5 Leadership Styles in Nursing

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A health care team holds a meeting.Nurse leadership can affect everything from staff morale to patient care quality, and specific leadership styles in nursing can have different impacts. By strategically choosing approaches to managing and guiding their staff, nurse leaders can achieve significant progress toward meeting and exceeding key nursing goals. This includes enhancing patient safety, improving health outcomes, and curbing nurse burnout.

Nurse leaders who strive to empower their teams to deliver top-notch care can benefit from exploring different leadership styles. Additionally, pursuing an BSN to DNP online can equip nurses with invaluable leadership skills.

What Are Leadership Styles and Why Do They Matter?

Leadership styles refer to the behavioral approaches nurse leaders use to coordinate, inspire, and guide their teams. These different approaches affect how nurse leaders implement plans, make decisions, and manage their professional relationships.

Whether a nurse practitioner or a chief nursing officer, leaders in the profession need to effectively mobilize and cultivate their teams. How nurse leaders communicate and build relationships with their teams can determine the speed, quality, and efficiency of care delivered by a nursing team. It can also affect the extent to which direct reports feel sufficiently supported to complete their work well, develop professionally, and receive recognition for their accomplishments.

For these reasons, it’s vital that nurses mindfully choose leadership styles that best motivate and guide their teams, and empower them to provide patients with the highest standard of care.

Types of Leadership Styles in Nursing

Nurses can select from any number of leadership styles. No singular approach to leadership, however, necessarily serves every situation. Various styles can prove more or less effective, depending on the demands and specific circumstances of a given situation or environment. For example, a leadership style appropriate for managing recent nursing school graduates might be less effective with a group of veteran clinicians.

It’s also worth noting that nurses’ leadership styles often combine elements of people’s personalities and experiences. Consider the following types of leadership styles in nursing, along with the potential strengths and limitations of each.


Transformational nurse leaders start with a clear vision and purpose. They use this vision to inspire their teams into action. This involves helping each team member discover how they can uniquely contribute to the realization of that vision.

Instead of simply delivering directives about what needs changing, transformational leaders seek out ways to show nurses what’s not working. They then focus on teaching their teams how to problem-solve and think for themselves. Transformational leaders motivate nurses by modeling integrity and fairness. Encouragement, support, and clear goal setting also characterize the transformational leadership style.

Under transformational leadership, nurses often outperform expectations. The excellent rapport transformational nurse leaders tend to build often results in high morale among nursing teams. High morale improves job satisfaction and work performance, which in turn contributes to fewer errors in patient care and improved patient safety. A recent study published in BMC Health Services Research noted that transformational nurse leadership can help create and sustain cultures of patient safety, as well as cultivate positive nurse work environments.

As the name implies, transformational leadership is designed to effect change in an organization. If not managed carefully, however, change can create confusion, disrupt systems, and lead to disorder. For this reason, transformational nurse leaders need to thoughtfully consider how and when they implement changes.


Servant leadership focuses on nurturing and protecting the well-being of nurses, backed by the belief that healthy, empowered nurses deliver the best patient care. Servant leaders use encouragement as a key tool, and prioritize the personal and professional growth and fulfillment of their teams.

Humility and a desire to serve characterize servant leaders who demonstrate empathy to their direct reports and a commitment to community building. This approach helps cultivate collaboration and makes individual nurses feel valued.

Servant nurse leaders regularly ask their teams what resources and help they need to solve their problems. This communication can enable servant leaders to quickly identify and address issues such as nurse burnout, ineffective nursing practices, and other pressing issues.

In servant leadership, mentorship and support of the whole team take precedence over the elevation of any one individual. As such, servant leaders are able to build trust and earn the respect of the nurses they oversee. This approach works especially well for managing interdisciplinary teams.

However, servant leadership can have drawbacks. It may not sufficiently support underperforming teams that need collective direction to improve. Additionally, servant leadership does not make it easy to implement top-down decisions or quickly align nursing teams.


The laissez-faire leadership style in nursing refers to a hands-off approach to managing teams. Typically, laissez-faire leaders offer limited feedback and give minimal direction to their staff. As such, the direct reports of laissez-faire nurse leaders have a great deal of responsibility when it comes to setting work goals and priorities and handling problems. Simultaneously, laissez-faire leadership gives nurses great freedom to work as they see fit.

Highly experienced and well-functioning teams may thrive under laissez-faire leadership, as it allows them to work according to their preferences. It can also eliminate micromanagement and empower nurses to take more ownership of their work. Additionally, a laissez-faire style can communicate to teams that their leaders have great confidence in their abilities. This can motivate nurses and make them feel valued.

While laissez-faire leadership can benefit some veteran nursing teams, many nurses, especially those newer to the profession, may struggle to find their way or resolve problems under this approach. Additionally, laissez-faire leadership may prove counterproductive in emergency situations that require quick decision-making and cohesive teamwork.


Autocratic leaders use a top-down management approach. They infrequently ask for input when making decisions and may not share information with their teams. Additionally, they don’t necessarily delegate responsibilities. Autocratic nurse leaders dictate the practices and processes their teams use, and tend to create highly structured work environments with clearly established rules.

In nursing, autocratic leadership can work well in emergency situations that demand quick decision-making. Its use can make sense when trying to ensure adherence to protocols such as surgical timeouts, designed to prevent unacceptable mistakes. The practice of surgical timeouts, for example, requires operating team members to confirm patient identity, surgical site, and procedure before making the first incision.

Though an autocratic style may have some useful applications, its general adoption can present problems. Autocratic leadership, by its very definition, fails to tap into the knowledge and insights of individual nurses. Autocratic leadership also shows little tolerance for mistakes. This can lead to poor transparency, making safety and quality issues harder to identify and address.

Additionally, autocratic leadership can result in problems such as presenteeism, in which nurses feel pressure to report to work while ill. A recent study published in BMC Nursing noted a correlation between autocratic nurse leaders and presenteeism, an issue that can result in increased nurse burnout and poor work performance.


Democratic leaders value the input of all team members in the decision-making process. As such, nurses using this leadership style encourage their charges to weigh in with ideas, voice concerns, and express opinions on a regular basis. For example, democratic nurse leaders may invite their teams to discuss best practices for onboarding new hires, strategies for implementing the latest technology, and problems with staffing shortages.

Democratic leadership style in nursing emphasizes communication and transparency, which can lead to better patient care through more effective collaboration and a greater ability to identify and fix problems. In line with this thinking, democratic nurse leaders openly share information with their teams. They also delegate decisions and responsibilities. These actions can build trust and help team members feel appreciated and respected.

Responding to the ongoing need for process improvement in health care often calls for teamwork. Since democratic leadership tends to nurture collaboration and encourage active participation, it works well for accomplishing this task and others in nursing that demand teamwork. Additionally, democratic leaders foster environments that make it possible for all team members to contribute. This can help raise the standard of care nursing teams deliver.

In some situations, democratic leadership can hinder a nursing team. Urgent situations that call for a rapid response don’t necessarily allow democratic leaders time to gather everyone’s input. Democratic nurse leaders who are overly reliant on their team’s feedback may struggle to act decisively in emergencies.

Discover How Effective Nurse Leaders Leverage Leadership Styles to Succeed

Understanding the different leadership styles in nursing — and when to put them into practice — empowers nurse leaders and their teams to deliver quality care. With the right education, effective nurse leaders can fine-tune the necessary skills to influence those under their charge to perform their best.

Discover how the Regis College online BSN to DNP program can equip you with the tools to be a nurse leader.

Recommended Readings

Adult Gerontology Acute Care vs. Primary Care: Comparing Two Specializations

How Holistic Care Is Used in Nursing

Nursing Leadership Roles for DNP Graduates


BMC Health Services Research, “The Role of Transformational Leadership, Job Demands and Job Resources for Patient Safety Culture in Norwegian Nursing Homes: A Cross-Sectional Study”

BMC Nursing, “Authoritarian Leadership and Nurse Presenteeism: The Role of Workload and Leader Identification

CFI, Leadership Styles

Creative Nursing, “The Effect of Nurses’ Leadership Behavior on the Quality of Nursing Care and Patient Outcomes”

Frontiers in Psychiatry, “Presenteeism in Nurses: Prevalence, Consequences, and Causes from the Perspectives of Nurses and Chief Nurses”

HealthManagement.org, “Nursing Leadership Practices and Patient Outcomes”

HealthStream, “Defining and Experiencing Good Nursing Leadership”

HealthStream, “How Leadership Styles in Healthcare Impact a Staff”

HubSpot, “Leadership Styles: The 11 Most Common & How to Find Your Style”

Indeed, “7 Leadership Styles in Nursing: Their Importance and Impact”

Indeed, “Common Weaknesses of Transformational Leadership and How to Avoid Them”

International Journal of Environmental Research and Public Health, “Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review”

IPS Interdisciplinary Journal of Social Sciences, “Nursing Leadership in Healthcare: The Impact of Effective Nurse Leadership on Quality Healthcare Outcomes”

The National Society of Leadership and Success, “Key Characteristics of Democratic Leadership”

Practice Nursing, “Is There a Place for Servant Leadership in Nursing?”

Relias, “5 Leadership Styles In Nursing”

Relias, “Characteristics and Examples of Transformational Leadership in Nursing”

Symplr, “How Nurse Leaders Drive Change and Affect Strategic Goals”