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Transformational leadership is a component of the full-range leadership theory which conceptualises a multidimensional leadership paradigm (Bass & Avolio, 1997). Other leadership dimensions within this leadership model are; transactional leadership and non- transactional leadership styles. Transactional leadership complements the effects of transformational leadership (Bass & Avolio, 1997). A key transactional leader behaviour is contingent reward (CR) which a leader’s exhibit when placing a focus on rewarding staff. Non-transactional leader behaviours are behaviours of avoidance. Transformational leader behaviours are exhibited by the leader demonstrating vision, charisma, an ability to motivate others to great outcomes, being capable of stimulating staff’s thoughts through their creative thinking and by demonstrating consideration for each staff member. The Multifactor Leadership Questionnaire (MLQ) is the tool that was used in the following six studies to measure the multidimensional aspects of nurse leaders.

Dunham-Taylor and Klafehn’s (1995) two part study surveyed “exceptional” hospital nurse executives and their staff nurses. Part one of the research studied a sample of 81 nurse

executives and an undisclosed number of staff nurses. The authors suggested that transformational leadership may be classified within three separate characteristics defined as charisma, individual consideration, and intellectual stimulation. These three behaviours sit within Bass’s model of transformational leadership, and the study found that charisma allowed the leader to provide effective communication of the vision and mission of the organisation (Dunham-Taylor & Klafehn, 1995). This leadership behaviour also allowed the leader to form relationships with individual nursing staff and thereby engage them in the importance of the work they and the organisation were doing (Dunham-Taylor & Klafehn, 1995). Utilising the leader behaviour of individual consideration the leader provided individual attention to each nurse by acknowledging the nurse’s strengths and limitations in relation to the job. The study identified heightened problem awareness and problem solving skills were provided through intellectual stimulation (Dunham-Taylor & Klafehn, 1995). Executive nurses who perceived they were high in transformational leadership considered nursing staff to be satisfied. Higher job satisfaction was associated with staff who perceived higher transformational leadership scores in executive nurses (Dunham-Taylor & Klafehn, 1995).

Further professional education such as a Master’s in Nursing and/or a doctoral degree were suggested as a way to strengthen an individual’s transformational characteristics (Dunham-Taylor & Klafehn, 1995). In the second part of their study, a structured interview with 81 nurse executives asked two open ended questions about excellence in nursing leadership and the leader’s individual strengths and weaknesses. The findings differentiated the relationship between transformational leadership and transactional leadership. The study’s results suggest that the most effective leaders have leadership characteristics from both transformational and transactional leadership style (Dunham-Taylor & Klafehn, 1995).

Medley and Larochelle (1995) also investigated the relationship between the head nurse’s leadership style and staff nurse job satisfaction using a correlation study design. Nurse leadership style was measured using the MLQ and satisfaction was measured using the Index of Work Satisfaction (Medley & Larochelle, 1995). The results from 122 staff nurses demonstrated a significant positive relationship between those head nurses who exhibited a transformational leadership style and job satisfaction of their nursing staff. In this study transactional leadership showed no correlation with staff satisfaction. A major difference compared to other studies which have measured transformational and transaction leadership was how contingent reward (CR) was measured in this study. Leadership style

using Bass and Avolio’s (1997) full leadership model usually scores contingent reward as a transactional leader behaviour, however in this study it was scored as a transformational behaviour. Within that context transactional leadership did not correlate with job satisfaction. Another study outcome of significance was that nursing staff perceived the transactional characteristic of management by exception as negative feedback, and it was correlated as a dissatisfying factor.

Transformational leadership was again quantitatively measured using the MLQ (Morrison et al., 1997). Similar to previous studies, this study found transformational leadership to have a significant impact on job satisfaction and empowering nurses to do their job (Morrison et al., 1997). The sample included executive nursing staff, nurse managers, licensed practical nurses, registered nurses, nursing assistants, and various administration staff. As well as the MLQ, four items from Spreitzer’s empowerment instrument; and job satisfaction was measured using a questionnaire by Warr, Cook, and Wall (Morrison et al., 1997). An expectation of the study was that leadership style would influence aspects of job satisfaction not accounted for by empowerment (Morrison et al., 1997). Unlike Medley and Larochelle’s (1995) study this research demonstrated both transformational and transactional leadership were positively related to job satisfaction; however only transformational leadership was positively related to empowerment. In this study contingent reward was scored as part of transactional leadership style and it was the only transactional subscale that demonstrated a positive relationship to satisfaction.

Participants were grouped into licensed and unlicensed staff for data analysis. The relative influence of leadership and empowerment on an individual’s job satisfaction and its variance by personnel group was an important finding of this study. Empowerment accounted for more variance in job satisfaction for licensed personnel than for unlicensed personnel. This evidence highlighted the requirement when designing job satisfaction interventions to make allowance for the relative influence of leadership as well as empowerment on varying classifications of nursing personnel (Morrison et al., 1997).

A later study by Gullo and Gerstle (2004) investigated a similar research question regarding whether nurse manager’s transformational leader behaviours were related to an increase in empowerment and job satisfaction of staff nurses. The difference in this study was the work context; the nursing department was undergoing a restructure. Registered nursing staff’s empowerment, job satisfaction, and perceptions of their manager’s

transformational leadership characteristics were the three variables measured in this study. Nursing staff who perceived their manager’s to exhibit transformational behaviours demonstrated a sense of empowerment. However registered nursing staff’s job satisfaction did not correlate with their perception of nurse managers who demonstrated transformational leader behaviours. In fact this study demonstrated an inverse relationship between an increase in transformational behaviours and job satisfaction. The findings of this study did not concur with other studies in which a positive association between job satisfaction and transformational leadership was demonstrated (Morrison et al., 1997; Medley & Larochelle, 1995). This study was undertaken when there was a progressively worsening nursing shortage in the USA, and nursing staff who participated in the study were involved in a restructure of the area. Leader behaviours in such an environment appear not to be able to counter the lack of job security.

Increased understanding of the relationship between leadership behaviours and retention was produced from Kleinman’s (2004) study which sought to describe perceptions of managerial leadership behaviours associated with staff turnover, and compared nurse manager leadership behaviours, as perceived by the managers, and by their staff nurses. The study’s sample consisted of 79 staff nurses and 10 nurse managers. Each provided demographic data and completed the MLQ. The causal model of staff nurse retention developed by Taunton et al. (1997) was used to examine the relationships between nurse manager leadership behaviours and staff nurse retention.

Nurse managers perceived they demonstrated a higher frequency of the leadership behaviours of predominantly transformational leadership behaviours, than did their staff. The leadership behaviour of management by exception (active) was reported by both nurse managers and staff nurses at a relatively low frequency; however it was the only leadership behaviour found to be significantly associated with staff nurse turnover. In the study, individual consideration was not associated with turnover. This latter finding differs from Taunton et al. (1997) who identified a strong association between the leader behaviour of individual consideration and staff retention. Taunton et al. (1997) study results however were from a much larger sample and a different leadership measurement instrument was also used. In Kleinman’s (2004) study staff nurses who considered leaving their job rated their managers as having a lower frequency of the leadership behaviour of intellectual stimulation. This leadership behaviour involves encouraging and supporting staff to participate in solving work-related problems, which generates flatter organisational structures that promote shared

leadership and involvement in decision making processes. Work environments with these characteristics have previously been identified as linked to increased job satisfaction in both the magnet hospital and empowerment studies.

Another study measured transformational and transactional leader behaviours using the MLQ to examine the relationship between leader behaviours and staff’s organisational commitment (McGuire & Kennerly, 2006). Overall the study’s finding validated that transformational nurse leaders promote a higher sense of commitment in nursing staff, however there were three interesting findings. First, nurse managers rated themselves higher on transformational leadership than did their staff nurses. Second, the leader behaviour of idealised influence showed the strongest correlation to commitment scores, and, the final, somewhat unexpected results was the leader behaviour of intellectual stimulation showed statistically significant results but these were negatively correlated with staff’s organisational commitment.