Nursing Leadership Paper

Nursing Leadership Paper



Case Study: Tom Johnson

The case study is about Tom Johnson, who was a nurse manager at a 12-bed capacity unit that was later merged under a 39-bed telemetry unit that was managed by another nurse manager. Tom is to step down from his position as the other manager will be the administrator of the new larger unit. Frustration has grown among nurses in Tom’s unit, and Tom’s morale has also deteriorated. Therefore, he wants to leave his position and leave the unit on a positive note. Various leadership concepts have been demonstrated in this facility, and the consequences have been evidenced in the nurses’ reactions.

Leadership Styles to Improve Positive Outcomes in the New Unit

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The nurse manager in the new larger units will have challenges in promoting a positive work environment. There are various nursing leadership styles that the new nurse manager would use to avert the impending situation in the larger merged unit. Following this merger, the new nurse manager will face higher nurse turnover, demoralized nurses, and demotivated nursing staff. Transformational leadership style would be an appropriate nursing leadership style the new manager would adapt to improve the outcomes of nursing care to patients. The transformational leadership style is visionary and promotes the building of relationships (Collins et al., 2020). Transformational leadership is based on collective nursing care change, the inspiration of other team members, and the motivation of team members (Collins et al., 2020). A transformational nurse leader, therefore, includes their subjects in the goal setting and shared outcomes of care. The new nurse manager will need to analyze and understand the prevailing situation and plan for the change outcomes for the new unit.

Transformational leadership has various strengths, some of which will help the new manager maneuver through building relationships and improve patient outcomes. Nursing job satisfaction is directly proportional to the patient’s care satisfaction (Specchia et al., 2021; De Simone et al., 2018) which is one of the determinants of quality of care. Transformational leadership improves staff motivations through inspirational leadership (Texas A&M International University, 2021). This boosts staff morale and satisfaction with the job and reduces the nurse turnover seen in the 39-bed unit. The organization aims at improving stability in the unit by promoting the merger. The incoming new nurses will require mentoring and guidance. Transformational leadership will instill trust between the nurse manager and new nurses, enable mentoring and inspiring new nurses, help in building their confidence (Aspen University, 2021). Therefore, transformational leadership is an ideal style that the new manager may adopt to improve care outcomes.

Impact of Tom’s Attitude

Tom’s attitude may impact the turnover of the nurses in the current unit before the merger. His current attitude has impacted the motivation of the unit’s nurses. Their demoralization has led to some nurses in tom’s unit handing over transfer requests before the merge. There are nurses in his unit that were loyal to him and agreed with his leadership styles. The 39-bed unit is known for high nurse turnover. In addition to Tom’s current influence and his decision to quit the unit, the big change move may not be successful because of the behavior of Tom’s unit nurses. His quitting of his position as a leader and as a nurse in the organization may cause the turnover of most of the current nurses in his unit.

Alternative Leadership Styles and Strategies

Authentic leadership and resonant leadership are some of the other leadership styles that would apply to the current situation. An authentic leadership uses a direct approach to ensure decision-making coordinate care. An authentic nurse leader will incorporate nurse staff viewpoints and utilize open communication to ensure nursing leadership. Resonant leadership utilizes emotional intelligence to influence the team and individual activity. By understanding the incoming nurses’ psychological reasons for demoralization, a resonant leader will utilize their cognition and behavior to engorges team participation.  Leadership strategies that would be positive in Tom’s situation will include but are not limited to self-efficacy, emotional intelligence, team engagement, and employee satisfaction (De Simone et al., 2018). These strategies will ensure that the new unit retains more nurses and ensures that the current nurses work towards a shared objective and improve patient care as a team. Effective communication between them will be paramount. Authoritarian and transactional leadership strategies will not be successful in this situation. The new nurses will require guidance and motivation. Therefore, their participation through reward and punishment methods will not be necessary.

Change Theory

The change theory in nursing describes three aspects of change: driving forces, equilibrium, and restraining forces. The driving forces drive care towards the direction of change while restraining forces counter their effects. To implement change in nursing, the driving forces must overcome the restraining forces to shift the equilibrium towards the direction of the change (Nursing Theory, 2019). In Tom’s case, the restraining forces include lack of motivation and demoralization of staff. To overcome these forces, I would implement teamwork through communication among team members to change the culture of nurse turnover. Establishing the new habit of teamwork would require that new nurses and current nurses in the 39-bed unit would require unfreezing the preexisting cultures.


The merging of Tom’s unit and the other unit is inevitable. Its impact on the unit’s staff morale would impact the success of the change. A change model would require unfreezing the current culture before creating a new unit culture of teamwork and communication. The transformational leaderish style would be the most advisable leadership strategy.



Aspen University. (2021, January 13). 7 leadership styles in nursing: How do they impact you? Aspen University.

Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nursing Standard (Royal College of Nursing (Great Britain): 1987)35(5), 59–66.

De Simone, S., Planta, A., & Cicotto, G. (2018). The role of job satisfaction, work engagement, self-efficacy, and agentic capacities on nurses’ turnover intention and patient satisfaction. Applied Nursing Research: ANR39, 130–140.

Nursing Theory. (2019, August 13). Lewin’s change theory. Nursing-Theory.Org.

Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership styles and nurses’ job satisfaction. Results of a systematic review. International Journal of Environmental Research and Public Health18(4), 1552.

Texas A&M International University. (2021, September 14). Transformational leadership in healthcare. Texas A&M International University Online.

Case Study #1

Read the case information below:

Tom Johnson is the manager in charge of a 12-bed step-down unit in the Bay Area Community Hospital. Bay Area’s hospital administration is down-sizing and the stepdown unit is moving to a telemetry floor that has 39 beds. In six months, this full transition is to be completed. Tom has been informed that the nurse manager of the telemetry floor will remain the administrative leader. Tom’s position will no longer exist. The staff, who have been very supportive and loyal to Tom, are angry about the change and many have requested transfers to other floors. For several years, the 39 bed telemetry unit has had high staff turnover and high use of agency nurses. The administration believes that this down-sizing plan and transition of nursing staff to the 39 bed unit would lead to a more stable nurse staffing for the larger unit. The morale on Tom’s unit continues to deteriorate, and Tom is worried that patient care will be affected and family members may hear the negative discussions that have increased in recent weeks. As a nurse leader at this hospital, Tom wants to leave this position and close the 12 bed unit on a positive note.

  1. Discuss the leadership style and strengths that the nurse manager of the 39 bed unit will require to make a positive work environment for the patients, families and staff.
  2. How can the attitude of Tom related to this big change affect the success of the move? Explain
  3. Discuss two different leadership styles and how that style would approach this change situation?
  4. What leadership strategies do you think would be positive in this situation? Explain.
  5. Which leadership strategies do you think would not be successful in this change situation.
  6. Discuss change theory and the steps to implement a significant change. How do you motivate staff to change as a leader?




Please complete this assignment in paragraph format, thoroughly explain and supporting your answers to each question. This assignment should be between 750-1000 words, excluding references. The case study should have a minimum of 2 scholarly sources in addition to the textbook. APA 7th edition formatting should be used for writing, citations and references. Please include a title page.


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