The ongoing changes in the health-care landscape are influenced most by globalization, economic and technological factors, and the aging of the population. The complexity of the healthcare environment requires us to examine the leadership needs for the APN roles that are applicable for today and the future (Joel, 2018). In chapter 21 (Leadership for APNs: If Not Now, Then When?) the author outlines serval leadership theories or styles including: Select one of the above leadership theories or style.


The changing dynamics of the healthcare landscape are being shaped by various factors including globalization, economic and technological advancements, and the aging population. These changes necessitate a closer examination of the leadership requirements for advanced practice nursing (APN) roles. As the demand for APNs increases, it becomes crucial to identify and adopt effective leadership theories or styles that can guide these professionals in delivering quality healthcare services. This paper aims to critically analyze one of the leadership theories mentioned in Chapter 21 of Joel’s (2018) book, “Leadership for APNs: If Not Now, Then When?”.

Leadership Theories and Styles in APN Roles:

The role of a leader in healthcare settings is paramount in envisioning and implementing the strategic direction of an organization. It is crucial to understand the different leadership theories and styles to identify the most appropriate approach for APNs in today’s complex healthcare environment. Chapter 21 of Joel’s (2018) book highlights several leadership theories and styles, including transformational leadership, transactional leadership, and situational leadership.

Transformational Leadership:

Transformational leadership is a leadership theory that emphasizes the leader’s ability to inspire, motivate, and intellectually stimulate their followers (Bass & Riggio, 2006). This leadership style focuses on the leader’s ability to create a shared vision and value system to promote a positive organizational culture. Transformational leaders are known for their ability to motivate their followers to exceed expectations and achieve exceptional outcomes.

In the context of APN roles, transformational leadership can be particularly effective. APNs often find themselves in challenging and complex healthcare environments, where they need to adapt and innovate. Transformational leaders can provide the necessary vision and inspiration to navigate these complexities and drive positive change. By fostering a culture of collaboration and shared accountability, transformational leaders can empower APNs to excel in their practice and contribute to the overall improvement of healthcare delivery.

Transactional Leadership:

Transactional leadership is a leadership style that focuses on the exchange relationship between the leader and their followers (Bass & Riggio, 2006). This style predominantly emphasizes contingent reward and management by exception. Transactional leaders set clear expectations, provide rewards and recognition for meeting those expectations, and intervene when deviations occur. This leadership style is often associated with maintaining the status quo and managing day-to-day operations.

In the context of APN roles, transactional leadership may not be the most effective approach. APNs require a level of autonomy and flexibility to fulfill their advanced practice responsibilities, such as making clinical decisions and coordinating patient care. Transactional leaders might inadvertently restrict the autonomy and innovation potential of APNs by focusing too much on following established protocols and norms. However, some aspects of transactional leadership, such as providing clarity in expectations and rewards for performance, can still be valuable when combined with other leadership styles.

Situational Leadership:

Situational leadership theory posits that effective leadership is contingent upon the specific situation and the readiness level of the followers (Hersey & Blanchard, 1969). This theory suggests that leaders should adapt their leadership style based on the needs and capabilities of their followers. The situational leader assesses the readiness level of their followers and adjusts their leadership approach accordingly, ranging from directing and coaching to supporting and delegating.

In the context of APN roles, situational leadership provides a flexible framework for leaders to adapt to the varying needs and capabilities of APNs. APNs often possess a high level of expertise and autonomy, which would necessitate a more supportive and delegating leadership style. However, there may be situations where APNs require more direction and coaching, especially when they are new to complex clinical situations or organizational changes. Situational leadership allows leaders to tailor their approach based on the developmental stage and readiness of the APNs, optimizing their growth and performance.


The changing healthcare landscape demands effective leadership in APN roles. Transformational leadership appears to be especially relevant as it aligns with the need for inspiration, innovation, and collaboration in complex healthcare environments. Transactional leadership, although valuable in certain aspects, may restrict the autonomy and innovation potential of APNs when used in isolation. Situational leadership, on the other hand, offers a flexible framework that allows leaders to adapt to the varying needs and capabilities of APNs. Ultimately, the choice of leadership theory or style for APNs should be based on an understanding of the organizational context, followers’ needs, and desired outcomes.

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