Leadership Strategy



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In the scenario this week, there is concern that too many of the nursing home patients in my facility are being sent to the ER who really don’t necessarily need to be there.  Regardless of the kind of leadership style or strategy that works for someone, there are still many fundamental values that any leader should have.  The traits of a true leader include articulating a vision for the desired futures state, seeing possibilities during challenging circumstances, communicating effectively, adapting to changes, and using experience and knowledge to assess for risks (Yoder-Wise, 2018). 

Looking at this particular situation, I think it is essential to take it on a case-by-case basis.  Elderly patients may change their condition very fast from my experience working in Long-term care.  Extra triage education for nursing staff is also essential.  Since I have always seen myself as more of a transformational leader, it would be vital for me to get education started and be involved in questions as much as possible.  Transformational leadership is defined as a leadership approach that causes a change in individuals and social systems (2021).

Transformational leadership would be the most appropriate leadership style to implement a change to decrease the number of patients sent to the ER.  It will take an effective leader to educate staff without making them feel like they were wrong to send patients to the ER.  Using a triage system would be more effective than being unsure and sending them on intuition.

Lastly, an important part of being a leader in this situation is listening to the concerns of the staff.  Suppose there are underlying issues as to why the patients are being sent, or inadequate supplies to care for nursing home patients with certain conditions. In that case, it is important to identify that early.  Making changes within the facility is important to facilitate a change with what staffing decides to do with residents.


In scenario 1, the nurse manager is being told that he/she is sending too many of the residents to the hospital emergency room that don’t necessarily need to be there. Since this is a nursing home, we assume that the patients are elderly and not able to independently care for themselves. The Alzheimer’s residents probably do not even understand their chronic health conditions. Certainly none of these residents can be relied upon to manage their own medicines, symptoms, and knowledge of their disease processes. 

According to Wofford (2021). a democratic leader is collaborative. They encourage communication, involvement, and feedback. By focusing on team success, they encourage both professional and personal growth. A democratic leadership style would be the most appropriate for this scenario because a strong leader is needed to figure out why the nurses are sending patients to the hospital. The staff need to all work together to implement new processes. By encouraging the staff to work together, a democratic leader can brainstorm and problem solve with the team. 

Since the hospital believes there are too many residents getting sent to the ER, we must brainstorm on why this is happening and how to fix it. The staff nurses need education on criteria for ER trip vs. urgent care or call primary MD. Are there CHF patients that require daily weights? If a urinary tract infection is suspected, could the MD be called for a urinalysis instead of heading straight to the ER? There are many simple solutions that require the nurses to brainstorm and educate each other. By making a poster board and having monthly meetings, the hospital trips can be decreased significantly.

Leadership Strategy in Nursing

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Leadership Strategy in Nursing

The patients in the case scenario are highly dependent, meaning there is a need to ensure the patient-nurse ratio meets the need of the health institution. The leadership style that best suits the situation is servant leadership. The lack of family and social support for the patients means nurses have to apply a hands-on approach to seal gaps and inconsistencies. The inability of the patients to understand how to manage their medical condition means the nurse leader has to motivate nurses to action by being actively involved in the care of the patients to build resilience that will overlook the challenges associated with the department (Conway et al., 2021). The bottom-up empowerment approach of servant leadership enhances collaboration and quick decision making when caring for patients. Since the environment can be stressful for nurses, leaders will ensure the personal needs of the workers are taken care of and ensure the institution’s agility is not lost.

The 25 CHF patients’ personalized care can become obstacles to providing quality care if an institution has under-staffing challenges. Therefore, servant leadership will empower nurses by providing tools that enhance multi-tasking, and the agility of the institution is maintained. The leader should remain humble and remain authentic in building trust between employees. Continuous utilizing feedback to build collaboration and provide the needed resources will increase the effectiveness of the team (Conway et al., 2021; Hall, 2017). For example, if there is a need to introduce mandatory overtime in the team, it should have a purpose that will not overshadow the team’s effort. The people-focused culture the team will have will develop empathy and ensure the patients appreciate the nurses and understand they are essential for their well-being. Although the concept of servant leadership might be time-consuming to the team, it will build a dedicated team with the foresight and understanding of their resourcefulness.

The leader needs to listen and continuously validate the team’s challenges and present themselves as part of the team rather than an overseer. According to Conway et al., 2021 servant leadership plays a vital role in the success of caring theories due to the awareness and purpose it builds in a team. It also promotes intrinsic motivation than external motivation factors as employee satisfaction comes from the adaptability of the decentralized management system encouraged by the system (Hall, 2017; Conway et al., 2021). A servant leader should ensure the recruitment of nurses that fit the collaborative work culture of the department. If there is a need to mentor nurses to adapt to the strong mental fitness in the department, they should provide it. The mentorship can come in the form of an organizational development program or through a continuous assessment program. The department can easily expand if independence and efficient communication is continuously supported.

The democratic leadership style promotes procrastination and negative emotions; servant leadership enhances cohesiveness and teamwork. Democratic leadership style does not fit the pressure and high tempo working environment the department has (Demirhan, 2020). The major drawback of servant leadership is the high risk of physical and emotional draining as the process is continuous rather than a goal. The leaders can also be perceived as weak and lacking authority. Continuous involvement of the leader in the affairs of the employees can demotivate some employees leading to poor quality of healthcare.


Demirhan, B. S. (2020). The Effect of Leadership Behaviours of Nurse Managers on Nurses’ Work Motivation. International Journal of Caring Sciences, 13(1), 381-391.

Hall, H. (2017). Advancing future nursing executive practice: The evidence base for servant leadership in nursing.

Neville, K., Conway, K., Maglione, J., Connolly, K. A., Foley, M., & Re, S. (2021). Understanding Servant Leadership in Nursing: A Concept Analysis. International Journal for Human Caring.

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