"A Case Study Investigating the Development, Implementation, and Perceptions of Transformational Leadership Practices of the Clinical Nurse Leader"

Elizabeth Smith Houskamp, Fielding's School of Human & Organizational Development

The hospital setting is a complicated, challenging, and complex environment in which to deliver high-quality, lower-cost care. It is particularly vulnerable to what is often termed “care fragmentation.” The Clinical Nurse Leader (CNL), the first new nursing role advanced nationally in decades, is an innovative strategy uniquely positioned to address teamwork and strengthen leadership at the bedside to improve patient outcomes for a reduced cost at the microsystem level. The CNL is less than 5 years old and limited research has been conducted, particularly around the development, implementation, and perceived transformational leadership aspects of the role. Consequently, to address the research gap, this study investigated the above aspects on 5 inpatient units. Qualitative findings regarding the role reveal the perception and alignment of a complex role for complex times, and the “pull of polarity” on multiple levels (organization, unit, staff and each other). Quantitative results suggest licensed personnel and those with higher educational preparation as group perceive the transformational leadership practices of the CNL to be higher than those unlicensed personnel and those with less education. Furthermore, it generally appears the longer the CNL has been practicing on the unit, the higher the perceptions of their transformational leadership practices.

Keywords: clinical nurse leader, transformational leader, Leadership Practice Inventory