The U.S. healthcare system is facing significant challenges today, such as staff shortages, aging populations, increased chronic illnesses and comorbidities, the Covid-19 pandemic, an opioid crisis, and financial instability (Broome & Marshall, 2021). In these pressing times, healthcare leaders can prove to be invaluable or superfluous, depending on the leadership qualities they possess. Broome & Marshall (2021) mention the following qualities of a transformational leader: respect for others, beneficence, truthfulness, assertiveness, (emotional) intelligence, compassion, communication skills, reliability, and adaptability. In this discussion post, I will be identifying two key insights about leadership behaviors from the scholarly articles I reviewed, as well as discussing leadership behaviors and skills I have witnessed in my practice.

Nurse leaders play a powerful role in patient safety culture. Patient safety is defined as, “the freedom from accidental injury and error” (Chegini et al., 2020). Errors happen in healthcare. Human error is inevitable, that is why we have something called “just culture.” Just culture is the idea that errors stem from a faulty process in the organization, and that when an error is made, staff should not be blamed or punished for the mistake. Rather, the team is responsible for determining what went wrong and how the process can be improved to prevent this mistake in the future. It holds the person and the organization accountable (Boysen, 2013). How a leader reacts and responds to these errors says a lot about his/her leadership style and ethics. Good leaders are expected to promote honesty and patient-centered care with error reporting. They should provide a safe, coaching environment for staff to report their error and receive education (Chegini et al., 2020).

If a leader does not promote just culture, staff are less likely to report their errors, putting patients at a higher risk of injury or mortality (Chegini et al., 2020). When I was a new grad, I was working on the inpatient adolescent psychiatric unit. It was flu season, and charge nurses were frequently reminding all staff members to offer and administer influenza vaccines to our patients before discharge. During my shift, I administered a vaccine to an adolescent patient without getting his guardian’s consent first. This was a policy I had forgotten about in the rush of my shift. Turns out, the guardian did not want him to receive the vaccine due to previous negative experiences. As a brand-new nurse, I sobbed and thought my career was over. My charge nurse was there and assisted me in informing the guardian of my mistake. She supported me and reminded me that mistakes will happen in nursing. She also educated me on the importance of slowing down and thinking about each step of a process. My charge nurse exhibited just culture and good leadership skills that day when she supported me through my mistake and educated me on it.

Nurse leaders must also motivate and empower their staff members, while promoting autonomy. By fostering this positivity, leaders will improve employee attitudes, mental health, and overall performance (Fernet et al., 2015). I have personally worked with two types of leaders: the burnt-out, negative ones, and the positive, motivating ones. Speaking from personal experience, I enjoy my work so much more when my leader exhibits these positive characteristics. Leaders influence the culture of the entire department, and attitudes are contagious. When they set the example of being a positive employee who is willing to work hard, be a team player, and provide high quality care, other staff members are more likely to mimic this behavior (Fernet et al., 2015). Leaders are responsible for modeling the mission, vision, and values of the organization.

When I started my nursing career, I was working for a manager that was not passionate about mental health. She was managing two units due to a staffing shortage and funding, and the behavioral health unit was one of them. She even openly admitted to not loving psychiatric care. This set the tone for a very negative work environment. I believe it is crucial to be passionate about the care we provide in order to provide the highest quality of care. With her as the leader, the work environment was dull and unfavorable. There was a considerable shift in culture when the new manager started. Employees started to pick up more over time, work as a team, and show compassion for our patients again. In this experience, I learned that the attitude of a leader can make or break the unit.


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

Boysen, P. G. (2013). Just culture: a foundation for balanced accountability and patient safety. National Library of Medicine.

Chegini, Z., Kakemam, E., Jafarabadi, M.A., & Janati, A. (2020). The impact of patient safety culture and the leader coaching behaviour of nurses on the intention to report errors: a cross-sectional survey. BMC Nursing19(1), 1–9. to an external site.

Fernet, C., Trépanier, S. G., Austin, S., Gagné, M., & Forest, J. (2015). Transformational leadership and optimal functioning at work: On the mediating role of employees’ perceived job characteristics and motivation. Work &Amp; Stress29(1), 11–31.

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