Different leadership styles in nursing

Written by sandy keefe
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A nurse leader may be a nurse manager, responsible for one nursing unit, or a nurse executive, responsible for all in-patient nursing units. Rather than choosing just one leadership style, an outstanding nurse leader typically uses multiple styles depending on the situations she's facing.


There are two basic leadership styles: permissive and autocratic. These styles can be further broken down into subcategories. A nurse leader who is a permissive democrat, for example, engages his nurses in decision-making and allows them to work independently. A directive autocrat, on the other hand, gives instructions without seeking input and supervises his nurses closely.

Situational Leadership

An experienced nurse leader chooses the leadership style that works best in any given situation. For example, she may act as a permissive democrat when it's time to buy new equipment for her unit. She can arrange to purchase the equipment the nurses want and then allow them to use it independently. When there's an emergency Code Blue, on the other hand, she may be a directive autocrat who gives instructions unilaterally to less experienced nurses while she closely supervises their work.


A nurse leader may alter his leadership style based on the age and experience level of his nurses. Veterans, nurses born before 1943, like to share their hard-earned expertise but don't want or need close supervision. On the other hand, younger and less experienced Generation Y nurses may benefit from close monitoring along with plenty of guidance and feedback.


When a nurse graduates from school and earns his RN license, he generally has basic leadership skills to apply to direct patient care. As he advances to charge nurse, nurse manager and, ultimately, nurse executive, he'll need to learn more about leadership. There are courses available through colleges and universities, professional education companies and hospitals. It's important for a nurse to seek advice and mentoring from a more senior nurse leader who can provide honest feedback about his leadership style.


Nursing has trended toward a shared governance model of management that involves nurses in decisions affecting their practice. In that model, a nurse manager uses a permissive democrat style, encouraging her nurses to actively participate in clinical decision-making and monitor their patient outcomes. The nurse executive, in turn, uses the same style to establish nursing councils with representation from staff nurses.

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