NUR5043 Module 2 leadership theory comparison example

Three Theories and a Problem Nobody Owns: Transformational, Servant and Complexity Leadership Applied to a Delay That Crosses Five Departments

Student Name

American College of Education

NUR5043: Nursing Leadership: Organizational Systems

Module 2 Assignment

Instructor Name

October 19, 2026

The Problem the Theories Must Answer

In the composite 190-bed community hospital described in the previous module, a bedside nurse who decides that a patient needs a pressure-redistribution mattress waits a median of 19 hours for one. The delay has three sources that sit in three different reporting lines: an approval rule written by system finance, an approval step that depends on one wound nurse who works weekdays, and a vendor contract that measures delivery from the moment an order is placed. Meanwhile the unit rate of stage 2 and deeper hospital-acquired pressure injuries has risen. The leader in this paper is the director of medical-surgical nursing, who owns five units, the staff who feel the delay, and none of the rules that cause it.

That last fact is the test for each theory. A theory of leadership earns its place in this analysis only if it tells the director what to do when authority stops at her own department's edge. The director's position is common for middle managers in nursing. She is accountable for the outcome, since pressure injury rates appear on her units' quality dashboards, but the levers that would change the outcome belong to people who do not report to her and who are measured on different things. Each theory below is therefore asked the same two questions: what would a director who followed it do first, and would that action reach the rule, the role or the contract that produces the delay?

Transformational Leadership

Burns (1978) held that leadership becomes transforming when leader and followers lift each other toward greater motivation and a larger sense of moral purpose than either begins with. Bass and Riggio (2006) later gave the idea four components: a leader who is trusted and admired (idealized influence), who offers a compelling picture of the future (inspirational motivation), who invites people to question assumptions (intellectual stimulation), and who attends to what each person needs to grow (individualized consideration). A transformational leader changes what people want, not only what they do, and the theory's strongest evidence comes from studies of followers' commitment and satisfaction.

A transformational director would start with her own staff. She would make pressure injury prevention a shared purpose on all five units, tell the story of one patient whose injury followed a weekend wait, and invite nurses to challenge the assumption that the delay is out of their hands. Intellectual stimulation might produce useful ideas, such as a unit list of patients awaiting surfaces handed off at every shift. What the theory does not supply is a way to change rules owned by finance and supply chain. Its influence runs mainly through followers, and the people who wrote the approval rule are not the director's followers. Transformational leadership would give the director an energized staff and the same 19-hour delay.

Servant Leadership

Greenleaf (1977) proposed that the leader is servant first: the test of leadership is whether those served grow healthier, wiser and more able, and whether the least privileged are helped or at least not harmed. A servant leader asks what the people doing the work need and removes what stands in their way.

Applied here, servant leadership points the director toward the barriers her nurses face every night. She might arrange for the house supervisor to approve surfaces when the wound nurse is off, carry equipment requests up the chain herself, and protect nurses from blame when an injury follows a delay they reported. That is more useful than inspiration because it acts on the process. The theory's limit is scale. Removing obstacles for one's own staff is different from redesigning a process that five departments share, and servant leadership says little about how to persuade peers and superiors who have their own legitimate goals, such as a finance officer who was asked to cut rental spending and did so.

Complexity Leadership

Uhl-Bien et al. (2007) argued that leadership in knowledge-era organizations cannot be located only in individuals at the top. Their complexity leadership theory describes three functions: administrative leadership, which runs the formal hierarchy; adaptive leadership, which is the emergent, collective process by which new solutions arise from interaction among people with different information; and enabling leadership, which sets up the conditions in which adaptive work can happen and then carries what it produces into the hierarchy so that it can be adopted.

This theory describes the hospital's problem almost exactly. No single person can fix the delay because the relevant knowledge is spread across finance, supply chain, the vendor, wound care and the units, and no one has convened those people. An enabling leader would not try to own the solution. The director would bring together a small group from each department, give it both the rental spending report and the pressure injury data that each side has never seen together, and ask it to redesign the process. Her formal authority would be used to protect the group's time and to carry its proposal to the executives who can change the rule. The director cannot command a fix, but she can create the one meeting where the fix is likely to be found.

What the Evidence Says About Outcomes

Theory choice should also answer to evidence. Cummings et al. (2018) screened 50,941 titles and kept 129 quantitative studies that related how nurses are led to results for the nurses themselves and for their workplaces. The pattern they reported was consistent: across many settings, staff whose leaders built relationships reported more satisfaction and commitment than staff whose leaders attended mainly to tasks, and 52 studies linked relational styles to higher nurse job satisfaction while 16 linked task-focused styles to lower satisfaction. Leadership focused only on getting tasks done was insufficient.

That evidence supports the relational core that all three theories share, but it does not settle this case. The review measured outcomes for nurses and work environments, largely within units, and complexity leadership has a thinner outcome literature because its unit of analysis is the network rather than the leader. The choice here therefore rests on fit with the problem more than on comparative effect sizes, and the paper should say so rather than claim more certainty than the research gives.

The Choice and When It Would Be Wrong

Complexity leadership is the best fit for this problem, with a transformational and servant manner in how the director works with her own staff. The problem is interdependent, the knowledge needed is spread across departments, and the director's formal authority is limited, which are the conditions that theory was built for. Transformational leadership alone would motivate people who cannot change the rule, and servant leadership alone would produce workarounds that leave the rule in place.

The choice would be wrong under different conditions. If the hospital faced an immediate cluster of full-thickness injuries, a slow collective process would be the wrong first move, and the director should use administrative authority at once, for example by asking the chief nursing officer to suspend the approval rule for patients meeting defined criteria while the group works. Complexity leadership is also only as good as the enabling leader's follow-through. A convened group whose proposal is never carried to decision makers teaches staff that participation is a ritual, and that lesson is hard to undo.

References

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

Burns, J. M. (1978). Leadership. Harper & Row.

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

Greenleaf, R. K. (1977). Servant leadership: A journey into the nature of legitimate power and greatness. Paulist Press.

Uhl-Bien, M., Marion, R., & McKelvey, B. (2007). Complexity leadership theory: Shifting leadership from the industrial age to the knowledge era. The Leadership Quarterly, 18(4), 298-318. https://doi.org/10.1016/j.leaqua.2007.04.002