The health care sector has consistently faced challenges about accountability of resource usage and delivering quality services. However, the managerial department has been significantly affected due to employee dismissal and retrenchment on the basis of lack of capital to pay for their services. As a result, now fewer managers are expected to exercise their authority over a large number of employees on a daily basis. Consequently, nurses are now being limited from acquiring mentorship sessions or a close, nurturing of their abilities as administrators are required to intervene in more needy situations. Due to this setback that has faced the managerial sector researchers have embarked on examining the effects that result from administrative exposure to a wide span of control within a hospital setting. Also, leadership styles have been scrutinized on various occasions to substantiate on the methods that can best satisfy patient care, unit outcomes, and daily practice areas of nursing. Consequently, this study will evaluate a research by students from Ontario University with a goal of substantiating the existing relationship between leadership, span of control, and the outcomes experienced by units, patients, and nurses. Also, different leadership skills are evaluated on the basis of the elements accrued to each and the positivity they influence on patient care, job satisfaction, and unit turnover.
Study Population and Settings
In a bid to determine how the managerial span of control impacts on leadership on performance in health care settings the Ontario University study was carried out in various settings and to different populations. The initiator of this study was a Ph.D. student at the University of Toronto in conjunction with the ethics review committees, associated hospital review committees, and the nursing faculty in the same institution (Doran et al., 2004). Also, the researchers consulted with the Institute for Social Research where they acquired statistical related services. The study was conducted in seven hospitals in Ontario, Canada, where their organizational structure is similar in every way. Questionnaires were the primary form of data collection materials. Initially, the target population in this study was ten nurses, patients, and managers in each unit. However, the available number of participants added up to a total of 41 managers, 686 patients, but only 680 of them attained the required criteria needed for this study, and out of 774 available nurses only 717 of them were allowed to undertake this research (Doran et al., 2004). Additionally, the research was drawn from 51 units within the health care settings inclusive of the surgical, obstetrics, and medical staff members. Concisely, patient participants were required to be 18 years of age and over with a good knowledge of English both in writing and reading. Participating professionals were required to be either registered or practical nurses with either a full-time, part-time or casual job.
Transformational Leadership Theory
In every setting, there is a need to have leaders who lead by a particular style. Transformational leaders are considered as the best and most influential authorities within any organization (Doran et al., 2004). Transformational leadership entails identifying a need that requires change, leading towards that change, inspiring ones followers and exhibiting total commitment towards a particular goal alongside each member. In transformational leadership, several traits are exhibited by a leader in various ways. First, transformative leaders show high levels of individualized consideration (Ali & Farid, 2016). Therefore, such administrators ensure to attend to every one of his followers needs at all times. Also, consideration entails acting as a mentor or role models to ones subjects while ensuring to listen to each of their needs and concerns. A transformational leader is also empathetic and supportive thus keeps every communication channel open while at the same time challenges the abilities of all their subjects. Nonetheless, these kinds of leaders ensure to uphold respect and reward any subject whose contribution positively impacts on the success of the team. As a result, employees under a transformational leader gain intrinsic motivation for their jobs and aspire to develop and evolve in their responsible places.
Another characteristic exhibited by transformational leadership is intellectual stimulation (Doran et al., 2004). Transformative leaders always thrive from their assuming nature, risk taking, and soliciting the ideas of their followers. In essence, these kinds of leaders constantly encourage their juniors to be creative throughout their practice. Consequently, transformational leaders recognize the uniqueness of each employee and ensure to nurture them into becoming independent thinkers (Ali & Farid, 2016). Essentially, such leaders value continuous learning where even unexpected situations are treated as opportunities for them. Further, due to their intellectual abilities, transformational leaders are very inquisitive, critical thinkers, and initiator of better ways of executing complex tasks.
Transformational leadership also entails being great inspirational motivators. Motivation is mainly exhibited through articulating an appealing vision and inspiring every employee to implement it as required (Doran et al., 2004). Moreover, a transformative leader ensures to challenge all employees to showcase the high standards of practices, communicate or work optimistically, while upholding a strong meaning to the companys vision. Concisely, due to the leader's motivation employees cultivate a personal drive and energy which moves the team forward. Nonetheless, on such occasions followers are required to be purposeful before they get motivated to implement any laid down goals (Ali & Farid, 2016). Notably, an inspirational motivator shows an ability to communicate conversantly with his followers where he or she precise outlines the vision of the company, makes it understandable, and powerfully engages his followers. As a result, employees exhibit a lot of willingness to invest their efforts in all health care activities, believe in their abilities, while they become encouraged and optimistic about the future of their careers and the organization.
Another crucial element that transformational leadership exhibits are an ability to have an idealized influence in each subject (Doran et al., 2004). By being influential means that such leaders practice what they relay and expect from their juniors. Therefore, they ensure to continually encourage employees and avoid open criticism, especially in public places. Therefore, transformational leaders are role models for their subjects. Consequently, such leaders win the respect and trust of their employees because their actions allow them to be regarded with the same virtues they exhibit (Ali & Farid, 2016). Also, such leaders are excellent at demonstrating high levels of ethical conduct. Moreover, they do not use their dominant positions for selfish purposes. Instead, they build an influential framework for their subjects to help in realizing the objectives of the business.
Relating Leadership, Span of Control, and Outcomes
In this study transformational and transactional leadership styles have been recognized for optimizing on positive outcomes within nursing units, patients, and organizational benefits. Apparently, if a transformational methodology nurses lead hospitals to realize job satisfaction and a significant turnover in their departments. In essence, positive turnover and satisfaction attribute to the supportive, empathetic, constant feedback, open communication and encouragement of a transformative leader. Concisely, the working environment becomes favorable and conducive for nurses to excel in their departments. Moreover, due to good working conditions nurses are protected from experiencing stress or emotional exhaustion while their levels of self-esteem increase each day. Consequently, due to job satisfaction associated with transformational leadership style hospitals record good outcomes regarding nurse retention levels as they are rarely affected. Additionally, nurses are more willing to serve an organization that does not expose them to constant stress or conflicting situations.
Similarly, transactional leadership style also has a positive effect on the level of job satisfaction among nurses in different departments. In fact, from this study nurses explain that the comfort of their jobs is associated with the transactional leadership style. Essentially, nurses tell that transactional leaders are good at specifying hospital procedures, excellent in assigning tasks while they ensure to clarify the expectations of the organization now and then (Doran et al., 2004). Consequently, working environments become conducive with little or no recurring emotional exhaustion. Also, each understands their responsibilities thus job satisfaction increases each day. On the other hand, patients satisfaction is associated with to health care a setting that is led by a transactional leadership style. Notably, by constantly reminding nurses about their duties, proper procedures, and practice expectations facilitates delivery of quality patient care.
On the other hand, a span of control only has an optimum moderating effect on the existing relationship between job, patient, and unit turnover satisfaction if managers operate on a small scale basis. For instance, in organizations where either transformational of transactional leadership is practiced patient satisfaction is optimized when managers work on the small scale span of control levels (Doran et al., 2004). However, records of patient dissatisfaction in service delivery are often seen when managers exercise authority over a wide span of control. Similarly, job satisfaction in an organization with a small span of monitoring is optimized due to the existing healthy relationship between the manager and members of staff. Moreover, with a limited number of nurses to monitor such managers can develop the abilities of their employees and ensure to encourage them towards achieving the organizations goals. However, in a wider span of control environments, nurses record job dissatisfaction because managers experience time shortages and a higher demand to administer at the same time. Nevertheless, this study has also outlined that in an organization where laissez-faire leadership skills are exercised over a wide span of control nurses tend to record optimum satisfaction in their jobs. In explanation, it is due to lack of frequent corrections from managers that lead to satisfied nurses in their workplaces (Doran et al., 2004).
The above analysis has substantiated that managerial span of control influences leadership and health care outcomes on various platforms. Essentially, leadership becomes important when the leaders create a positive working environment for their employees and patients here both transformational and transactional styles are the most regarded. Transformational leaders especially have been recognized for being vision bearers, inspirational, empathetic, critical, influential, and motivational (Doran et al., 2004). Essentially, in this study transformational leadership style has been positively attributed with excellent unit turnovers and job satisfaction. On the other hand, transactional leadership is associated with optimized effects in patient care satisfaction and stable unit turnovers. However, due to exposure to a wide span of control, managers are now faced with the challenge of delivering in their administrative fields which in turn leads to dissatisfaction in patient care plat...
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