Transformational leadership in nurses' practice in a university hospital

Objective: To analyze the exercise of transformational leadership in nurses' practice in a university hospital. Methods: Mixed-method explanatory sequential study. In the quantitative phase, a questionnaire of attitudes towards leadership styles adapted to the frequency of adoption of transformational leadership behaviors was applied to a non-probabilistic convenience sample of 152 nurses from the university hospital. Descriptive and analytical statistical tests were used for data treatment. In the qualitative phase, 25 participants from the first phase were randomly selected (draw) and responded to a semi-structured interview that was analyzed by thematic content analysis. Results: The practice of transformational leadership was identified frequently among nurses. However, they had difficulties to exercise this leadership model, because of lack of institutional support, since vertical leadership is the most adopted style, as well as lack of training for care nurses, and weaknesses in communication and discussion of problems before decision making. Conclusion: The managers' greater exercise of vertical leadership offers resistance to the transformational leadership practice. However, nurses believe that leadership with horizontal behavior can favor structural and behavioral institutional changes.