Reflection Assignment 4: Meeting Essential VIIIThis week, reflect on your perception of change theory, management roles and nursing leadership, communication conflict, and the nurse management role in

TRANSFOMATIONAL LEADERSHIP AND BURNOUT

The Impact of Transformational Leadership on

Nurse Burnout

Jodi Turco, RN

West Coast University

LDR432: Principles of Leadership for

Healthcare Organizations

Dr. Lisa Parenti

June 23, 2019

Abstract

Burnout is an all too common occurrence within the nursing profession. It is described as a psychological phenomenon that manifests as a decline in physical, emotional, and psychological energy that results from job-related stress. The purpose of this paper is to explore the impact of a transformational leadership style on burnout by conducting a literature review and evaluating the qualitative and quantitative studies performed by authors of peer-reviewed articles. Various approaches to determining the correlation between leadership style and burnout have been attempted, although it appears that further investigation is required. Many of the attributes of a transformational leader can be linked to a higher level of job satisfaction among staff as well as recruitment and retention, but there is insignificant evidence to support that there is a direct connection between leadership and burnout.

Keywords: burnout, transformational leadership, leadership style, staff retention

The Impact of Transformational Leadership on Nurse Burnout

Burnout is defined by Maslach and Jackson as a “syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment.” With the ever-changing environment in healthcare organizations, it is imperative that today’s leaders adopt methods that will transform a staff nurse’s work environment to be more supportive of them while meeting the increased demands of the healthcare environment. Transformational leaders empower nurses to use their own knowledge and skills to perform their job well and increase satisfaction among staff which can decrease the occurrence of burnout. This paper examines research conducted and recorded in peer-reviewed articles with the aim of drawing a positive relationship between transformational leadership and nurse burnout.

“Transformational leadership is the process whereby a person engages with others and creates a connection that raises the level of motivation and morality in both the leader and the follower; the leader is attentive to the needs and motives of followers and tries to help followers reach their fullest potential” (Northouse, P.G., 2019). The original concept of transformational leadership is attributed to James MacGregor Burns, who laid the foundational framework in 1978 by studying political leaders and their behaviors. Burns’ idea of transformational leadership was that followers were motivated to comply with their leaders based upon receiving a reward for doing so (transaction) and that they would be meeting higher order needs (transformation). The concept of transformational leadership utilized today is an expansion upon Burns’ theory by Bernard M. Bass in 1985. According to Bass (1985, p.20), “transformational leadership motivates followers to do more than expected by (a) raising followers’ level of consciousness about the importance and value of specified and idealized goals, (b) getting followers to transcend their own self-interest for the sake of the team or organization, and (c) moving followers to address higher-level needs.”

As it relates to healthcare today, studies indicate that transformational leadership has been shown to increase nurse recruitment, retention and promote a healthy work environment. With the nursing shortage on the rise, it is critical for organizations to effectively recruit and retain RNs. Transformational leadership is currently the most commonly utilized leadership theory in leadership research – specifically within the nursing field.

Burnout

Nurse burnout is a phenomenon characterized by emotional exhaustion, lack of motivation, and feelings of frustration that are caused by many different aspects of work-related issues. From the emotional strain felt when a patient is lost, to working the night shift, and even working in an environment such as the emergency department, nurses are one of the most common populations to succumb to burnout. There are 3 main aspects of burnout:

• Emotional exhaustion is described as the state of being physically and emotionally exhausted by work stress

• Depersonalization is an interpersonal aspect of burnout that results in numbness and detachment from caring and instructions.

• Low personal accomplishment is negatively evaluating one’s self as incompetent or inadequate.

Burnout is also a costly problem at the organizational level, as burnout causes higher levels of absenteeism and turnover. It is said that “high levels of burnout are linked to work overload, job dissatisfaction, and turnover” (Mudallal, R.H., Othman, W.M., Hassan, N.F., 2017).

Transformational leadership and burnout. In the 1980’s the American Academy of Nurses (AAN) studied why some hospitals can recruit and retain nurses better than others. Today, these hospitals are known as Magnet hospitals. The AAN describes five characteristics that are known as the “Forces of Magnetism”. Number one on the list is transformational leadership. Nuria O’Mahony states in her article that “burnout subscales are correlated with nurse working environment subscales.” These subscales were taken from the ANCC’s findings of Magnet hospital characteristics of (a) nurse participation in hospital affairs, (b) nurse foundations for quality of care, (c) nurse manager ability, leadership and support for nurses, (d) adequacy of staffing and resources, and (e) collegial nurse-physician relations.

The quantitative measurements taken by the authors of the articles selected for review were many. The measurement utilized most frequently was the Multifactor Leadership Questionnaire (MLQ). The review of statistics produced via the MLQ by Werberg, D. show that “transformational leadership was shown to increase well-being and decrease burnout factors in staff; transformational leadership was related to an increase in staff satisfaction whereas the other leadership styles were related to a decrease in staff satisfaction”. He further elaborates the findings of the MLQ to show that a “leader that instills pride, faith, and respect, and has a gift for seeing what is really important and transmits a sense of mission has the highest correlation to increased job satisfaction.” Kleinman distributed the MLQ to nursing staff at Seton Hall University. She further breaks down the questionnaire into demographics such as gender, education level, shift assignment, marital status and race. She concludes that the only specific leadership style related to significant turnover is management by exception. Furthermore, she says that “staff nurses who have limited interaction with their managers have a less favorable perception of their manager’s leadership style.”

Conclusion. After thorough review of the articles and their statistical data, it can be concluded that the correlation between transformational leadership and nurse burnout requires further investigation. There is significant evidence that shows that many of the behaviors described by the transformational leadership theory (i.e., nurse empowerment, management visibility within the unit) are related to increased job satisfaction and retention among staff, there is not any significant evidence that connects transformational leadership to a decreased occurrence of burnout.

References

Bass, B.M. (1985). Leadership and performance beyond expectations.

New York, NY: The Free Press

Hutchinson, M., & Jackson, D. (2012). Transformational leadership in nursing: Towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22. doi:10.1111/nin.12006

Kleinman, C. (2004). The Relationship between Managerial Leadership Behaviors and Staff Nurse Retention. Hospital Topics, 82(4), 2-9.

Lewis, H.S., & Cunningham, C.J. (2016). Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement. Nursing Research, 65(1), 13-23. Doi:10.1097/nnr.0000000000000130

Northouse, P.G., Interactive: Leadership: Theory and Practice Interactive eBook. VitalSource Bookshelf. Retrieved from https://online.vitalsource.com/#/books/9781544325194/

O’Mahony, N. (2011). Nurse burnout and the working environment. Emergency Nurse, 19(5), 30-37. doi:10.7748/en2011.09.19.5.30.c8704

Weberg, D. (2010). Transformational Leadership and Staff Retention: An Evidence Review with Implications for Health Care Systems. Nursing Administration Quarterly, 34(3), 24 6-58. Doi:10.1097/NAQ.0b013e318e7298