The Differing Approaches of Nursing Leaders to Issues in Practice


Nursing leadership and management have become a solution to matters of continued quality improvement and patient care practice. In quality improvement and patient practice, the key driving force for successful and sustainable quality improvement depends on how change is incorporated and implemented. The responsible agents for driving these changes are the nursing managers and leaders. However, the approaches that nursing leaders and managers employ in addressing different issues differ, but they share some similarities. Even though the roles that nursing leaders and managers take in quality improvement and patient practice are more likely to be common, the criteria in which they approach them differ. This paper takes a critical approach to introduce some of the core ideas and practices that nursing leaders and managers employ in the implementation process. This paper identifies nursing leaders as more effective in implementation as compared to managers, but the version acknowledges both as sets of rare talents that are crucial and valuable to the nursing environment.

Roles of nursing leaders versus managers

In a bid to establish the difference in the approaches that are advanced by leaders as well as managers, one has to understand their roles, interactions, and goals. Leadership and management have to be assessed from an organizational perspective in which the professional and personal philosophies are implemented. Since the nursing practice is all about people interacting, leaders and managers need to apprehend and plan for human factors and mistakes that can trigger different issues in service delivery (Booker & Waugh, 2007). In maintaining quality standards, leaders focus on examining and understanding the applicable theories on working with people and the constituting elements of a good teamwork. In the process, leaders win followers. Nursing leaders unlike managers win the spirit and morale of nurse workers. Managers have employees whom they coordinate and organize. Workers under managers will be quick to do their roles only for they have to, but not because they are motivated. Since the nursing practice entails human caring and interpersonal relationship between nurses and patients as emphasized by the Watson’s human caring theory, it becomes necessary for nurses to develop a sense of care at both professional and personal levels (Huber, 2014). As Watson’s theory of human caring challenges nurses to help build an environment of transpersonal compassion and care, which promote patient healing, nursing leaders facilitate the process of implementing these moral values.

Managers react to change, but leaders create it. In most cases, nursing managers have often played a catch-up management style as emerging nursing issues keep on evolving. Managers have high egos and they will not be ready to ask for assistance of things they do not understand. On the contrary, leaders will engage fellow workers to create the desired change and establish measures to solve any emerging organizational crisis. Managers direct groups of workers to accomplish certain tasks, while leaders create teams who work closely together to ensure that they remain effective at all levels of interaction. Managers have good ideas, which they keep to themselves, while leaders construct good ideas and involve all stakeholders to implement them. Leaders will persuade workers to cherish what improves patient-nurse relationship while the managers will communicate what they feel is appropriate without considering the views of others (Booker & Waugh, 2007).

As managers may avoid teamwork in a bid to achieve some targets as individuals and try to be heroes, leaders enhance teamwork and consultation to make everyone be part of the system and make heroes of every person around them. Just as the Peplau’s theory of interpersonal relations emphasize the purpose of nurses as assisting others to identify their felt challenges, leaders help team members to identify and work on their weaknesses (Chitty & Black, 2007). Managers are quick to take credit of milestones achieved by other workers, while leaders take responsibility of guiding others to achieve efficacy when dealing with patients. Managers are focused on quality, sustainability, and the involvement of nurses in desired health care practices, while leaders make the organizational goals a shared focus for all. Leaders achieve this goal by developing power together with the fellow workers, while managers focus on exercising authority and power over workers. As a nurse leader, one has to be an example to others by adopting certain leadership traits linked to a specific situation (Huber, 2014).

Application of nursing theories in nursing leadership and management practice

Nursing theories provide leaders and managers with a structure for addressing issues to members of the healthcare system. Leaders incorporate concepts of the nursing theory such as patient, healthcare, and nursing. Even though these concepts are common in all nursing theories, the may differ in the way managers and leaders incorporate them into the nursing practice. Theories help nursing leadership and management in developing certain beliefs, values, and principles, and thus nurses should learn to appreciate fellow workers’ beliefs and assist each other without compromising their personal tenets (Chitty & Black, 2007).

My nursing philosophy

As nurses examine their practice, they have to decide on what is important to them as individuals and as nurses. Such demands push nurses to examine what motivated them to join the profession of nursing (Booker & Waugh, 2007). However, my nursing philosophy hinges on the desire to help individuals and families in need of quality healthcare regardless of race, religious beliefs, financial status, or disabilities. Nursing is an honorable career beyond the benefits of a paycheck and the greatest reward comes from seeing a patient appreciate your assistance by making a difference in their life and health. My philosophy is that nurses have a responsibility of ensuring safe, holistic, and desired patient care. As advocates, we are charged with the mandate of providing a healing environment by encouraging patients to help us by actively engaging in their personal care and healing. My desired leadership style involves learning each day through interacting with co-workers as well as my patients and applying what I learn to serve my patients optimally. My leadership style of learning from my team and my philosophy of caring for myself as well as others provides a complimenting aspect, which boost my professional and interactive skills by applying what I learn in the nursing practice. In cases when we deviate from our personal beliefs in a bid to fit into those of our patients, as nurses we should seek advice from our mentors to guide us and find a solution that solves the needs of our patients, whilst holding our personal beliefs.


In nursing leadership and management, every day brings unique challenges and opportunities. The main objective should be to foster the ability to offer hope to patients and their families by ensuring continuous quality improvement. Being an inspiration to fellow workers and patients can enhance illness-wellness environment. In a bid to live by the caring and compassionate philosophies, leaders, managers, and nurses should put in mind the human factors first. After understanding that we are all humans, and thus vulnerable to making unintended mistakes, it becomes easy for all to develop professionally through learning from our experiences and taking advice from others.


Booker, C., & Waugh, A. (2007). Foundations of nursing practice: Fundamentals of holistic care. Oxford, UK: Elsevier.

Chitty, K., & Black, B. (2007). Professional nursing: Concepts and challenges. Oxford, UK: Elsevier.

Huber, D. (2014). Leadership and nursing care management. St. Louis, MO: Saunders.

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