NUR4063 Module 1 leadership styles analysis example

Three Situations in One Month: Matching Leadership Style to What a Step-Down Unit Actually Needed

Student Name

American College of Education

NUR4063: Leadership and Management in Healthcare

Module 1 Assignment

Instructor Name

September 7, 2026

Styles as Choices

Leadership styles are often presented as types of people: some leaders are democratic, others authoritarian, others transformational. That framing makes leadership sound like temperament. A more useful view for a nurse manager is that styles are patterns of behavior a leader can choose among, and that the skill lies in reading what a situation needs. Marquis and Huston (2021) describe the classic continuum from authoritarian leadership, in which the leader makes decisions and directs others, through democratic leadership, in which the leader shares decisions with the group, to laissez-faire leadership, in which the leader gives little direction. They add that effective leaders move along that continuum as circumstances change.

Transformational leadership adds a different dimension. Bass and Riggio (2006) describe transformational leaders as those who inspire followers to exceed their own expectations through four kinds of behavior: acting as a role model people want to follow, communicating a motivating vision, pushing staff to question old assumptions, and coaching individuals according to what each one needs, in contrast to transactional leaders, who work mainly through exchanges of rewards and corrections. This paper uses those definitions to analyze three situations faced by a new nurse manager of a 20-bed cardiac step-down unit during her first month in the role. The manager, staff and events are composites written for this assignment. The claim of the paper is that each situation asked for a different style, and that choosing the wrong one would have failed even with good intentions.

Situation One: A Patient Deteriorating at Shift Change

At 1850 on her ninth day, the manager was on the unit when a patient two days after a cardiac catheterization became hypotensive and confused. Report was underway, the day nurse was at the station and the night nurse had not yet seen the patient. For about ninety seconds, several people talked at once about who should call the rapid response team and whether the patient's femoral site was the source. The manager stepped in and gave short, direct instructions by name: one nurse to call the rapid response team, one to check the groin site and apply pressure if bleeding, one to bring the monitor and fluids, and the charge nurse to take over the day nurse's other patients.

That was authoritarian leadership in its original sense, and it was the right choice. In an emergency, the situation calls for speed and clear roles, not consultation, and the staff needed someone to reduce confusion rather than to ask for opinions. The risk of choosing a participative style in that moment was obvious: more discussion and a longer delay. The risk of the directive style is that a manager who is effective in emergencies comes to rely on it everywhere. Directive leadership earns trust in a crisis precisely because the staff know it will stop when the crisis does. After the patient was stabilized and transferred, the manager held a five-minute debrief and asked the team what should have happened in the first ninety seconds, which returned the unit to a shared style.

Situation Two: Introducing an Early Warning Score

The hospital had decided to introduce a modified early warning score on all inpatient units, requiring nurses to calculate a score from vital signs and level of consciousness every four hours and escalate at defined thresholds. The step-down nurses, many with more than ten years of cardiac experience, saw it as a checklist that told them what they already knew. Several said that the score would add documentation without changing care.

A directive approach would have produced compliance on paper and resentment on the unit. The situation asked instead for transformational behaviors. The manager connected the score to something the staff cared about by presenting two unit cases from the previous year in which subtle changes were charted for hours before a rapid response call. She asked the most skeptical senior nurse to lead a two-week trial on one hallway and report what the score caught and missed, which used intellectual stimulation and individualized consideration at once. When the trial found that the score flagged one patient forty minutes before any nurse raised a concern, the senior nurse presented the case at the staff meeting herself.

The risk of the transformational approach is that it takes time and depends on the leader's credibility, which a manager in her first month has not yet earned. The manager reduced that risk by borrowing credibility from a respected staff member rather than relying on her own.

Situation Three: Redesigning the Schedule

The third situation was the unit's schedule. Staff had complained for years that the self-scheduling process favored senior nurses and left newer nurses with most weekends and holidays. The manager had authority to impose a new rotation, and she had a draft ready. She did not use it. The decision affected every nurse's life outside work, the staff knew far more than she did about which patterns were sustainable and a solution the manager imposed would likely be resisted or quietly undermined.

She chose a democratic approach: a scheduling committee of five nurses from both shifts and three seniority levels, with a mandate to propose rules within two limits she set, minimum staffing on every shift and equal distribution of holidays over two years. The committee's proposal was different from her draft in two respects, both of which were improvements she had not thought of. Sharing a decision is not the same as giving it away; the manager set the boundaries that protected patients and let the people who lived with the schedule design the rest. The risk of the democratic style here was delay, and it took six weeks rather than one. The benefit was a schedule the staff defended as their own.

Which Style Should Be the Default?

If style should vary with the situation, it is fair to ask what a manager should do between situations, in the ordinary weeks when nothing demands an obvious choice. The evidence gives a clear answer. Cummings et al. (2018) systematically reviewed studies of leadership styles and outcomes for the nursing workforce and found that relational styles, including transformational and resonant leadership, were associated with better outcomes such as higher job satisfaction, lower intent to leave and healthier work environments, while task-focused styles, including dissonant and management-by-exception approaches, were associated with poorer outcomes. The review drew mostly on cross-sectional survey studies, which limits causal claims, but the pattern was consistent across many studies.

For this manager, that means her default should be relational, with directive behavior reserved for situations like the deteriorating patient, where time and safety demand it. The three situations support that conclusion. The directive moment worked because it was brief and followed by a debrief. The transformational and democratic approaches built the trust she would need the next time she had to give orders.

Conclusion

A new nurse manager's first month on a step-down unit produced three situations that asked for three different kinds of leadership: directive action in a crisis, transformational engagement for a change the staff doubted and democratic decision-making for a problem the staff understood better than she did. Choosing correctly in each case depended on reading what the situation required rather than defaulting to a preferred style. The evidence on relational leadership suggests a home base for the ordinary days in between. Leadership, in this account, is less a personality than a series of judgments about what a moment needs.

References

Bass, B. M., & Riggio, R. E. (2006). Transformational leadership (2nd ed.). Lawrence Erlbaum Associates.

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19-60. https://doi.org/10.1016/j.ijnurstu.2018.04.016

Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: Theory and application (10th ed.). Wolters Kluwer.