Gianluca Azzellino 1*, Massimo Bordoni2
1 Department of Territorial Assistance, Local Health Authority (AUSL 04) of Teramo, Italy
2 Department of Social Health. Local Health Authority (AUSL 04) of Teramo, Italy
Corresponding author: Gianluca Azzellino, Department of Social Health. Local Health Authority (AUSL 04) of Teramo, Via Finlandia n. 7/1,65015 Montesilvano, Italy
Email: gianluca.azzellino@aslteramo.it
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ABSTRACT
This commentary responds to the recently published article on transformational leadership in the healthcare context. The article explores how transformational leadership can significantly improve efficiency and job satisfaction in nursing teams. Specifically, it highlights the crucial role of this leadership style in fostering a positive work environment and reducing intentions to leave the profession among nurses. At a time of profound crisis for the nursing profession, characterised by staff shortages, increased workload and high rates of abandonment of the profession, transformational leadership could represent an effective model to address these challenges. This leadership approach, based on vision, inspiration, and involvement, can strengthen nurses’ motivation and satisfaction by promoting a positive and stimulating working environment. The analysis emphasises the importance of adopting innovative management practices to address current challenges in the healthcare sector, providing a basis for further research and practical implementation.
Keywords: Nursing leadership, Burnout, intention to leave, professional development, nurse education, job satisfaction
INTRODUCTION
The authors read with interest the article by Rizzo et al. (2024) entitled “Transformative leadership and job satisfaction in the nursing profession: A narrative review”. The article offers an in-depth analysis of the effect of transformative leadership on the nursing profession. The authors explore how this leadership style not only positively influences nurses’ job satisfaction, but also their intention to leave the profession. This is particularly relevant in a global context in which the nursing shortage is a critical challenge for healthcare systems. However, the increasing complexity of the healthcare system, coupled with the new challenges posed by the global pandemic, has made the need for an evolution in the nursing leadership model evident. This commentary aims to further explore the findings of Rizzo et al. by contextualizing their study within the current issues facing the nursing profession and discussing the importance of implementing transformative leadership strategies to improve both the quality of healthcare and the intention to stay. Our analysis through a combination of direct experience in the field and critical review of relevant literature, proposes to offer an in-depth perspective on how transformational leadership can be implemented effectively to address current challenges in nursing.
DISCUSSION
It was interesting to read the research work by Rizzo et al. (2024) on the relationship between transformational leadership and job satisfaction. At a time when the healthcare sector is facing unprecedented challenges, stability and satisfaction of nurses have become crucial priorities. Transformational nurse leaders can recognise and anticipate the needs of their nursing staff by establishing a good rapport and making significant efforts to meet their needs to encourage a sense of empowerment and autonomy that can subsequently translate into job satisfaction [1]. Recent studies have shown that nurses working under the guidance of transformational leaders tend to show greater attachment to their role and to the organisation. This results in fewer people leaving the profession, thus reducing turnover and the costs associated with training and induction of new staff. Transformational leadership, defined by Bass as a leadership style that inspires and motivates employees through shared vision, effective communication, individualised attention, and intellectual stimulation, stands out as a leadership model capable of fostering a positive and motivating work environment [2]. A leadership style that promotes autonomy, support and empowerment of nurses can improve job satisfaction, organisational commitment, and nurses’ intention to remain in their position by reducing emotional exhaustion [3]. As Rizzo et al. points out, there is therefore a need to identify and fill current gaps in nursing leader competencies and skills through processes of two-way communication and mutual trust between managers and nurses. Cummings et al. conducted a systematic review that showed that transformational leadership behaviour is positively correlated with job satisfaction [4]. Strengthening the sense of belonging and personal fulfilment can reduce burnout and the intention to leave the profession. In an environment where nurses feel valued and supported, they are more likely to remain committed and motivated in their work. Overall, studies support the fact that having positive support factors and working relationships in place, including positive relationships with physicians, leader support, positive leadership style and teamwork, can play a protective role against Burnout [5]. Another positive aspect of this style is its ability to motivate professionals to overcome daily challenges and actively engage in their work. Leaders who display transformational behaviour can inspire staff to see their work as a meaningful mission, rather than just an occupation. Kanste highlighted how transformational leaders are able to foster a sense of purpose among nurses, encouraging them to contribute beyond basic expectations [6]. This increased motivation can result in a reduction in the intention to leave the profession. A cohesive environment can improve the quality of care and increase job satisfaction. Boamah et al. showed how transformational leadership fosters the creation of cohesive and collaborative teams, thus improving outcomes for both patients and nurses. This team cohesion can reduce feelings of isolation and increase the sense of support among staff [7]. Professional development programmes that focus on transformational leadership skills can prepare nurse leaders to lead their teams effectively. It is therefore crucial to invest in the training of leaders capable of adopting this leadership style in order to build motivated and resilient teams. Despite the fact that a transformational leadership style is correlated with better job satisfaction, existing evidence shows that it is rarely used by nursing leaders in healthcare settings [8]. Furthermore, fostering a culture of continuous feedback and professional growth can help leaders develop and maintain transformational behaviours. Secondly, it is crucial to promote policies that foster work-life balance, the creation of open and transparent communication channels, and the recognition and valuing of nurses’ contributions. The choice of the best leadership style could be one of the modifiable factors that a healthcare organisation can adopt to create a favourable working environment and promote quality care [9]. Rizzo et al. correctly identified the increasing pressures on nurses and the need for innovative strategies to address the problem. However, we believe that an emphasis on transformational leadership can offer a sustainable solution and practice. The scientific community and policy makers need to seriously consider adopting this leadership model as part of strategies to address the professional crisis. Transformational leadership offers a promising perspective to improve job satisfaction, reduce burnout and intent to leave, and thus contribute to building a more attractive and sustainable healthcare system.
Conflict of interest
The authors declare no competing interests
Financing
No funding to declare
Author contributions
All authors contributed equally to the work
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