Transformational Leadership in Oncology

By Support

Functionality of transformational leadership theory in an oncology unit in an acute care hospital


This essay seeks to comprehensively discuss transformative leadership theory and provide a compelling account of its functionality within the nursing context.  I have employed an oncology unit within an acute care hospital as the specific context of its application.  This case study sample is assumed to be reflective of other acute care settings.  The essay is grounded on using the theory to increase the access and quality of patient care.

Its scope will include the unit`s nursing managers, subordinate nurses and the patients.  The nursing managers will discharge their leadership mandates grounded on this theory.  On the other hand, the nurses will practically adopt it.  The harmonious cooperation between the managers and their subordinates will translate into the desired quality and access to healthcare services.

  The essay is structured into three parts, namely:

  1. A summary of the history and chief premises of the theory
  • History of development to present time
  • Its main premises
  • Description of the theory and its components
  1. A description of its possible application in an oncology unit
  • Identification and description of the context
  • Argument for the suitability of the theory
  • Identification of the likely outcomes of its applicability
  1. A conclusion.

 Part one: A summary of the history and chief premises of the theory    

The term `transformational leadership` was coined by a renowned sociologist by the name James V. Downton in 1973 (Bruce & Francis, 2013).  He devised the terminology to explain the relationship between change and leadership.  Later on, a leadership expert by the name of James McGregor Burns first introduced the transformational leadership concept in his 1978 book titled `Leadership` (Curtis, Vries, & Sheerin, 2011).  According to him, transformational leadership refers to a process where leaders and their followers uplift each other to greater levels of motivation and morality.

Bernard M. Bass later made some further developments on the transformational leadership concept, as evidently pointed out in his 1985 book titled “Leadership and Performance Beyond Expectations“ (David & Kirimi, 2012). He argued that this type of a leader has the following attributes, namely: sets vivid goals, is a reflection of fairness and integrity, exhibits high expectations, offers support and recognition, encourages others, has the ability to stir up other peoples` emotions, gets individuals to look beyond their self-interest and inspires and motivates individuals to reach for the improbable.  There have been perpetual developments done to the theory over time (Diane, 2013).  Now over 25 years after Bass` book, it is argued that transformational leadership is one of the immensely paramount concepts in organizational leadership.

This theory is grounded on several fundamental premises.  These premises include the following (Duygulu & Kublay, 2011): Individuals will follow a person who inspires them, an individual with a vision and passion can accomplish immense things and the avenue to get things executed involves injecting energy and enthusiasm.  Usually, people will follow the leader whom they perceive to inspire them.  It is assumed that their belief that the individual has some inspiration and motivation to them will act as a trigger and driving force for them to follow the leader voluntarily. 

 Additionally, it is assumed that a person with a vision and passion is in a good position to achieve things of great magnitude. This means that the key steering factors for the person to accomplish commendable things in the leadership capacity, for instance, are vision and passion.  The two elements are used as the underlying factors when a person desires to achieve great things.  Also, using enthusiasm and energy facilitates getting things done.  This implies that the two elements are indispensable when an individual in a leadership position wants things to be executed accordingly.

Transformational leadership theory describes a leadership approach that brings about change in people and social systems (Edgar, 2016).  Ideally, it creates positive and valuable change in the followers.  When authentically enacted, it heightens the followers’ morale, motivation, and performance via different mechanisms.  Such mechanisms include: linking the followers` sense of self and identity to the organization`s mission and collective identity, being an inspirational role model to them, challenging the followers to take immense ownership of their work and comprehending their strengths and weaknesses.  This enables the leader to align them with the tasks they can optimally perform (Elaine, 2012).

The chief components of the theory include (Elesa, 2013): intellectual stimulation, individualized consideration, inspirational motivation and idealized influence.  Intellectual stimulation describes the level to which the leader takes risks, challenges assumptions and solicits the ideas of the followers.  This promotes the development and nurturing of individuals who think independently.  Individualized consideration is the degree to which the leader addresses individual follower`s needs and concerns.  The empathy and support offered by the leader give them intrinsic motivation to perform their tasks.  Inspirational motivation is the ability of the leader to articulate a vision that is inspiring and appealing to the followers (Gilbert, 2011).  This offers the entity`s meaning and purpose hence steering the group forward.  Idealized influence reflects high ethical conduct, earns respect, and instils pride and trust.  It enables the leader to walk the talk.   

Part two: A description of its possible application in an oncology unit

 Today`s nurses employ fundamental transformative communication principles to enhance interactions with patients, peers, family members and colleagues (Heuston & Wolf, 2011). This implies that transformative leadership principles are indispensable in bringing harmony among the parties mentioned above.  This is efficacious in enhancing patient care and professionalism within the different contexts of the highly diverse society (Hutchinson & Jackson, 2013).

  An example of the most suitable context for the application of the transformative theory is in the oncology unit in an acute care hospital.  The department is ever busy since it provides the following services (Owen, 2012): a diagnostic job to identify a new diagnosis, treatment of therapy complications, administration of investigational and standard chemotherapy, supportive care, radiation therapy, biopsies and surgical operations just to mention a few.  The department team is quite huge.  Some work round the clock with reasonable breaks, while others usually work on a shift basis.  The employees possess varied expertise, education, motivation and experience (Kwame, 2012). The operations of the unit are quite commendable since the patients received in the department are offered fairly excellent services around the clock.

However, there have been several challenges within the unit.  Such problems include (Marshall, 2010): poor design of systems, inadequacy in meeting the health needs of chronically ill patients, inadequacy in harnessing the developments in information technology, lack of a shared decision-making relationship between nursing professionals and patients and ineffective recruitment and retention of nursing staff and other healthcare providers in the unit.  Traditionally, healthcare institutions have experienced challenges linked to the process of how patient care is provided (Michael, 2011). This implies that problems are inevitable in the healthcare sector, particularly for healthcare institutions.  As such, acute care hospital is not an exception.

There has been quite poor systems design in the oncology unit.  Such a key system is the patient health documentation system in the unit.  For a long time, chronically ill patients’ health and treatment records have been managed poorly.  This means the patients usually spend a lot of time waiting for their medical documents to be retrieved at the unit (Bradley, 2016).  As a result, this has evidently led to poor quality of patient care and widespread dissatisfaction and disappointments among the unit’s patients. 

 The inadequacy to satisfy the health needs of the patients who are chronically ill in the unit has perpetually proved to be a challenging issue.  Such needs include counselling and advice on aspects like lifestyle, chemotherapy, radiotherapy, and biopsies, among other paramount needs and services offered by the unit (Nurse, 2012).  This has been immensely contributed by the absence of enough attention to behavioural health determinants and prevention and the disharmonious collaboration between and among the nurses and other health care providers working in the unit.

The inadequacy in harnessing the developments in information technology in the unit is also a challenge.  The unit has not commendably employed modern information technology in relaying health records to the patients. This means there has been poor communication of health records to the patients (Michael R., 2013).  As such, this has caused great inconvenience to the patients.

The unit’s lack of a shared decision-making relationship between nursing professionals and patients has been overtly present.  This implies that there has been an absence of openness between the providers, nurses, and patients (Patricia, 2011).  Critical decisions have been made independently either by the health providers or the patients.

Ineffective nurse recruitment and retention of nursing staff and other healthcare providers in the unit is alarming.  This means that there have been periodic human resource shortages in the unit.  Consequently, this has caused detrimental impacts, such as the mismatch between the health service demand and supply in such a critical and indispensable unit (Patrick, Laschinger, Wong, & Finegan, 2011).

The transformative leadership theory is overtly the most appropriately applicable theory in addressing the above-discussed challenges in the workplace situation.  This is essential because all the key challenges highlighted above relate to the theory (Sadeghi & Pihie, 2012).  That is, it calls for change or transformation.  This will positively impact the service delivery in the crucial unit.  Also, the theory is evidently applicable since it seeks to empower each staff member to achieve his or her full potential besides focusing on the general performance of the department.

The theory is very instrumental in addressing the above-described situation.  For example, the transformative leadership theory is essential in resolving the issue of poor systems.  It will aid in enhancing the patient health records documentation system.  This will be achieved by bringing the responsible staff on board for an in-depth discussion with their leader (Salanova, Lorente, Chambel, & Martinez, 2011).  The leader will precisely articulate the vision and the need to handle the documents of the patients efficaciously.  This will motivate the staff to execute their mandates more effectively, hence averting inconveniencing the patients when they require their medical records.

 As such, this will motivate and inspire the unit employees on the need to be quick and swift when handling the patients` documentation.  This can also be done by taking them through an induction session and also the manager challenging the staff members and inspiring them with a sense of purpose and excitement. As such, the employees will be more likely to change or adjust their perceptions, influencing how they handle such documentation (Smith, 2011).

The theory is also useful in satisfactorily addressing the issue of inadequacy in meeting chronically sick patients` needs.  Addressing such needs will require reforming how attention to behavioural health determinants and treatment and prevention is done in the unit (Tricia, 2015).  Since the transformational leadership theory involves implementing new ideas that the followers can comfortably identify with, the leader will be able to inspire and motivate enhanced collaboration and coordination among the staff in the unit regarding the awarding of adequate attention and considerations to treatment and prevention options available and suitable to each unique individual patient.

Additionally, transformative leadership is paramount in mitigating the lack of a shared decision-making relationship between nursing professionals, other healthcare providers, and patients within the unit.  This means that since the theory promotes increased ethical conduct, respect, and trust, the unit staff will be spurred to embrace a shared decision-making association with their patients (Wong, Cummings, & Durchame, 2013).  This will lead to enhanced and prudent decision options from which informed choices can be arrived at.  Essentially, this will also remarkably address the need to be increasingly attentive and considerate to the patient’s preferences, values, and cultural backgrounds visiting the unit.  Consequently, this will cause high-quality service provision.

Part three: Conclusion

Transformational leadership is essentially about causing a change in people and social systems at large.  This theory dates back to 1973 when James V. Downton coined the terminology.  He aimed to demystify the connection between leadership and transformation.  However, later on, the concept was advanced by Burns in 1978 in his book titled `Leadership`.  He argued that transformational leadership referred to a process where leaders and their followers uplift each other to greater levels of motivation and morality.

It was further developed by Bass in 1985 through his book titled “Leadership and Performance Beyond Expectations“.  The important premises of the theory include: people will follow a person they feel inspires them, an individual with a vision and passion is likely to attain great things, and the way to have things done involves injecting energy and enthusiasm.

 The theory can be applied in the oncology unit in an acute care hospital to transform and enhance service delivery.  The importance of the theory is inevitably remarkable.  This is because it is suitably applicable in addressing some of the identified challenges in this unit.  This is grounded in the theory`s attributes like motivating change, inspiring, connecting and challenging.  This theory is a masterpiece in establishing desired positive and transformative change.   


Bradley. (2016, 04 19). How Nursing Leadership Styles can Impact Patient Outcomes and Organizational Performance. Retrieved from online>Resources>Inforgraphics

Bruce, A., & Francis, Y. (2013). Transformational and Charismatic Leadership. Emerald Group Publishing.

Curtis, A., Vries, J., & Sheerin, K. (2011). Developing leadership in nursing: exploring core factors. British journal of nursing.

David, M., & Kirimi, B. (2012). Transformational corporate leadership. Andrews UK Limited.

Diane, H. (2013). Leadership and nursing care management. Elsevier Health Services.

Duygulu, S., & Kublay, G. (2011). Transformational leadership program for charge nurses. Journal of Advanced Nursing, 633-642.

Edgar, S. (2016). Organizational culture and leadership. John Wiley & Sons.

Elaine, R. (2012). Management and leadership in nursing and healthcare: an experiential approach. Springer Publishing Company.

Elesa, Z. (2013). Leadership: A Critical Introduction. Routledge.

Gilbert, F. (2011). Real Leadership: How spiritual values give leadership meaning. ABC-CLIO.

Heuston, M., & Wolf, A. (2011). Transformational leadership skills for successful nurse managers. Journal of Nursing Administration, 248-251.

Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: Towards a more critical interpretation. A nursing inquiry, 11-22.

Kwame, G. (2012). Transformational Leadership. Xulon Press.

Marshall, S. (2010). Transformational Leadership in Nursing: from expert clinician to influential leader. Springer Publishing Company.

Michael, L. (2011). Transformational Leadership. GRIN Verlag.

Michael, R. (2013). The Oxford Handbook of Leadership. OUP USA.

Nurse, L. (2012, 01 19). Becoming a Transformational Nurse Leader-Emerging Nurse Leader. Retrieved from

Owen, D. (2012). Transformational Leadership in Nursing Practice. British Journal of Nursing, 20.

Patricia, K. (2011). Nursing Leadership and Management. Cengage Learning.

Patrick, A., Laschinger, S., Wong, C., & Finegan, G. (2011). Developing and testing a new measure of nurse clinical leadership: the clinical leadership survey. Journal of Nursing Management, 449-460.

Sadeghi, A., & Pihie, L. (2012). Transformational leadership and its predictive effects on leadership effectiveness. International journal of business and social sciences.

Salanova, M., Lorente, L., Chambel, J., & Martinez, M. (2011). Linking transformational leadership to nurses` extra-role performance: the mediating role of self-efficacy and work engagement. Journal of Advanced Nursing, 2256-2266.

Smith, A. (2011). Are you a transformational leader? Nursing management, 44-50.

Tricia, T. (2015). Management and Leadership for Nurse Administrators. Jones & Bartlett Publishers.

Wong, A., Cummings, G., & Durchame, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of Nursing Management, 709-724.