Patient outcomes are dependent on several different factors, including the quality of care delivered to the patients, the experience and diagnosis of the physician, the severity of the patient's illness/condition and the quality of nursing care provided to the patient. In other words, the entire healthcare team plays a role in a patient's successful recovery.
The nurse-patient relationship has always been an important dynamic in healthcare. The quality of care provided by nurses helps promote patient-centred care. There is sufficient evidence to show that a good nurse-patient relationship reduces the number of days a patient spends in the hospital and plays a major role in patient satisfaction.
Hence, good nursing practice is crucial for high-quality care. And nursing practice more likely to be effective if nurses are led by effective nurse leaders. There is no doubt that nurse leaders often need to make strategic decisions that can influence the patient's overall condition and satisfaction. In addition, nurse leaders are involved in several areas of patient care, including staffing, patient flow, quality improvement activities and overall care delivery.
While nursing activities must be based on providing the best possible care to the patient, the quality of the nursing practice is highly influenced by the leadership styles in nursing. There are different nursing leadership styles, some of which include:
Task-oriented leadership
A task-oriented approach to leadership is designed to achieve common goals. The primary focus of nurse leaders following this approach is on structures and tasks. In particular, task-oriented leadership would require nurse leaders to clearly define the role of everyone in the team, establish clear lines of communication, monitor the achievement and progress of each task and provide direction and clarification as and when needed.
Relational oriented leadership
This is a leadership approach that focuses on people and building relationships. The primary focus of nurse leadership following this approach is to ensure everyone is well respected and that good work is rewarded and appreciated. In addition, all members are made to feel part of a team and have the necessary support and guidance from their nurse leader. The theory is that leaders who follow this approach are more successful at motivating team members to go above and beyond their assigned goals.
Autocratic leadership
This type of leadership style does not take any input from team members. The primary objective is to delegate tasks, give directions and get results. While this leadership style may fulfill everyday tasks, it fails at building team camaraderie and trust.
Transformational leadership
Nurses who follow the transformational leadership style consider their nursing team to be the core of their nursing practice. Transformational nurse leaders have a long-term vision and are committed to building teams that are engaged and motivated. The goal is not only to get tasks done but to improve overall patient care and outcomes.
Whatever leadership style is adopted, the ultimate objective is to ensure the best patient outcomes. This would include patient mortality, patient safety, the minimum incidence of medical errors and adverse events, patient satisfaction, and length of hospital stay. Transformational leadership, in particular, is strongly associated with improved patient outcomes - specifically in terms of reduction of adverse events, medication errors, staff expertise, turnover, absenteeism, overtime and nurse to patient ratios. Hence, effective nursing leadership is critical to creating an effective nursing work environment and improving patient outcomes.
Despite the impact of nursing care on patient outcomes, nurses continue to be underrepresented in leadership roles. They are generally viewed as functional doers and not as partners in a patient's care journey. This is slowly changing as growing evidence demonstrates that effective nursing leadership practices in a clinical setting can directly impact patient safety, quality of care, and patient outcomes. The National Academy of Medicine also recommends that healthcare systems should expand leadership opportunities for nurses beyond that of a shift manager and utilise the potential of nurse leaders by allowing them to become clinical leaders, directors of nursing, and healthcare team leaders. Nurse leaders can contribute to improving patient care as they can influence the direction of patient care.
Overall, it is safe to conclude that effective nursing leadership can improve the overall quality of care and increase patient satisfaction. Nurses can function as both leaders and managers and are usually effective in these roles because they are constantly involved in making functional decisions that directly impact a patient's health. Therefore, patient outcomes are strongly related to the leadership style of nurse managers.
