Patients' Perceptions and Nurses' Perceptions of Nurse Caring Behavior

Successful nursing leadership requires positive interpersonal qualities, superb critical thinking skills, diverse expertise and knowledge (Allen, 1998). Most importantly, nursing leaders must be flexible, supportive, visionary and highly visible to their staffs. Outhwaite (2003) suggests that any individual who engages within a leadership role needs to initially explore their own values and beliefs and strive to develop their self-awareness. In addition, team members should also engage in the same process, thus enabling them to identify needed changes and to become empowered in the process. The characteristics of rural nursing leaders and rural practice differ from those of their urban counterparts. The leadership style demonstrated by these leaders can impact staff negatively or positively, which ultimately affects the quality of patient care. The purpose of this investigation was to describe leadership styles of rural chief nursing executives in Kansas, and to identify leadership styles that describe the unique characteristics of rural nursing practice and compare the findings in Adams (1993) study. The framework for this investigation was based on Blanchard and Hersey's model of Situational Leadership (Hersey & Blanchard, 1993). Situational Leadership provides a framework or the importance of tile leadership style and behavior exhibited and the readiness of the follower. The research design for this investigation was a descriptive correlational design. Data were collected from 52 chief nursing executives in acute care hospitals in Kansas with 100 beds or less. The survey results were based on the information gathered from the instrument, Leadership Effectiveness and Adaptability Description-Self (LEAD -S) developed by Hersey (1989). Both leadership style and leadership adaptability were measured using the LEAD-S. The results of the LEAD-S analysis revealed that rural chief nurse executives in Kansas chose high relationship leadership styles such as selling and participating. With regards to leadership adaptability, the rural nurse leaders were average in their ability to adapt their leadership style to the readiness level of their followers, which is consistent with the findings in Adams (1993) study.