Leadership Theories in Practice

Response to Tonjalia

Many names come to mind when I think of leaders and what they exemplify. So, the creative part of my brain wants to box the role of leaders into this form-fitting image that I’ve created, but reality presents something different. I took some time while writing this discussion post to think about leaders that have paved the wave within healthcare. Not only does that list go on forever, but the thought of what they’ve accomplished encourages me as a follower. Leadership is critical in healthcare, especially if we want to improve population health (Broome & Marshall, 2021). Every leader is fundamentally different in managing, therefore creating foundational theories for self-identification. The vital component in healthcare leadership is constructing an environment or culture that promotes job satisfaction (Broome & Marshall, 2021).

Two scholarly resources evaluated the impact of leadership behaviors in creating healthy work environments, “Hotels’ Environmental Leadership and Employees’ Organizational Citizenship Behavior” and “Good for Nurses, Good for Patients”: Creating a Healthy Work Environment in a Pediatric Acute Care Setting.” Both articles were interesting in pointing out essential factors that establish leadership styles and behaviors. Two key insights identified were proactive behaviors in taking direct initiation and not reacting. They also established repours by communicating and building relationships with their employees (Broom & Marshall, 2021). For example, “Good for Nurses, Good for Patients” assessed bullying on several of their units and developed a plan to promote awareness, education, and interventional strategies. The evaluation of the study identified that their pro-activeness rather than reacting was a success. Disorganization within an organization requires a favorable environment (Sarik et al., 2019). In “Hotels’ Environmental Leadership and Employees’ Organizational Citizenship Behavior,” communication in building relationships was established by leadership with their associates that work in the hotel industry, encouraging and promoting influential behaviors and providing available resources to evaluate the effectiveness of the environment. The article identifies the communication and relationship building they built with their staff. Motivation is a natural element that influences behavior (Kim, 2020). For example, leadership initiated green practices (towel re-usage, recycling), increasing customer satisfaction. With their encouragement through consistent communication and incorporating practices in the organization’s policy, the result was to identify the employee’s behavior. Therefore, continuing to promote the positive environment leadership initially created. Within this development, it establishes relationships with leadership and the employees.

Those characteristics grasped my attention right away because of a current director that exemplifies those same behaviors. My current director is consistently at the forefront of all of her associates. She has a downline staff of over 125 employees and makes time to show up at least once a month during monthly meetings to hear the associates out, advises their direct outreach if needed, schedules random quarterly one on one’s, and schedules face to face monthly engagement activities. She believes in building consistent relationships with all of her downlines. The associates appreciate her direct communication consistently, and they began to feel that upper management cares that their well-being and opinions matter. Her strategy produced a positive work environment for all case management teams, reflected in our yearly regional survey result. For five years, our region ranked first or second in customer and employee satisfaction.

There was an opportunity to react to a situation involving the organization’s president. Our region has a direct mailbox (email) in which any internal or external entities can make outreach. Only one case management nurse knows how to coordinate the work within. There was an email that was sent from the corporate office. Per our process, any emails of this nature are immediately reported to the director. The nurse didn’t comply with the policy and replied to the department with incorrect information. Instead of reacting, my director pro-actively gathered resources to reeducate the staff in following the correct process and revamped the original policy that reflected precise instructions. This strategy created a check and balance system that was positive. Therefore, never occurring again. Instead of the nurse working all incoming emails in the mailbox, non-clinical staff was assigned to sort and use a color-coding system per urgency. Any urgent case management matters were immediately reported, including their manager, nurse working the mailbox, and the nurse’s manager. The managers were to notify the director for correspondence and alter the email per the manager’s color-coding system that tells all completed steps. Changing the policy for efficiency made the associates involved in this process comfortable and decreased anxiety overall.

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Leadership matters and is essential for all organizations.


Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.

Kim, W. G., McGinley, S., Choi, H.-M., & Agmapisarn, C. (2020). Hotels’ environmental leadership and employees’ organizational citizenship behavior. International Journal of Hospitality Management, 87. https://doi.org/10.1016/j.ijhm.2019.102375

Sarik, D. A., Thompson, R., Cordo, J., Nieves Roldan, I., & Gonzalez, J. L. (2020). Good for Nurses, Good for Patients: Creating a Healthy Work Environment in a Pediatric Acute Care Setting. Nurse Leader, 18(1), 30–34. https://doi.org/10.1016/j.mnl.2019.11.005

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Leadership Theories in Practice: Response to Tonjalia

Your description of the concept of leadership within your organization and with reference to your own experiences is indeed vivid. I agree totally that leadership is essential in organizations, and especially in healthcare organizations that have to guard patient safety. Indeed, it is only good leadership that can achieve the goal of promoting population health by healthcare organizations. As a matter of fact, every leader is different in their own way in how they manage and interact with their followers and subordinates. This is what you state and it is quite true. I would like to point out at this juncture that two leadership theories most cited are transformational leadership theory (Northouse, 2019), and trait theory of leadership (Swan, 2016).

I very much agree also with your observation that leadership within healthcare organizations is all about creating a positive work environment that promotes job satisfaction. This is what has been referred to as transformational leadership (Broome & Marshall, 2021; Choi et al., 2016). A transformational leader motivates, empowers, and uplifts their subordinates. This is how a welcoming and psychologically safe work environment is created ensuring employees feel loved and appreciated. You present two scholarly sources about this subject and I note that one of them directly addresses the issue of the creation of a healthy work environment by the leader. That is exactly what a transformational leader does.

It is very uplifting to learn that one of your leaders (director) at your organization with 125 employees directly under her is a transformational leader in the true sense of the word. You state clearly that despite being a director she finds time to listen to her subordinates and also see them face-to-face to listen to their grievances and concerns. The other thing you say is that she is a good communicator and adept at creating long-lasting interpersonal relationships. And true to the power of transformational leadership, her efforts have made your organization rank tops in terms of employee satisfaction. That is something to be proud of.


Broome, M., & Marshall, E.S. (2021). Transformational leadership in nursing: From expert clinician to influential leader, 3rd ed. Springer.

Choi, S.L., Goh, C.F., Adam, M.B.H., & Tan, O.K. (2016). Transformational leadership, empowerment, and job satisfaction: The mediating role of employee empowerment. Human Resources for Health, 14(1), 73. https://doi.org/10.1186/s12960-016-0171-2

Northouse, P.G. (2019). Leadership: Theory and practice. 8th ed. Sage Publications, Inc.

Swan, W. (2016). Trait theory of leadership. Springer International Publishing AG, 1-4. https://doi.org/10.1007/978-3-319-31816-5_1909-1