Leadership theories have been tested mainly in the disciplines of psychology, business, and military, but a dearth of literature within the healthcare service is evident. Transformational leadership behaviour has been widely promoted by a large number of government reports as the most appropriate leadership theory in healthcare organisations. Considerable empirical evidence exists that demonstrates that transformational leadership behaviour is associated with a number of positive patient and nurse outcomes. Recent research is also emerging that demonstrates that the work environment also influences the nurse and patient outcomes, in particular, professional practice environments. However, the relationship between these constructs is not clearly understood or articulated. Moreover, little is known about the influence of the clinical nurse manager leadership behaviour and the professional practice environment. Clinical nurse managers working at the front line of clinical practice are in a pivotal position to influence positively or negatively the quality of care provided and the outcomes of care.
The primary aim of this research therefore was to address this deficit by exploring the relationship of the transformational leadership behaviour of the clinical nurse manager and professional practice environment. It also aimed to identify which dimensions of leadership behaviour are predictors of professional practice environment and finally, to identify the workplace diversity variables that predict a professional practice environment in acute care hospitals in Ireland.
This study used a two-phased approach whereby the first phase explored the views of nurses in relation to leadership behaviour and the practice environment. The second phase measured transformational leadership behaviour of the nurse manager and extent to which they believed that the characteristics of professional practice environment were present at the front line of clinical nursing practice.
The overall findings identified that there was a strong positive significant relationship between the transformational leadership behaviour and the professional practice environment. The leadership dimension ‘showing genuine concern’ was shown to be the most important dimension and an important predictor of professional practice environment. The findings also identified that position and ethnicity were important workplace diversity factors in determining a professional practice environment in an Irish context. In conclusion, the transformational leadership behaviour of the clinical nurse manager is an important element in the development of a professional practice environment. This study provides evidence that in the current context of economic and social change, promoting transformational leadership at the frontline of clinical practice and recruiting nurses at the front line from all ethnic backgrounds should encouraged, promoted and developed.