Transformational Nursing Leadership and Work Effective Environments in Rural Acute Healthcare Organizations
Authors:   , Zenger Rhonda 
Published: February 2023

The nurse administrator leadership style influences the professional nurse's perceptions of work effectiveness. In today's rapidly changing healthcare industry, this relationship between leadership style and condition of work effectiveness warrants further investigation. By developing knowledge regarding the relationship between transformational nursing leadership and work effectiveness, the implementation of research-based interventions into the work environment benefits rural acute healthcare organizations. In contrast with urban tertiary healthcare systems, rural acute healthcare organizations provide quality healthcare services from a limited supply of registered nurses due to their local geographical constraints. In rural communities, healthcare organizations need to develop ways in which transformational leadership talent is developed from within the organization. Registered staff nurses employed at rural healthcare organizations, develop unique relationships among themselves as a response to being in a rural environment, thus a focused research agenda is needed for this unique population. A systematic review of the literature using a computer search of CINAHL, MEDLINE, ABI-lnform, and INFOTRAC suggests that in order for staff nurses to provide quality care, nurses need to have access to the opportunity, information, support, and resources. The relationship between transformational leadership and work effectiveness was investigated using a quantitative, non-experimental, descriptive-correlational research design. The sampling process consisted of census sample of 1,115 registered nurses living in ten randomly selected counties in Kansas with the total usable responses of 44 (N = 44). Orem's (2001) Self Care Deficit Theory of Nursing (SCDTN), Kanter's (1993) Structural Theory of Power and Bass and Avolio's (1994) Transformational Leadership Theory were abstracted together into a new conceptual model to guide this investigation. The Multifactor Leadership Questionnaire by Bass and Avolio (1995), was used to measure transformational leadership. The Conditions of Work Effectiveness Questionnaire II (CWEQ-IJ), by Laschinger, Finegan, and Shamian (2001), was used to measure work effectiveness. The descriptive data results revealed that the rural nurse participants perceived their leaders to function at high levels of transformational leadership across all subscales. In addition, they perceived their leaders to function at high levels in facilitating a work effective environment across all subscales with highest above mean scores found within the opportunity subscale. Statistical analysis using Pearson's Product Moment Correlation coefficient was used to determine if a correlation existed between: (a) transformational leadership and the subscales of extra effort, effectiveness, and satisfaction; (b) conditions of work effectiveness subscales and predictive work effectiveness, overall work effectiveness, and global work effectiveness; and (c) the mean of the total score of the MLQ-5X subscales and the mean between the total score of the CWEQ II subscales. Level of significance was set for the investigation at .05 (p &lt; .05). A statistically significant correlation existed between transformational leadership and extra effort (r = .866), effectiveness (r = .813), and satisfaction (r = .827). Significant correlations were found across all CWEQ-II subscales ranging from .683 (r = .683) to .975 (r = .975). In addition, statistically significant correlations were found to exist between transformational leadership and work effectiveness (r = .439), predictive work effectiveness (r = .507), overall work effectiveness(r = .571), and global work effectiveness (r = .520). Conclusions, implications, and recommendations are provided with a focus on nursing theory, nursing research, nursing practice, and nursing education.