach is particularly useful during emergencies or high-stakes situations that require immediate action. Leaders must make quick decisions and expect their team members to follow directions to the letter.

Strengths

• Allows for rapid decision-making
• Critical in emergency and high-risk scenarios
• Provides clear direction during complicated situations
• Ensures consistent adherence to established protocols

Challenges

• Can hurt team morale
• Reduces team member engagement
• Limits creative problem-solving
• May lead to a fear-based work environment

7. Situational Leadership

Situational leaders are the most adaptive and willing to modify their style based on specific circumstances and their team members’ capabilities. These leaders recognize that effective management requires flexibility and a nuanced understanding of the needs of team members, patients, and the hospital itself.

Strengths

• Maximizes adaptability in diverse healthcare environments
• Recognizes individual team member capabilities and contributions
• Allows for personalized leadership
• Supports continuous team development

Challenges

• Requires exceptional interpersonal skills
• Can be mentally and emotionally exhausting
• Demands constant assessment and adjustment
• Potentially creates inconsistent team experiences or expectations

How To Identify Your Leadership Style as a Nurse

Self-awareness is the foundation of effective leadership. Some people are natural leaders, while others have to consciously work toward becoming one. However, with the right tools, anyone can learn how to positively influence the people around them and direct their team with aptitude and conviction. 

Nurses can begin identifying their leadership style by reflecting on past interactions, seeking feedback from colleagues, and honestly assessing their natural tendencies. Personal values, professional experiences, and individual strengths will play a significant role in uncovering what kind of leader you are, or what areas you need to focus on to become the leader you want to be.

Since 1995, PsychCentral, now a part of Healthline, has been a hub for mental health information and news. Their free Leadership Style Test can help you find the approach to leadership that is best suited to your personality and strengths. However, no simple test can give you a definitive, irrevocable answer. Instead, these tests highlight tendencies or the most dominant parts of your leadership style as it is today. Therefore, treat them as a guide, and let your own intuition and goals help you to construct and execute the leadership style you want that will best serve your team.

The Impact of Leadership Styles on Patient Care and Nursing Teams

Research demonstrates a direct correlation between nursing leadership styles and patient outcomes. Specifically, a 2023 study by Marja Hult et al. reviewed organizational and patient outcomes based on relational leadership (like transformational, service, and situational leadership), task-oriented leadership (transactional leadership), passive leadership (laissez-faire and democratic leadership), and destructive leadership (authoritarian leadership).  

Relational leadership showed better patient outcomes, especially with respect to patient satisfaction, perceived quality of care, and perceived safety and comfort. This leadership style also increased staff members’ intent to stay, thereby decreasing turnover for new nurses. Knowing how your leadership style affects your staff is important in creating a constructive work environment and highlighting areas for your own self-improvement. 

Essential Skills to Becoming a Successful Nursing Leader

Becoming an effective nursing leader requires more than clinical expertise. Success in leadership comes from developing interpersonal, cognitive, and emotional capabilities that both work within and extend beyond traditional medical training. Nursing leaders must nurture and grow essential qualities and skills that allow them to balance patient care, team management, organizational objectives, and their own personal and professional growth. These leadership skills include:

• Communication: Effective communication goes beyond sharing information — it’s about building trust, fostering clarity, and creating mutual understanding among team members and patients. Exceptional nurse leaders listen actively, express themselves clearly, and ensure everyone feels heard.
• Emotional Intelligence: Being able to read the emotional energy in a room or within an individual allows nursing leaders to approach their team with empathy and strategic insight. By managing emotional dynamics thoughtfully, nurse leaders create stronger, more supportive healthcare environments that encourage resilience and collaboration.
• Conflict Resolution: Even under the best leadership, conflict will occur. The way you resolve conflict is what matters most, especially in high-stress medical settings. Successful nursing leaders should develop strategies to address disagreements constructively in a way that maintains team camaraderie and remains centered on patient care.
• Delegation: Effective delegation involves strategically distributing responsibilities while maintaining accountability. Great leaders recognize each team member’s strengths and assign tasks that align with their expertise while also providing opportunities to develop new skills and foster professional growth.
• Critical Thinking: Logic-driven reasoning is essential for making rapid, accurate decisions in hospitals and healthcare organizations. Nursing leaders should focus on consistently analyzing complex situations objectively and making informed choices that prioritize patient safety.

Adapting Your Leadership Style to Evolving Healthcare Needs

Healthcare is constantly changing, requiring flexible and adaptive leadership. Successful nursing leaders prioritize continuous learning by attending conferences, participating in professional organizations, and networking with peers to stay current with emerging best practices and technologies. At HealthStream, we work with healthcare organizations to create high-quality training videos and continuing education resources to help make sure your team is always learning and growing – no matter which management style you choose.

How HealthStream Can Help Your Nursing Management Develop Their Leadership Styles

At HealthStream, our team is dedicated to developing proprietary medical software and providing comprehensive support for nursing leadership development, designed to drive meaningful change in organizations. Our videos, analytic software, and educational resources help healthcare professionals understand, refine, and implement effective leadership strategies.

Through personalized training modules, real-time reporting, and evidence-based research, HealthStream provides nursing staff leaders with the tools necessary to excel in an ever-changing healthcare environment. Wherever you are in your leadership journey, HealthStream is here to help. Contact us today and see how our software and training resources can make a difference for you and your team.