Autocratic Leadership in Nursing



Autocratic Leadership in Nursing

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Leadership refers to the capacity to motivate, influence as well as make others able to participate in making sure that the organization's goals and objectives are met (Buisman, 2009). The style of leadership is how a leader prompts particular leadership behavior. Autocratic leadership, also known as authoritarian, is the one when the leader makes all the decisions regarding the operations of the organization without the input of other staff members (Kisner, 2013).

Such leaders use their ideas to make choices and have no regard for the advice of people working below them. The use of this style of leadership has been associated with a lot of setbacks. The leader does not accept opinions from others despite their benefit to the institution or group (Romey, 2002).

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When it comes to jobs, the majority of nurses are not satisfied when this style of leadership is used in a hospital setting. This is because of the many problems it exhibits (Hayes et al., 2005). The purpose of this work is to examine whether the autocratic leadership style decreases job satisfaction in nurses. This study will look at various problems associated with this style of leadership. It will also examine whether this style leads to low job satisfaction among nurses.


There have been several types of research done on job satisfaction in many organizations as well as countries. More work has been done on the job satisfaction of nurses and teachers about leadership style (Doran, 2004). Several studies have confirmed this relationship. Job satisfaction due to the leadership style accounts for 29% (Romey, 2002). Recent studies have shown that the style of leadership in a hospital setting plays an important role in ensuring job satisfaction. There is thus a high need for leaders in a hospital setting to ensure that they are using other styles of leadership such as transformational.

Such a move will prevent nurses from leaving their job, thus saving a lot of money, which would have been spent on employing new nurses (Kisner, 2013). Such style is likely to be accepted by nurses as it encourages commitment among staff, reduces stress as well as increases workers' morale. This eventually enhances the satisfaction of workers (Doran, 2004).

Numerous researches are touching on the styles of leadership in healthcare. Recent studies have shown that supervisory relations quality, as well as leaders' behavior, influences the job satisfaction of nurses (Pallls & Duffield, 2005). It is thus essential for the hospital to consider looking at factors, which result in the rise of nurse retention. Job stress is more likely to occur in the autocratic style of leadership. Such style is associated with the low cohesion of the group. Most studies have shown that the autocratic style of leadership is associated with a negative effect on nurses' job satisfaction (Doran, 2004).

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Studies have concluded that the autocratic style of leadership leads to stress, job dissatisfaction as well as strain. According to Romey (2002), this style of leadership fails to involve his staff in decision-making, leaving him as the sole decision-maker. The subsidiary staff cannot air their opinions despite them being beneficial to the organization. This form of leadership is full of bureaucracy, which prevents autonomy (Buisman, 2009).

Hospital managers should thus ensure that their leadership styles encourage autonomy. This will lead to job satisfaction. Under the autocratic leadership style, nurses do operate under a lot of pressure (Buisman, 2009). They are compelled to do things aimed at the improvement of quality in the provision of care and this has contributed to their loss of morale. Their performance tends to be poor and this has led to low production in the hospital setting (Doran, 2004).

The autocratic leadership style also leads to the tendency of nurses to leave their jobs owing to their dissatisfaction. This style does not allow the staff to participate in the organization's common commitment that leads to an ideal working environment (Hayes et al., 2005). There is no room for creativity in such a leadership style. The long-term effect of such a style of leadership is the demotivation of the staff (Buisman, 2009).

Leaders using this style do not require group opinions. Every individual is expected to follow orders. There is a growing concern about job satisfaction among nurses in the hospital setting. Unsatisfied workers are more likely to leave work than their colleagues who are satisfied (Kisner, 2013). Retention, as well as staff turnover, belongs to critical issues as far as management of the health sector is concerned. Employees who are satisfied with their jobs are more likely to have high production as well as retain their jobs (Doran, 2004).

There is also a higher level of innovation among employees who have job satisfaction than those who are dissatisfied. Job satisfaction among nurses is directly related to patient satisfaction (Doran, 2004). Leadership is critical as far as job satisfaction is concerned. The use of an effective leadership style by managers can lead to job satisfaction among nurses. The capacity of a leader to ensure that the subordinates perform at their highest capacity is what leadership is. Recent studies have shown that the style of leadership plays an important role in the promotion of workplace empowerment, job satisfaction as well as organizational commitment (Doran, 2004)

Hospital leaders are faced with the challenge of choosing the leadership style, which is vital in leading nurses. According to the research, a transformational leadership style is important in ensuring that nurses are satisfied in the workplace (Hayes et al., 2005). This is because of its ability to instill commitment levels in employees, which is higher. This in return reduces employees' stress while at the same time it increases their morale.


Each day, the responsibility of nurses is to ensure that patients are healthy and their wellbeing is taken care of. Clinical leaders in the hospital setting should play a critical role in ensuring that nurses are satisfied with their jobs. This will help in ensuring that they remain committed to their work as their morale will be high (Romney, 2002). The choice of leadership style determines the job satisfaction of nurses.

In this case, the autocratic style of leadership is examined. Among the characteristics of this leadership style, there is the fact that group members have little input as far as decision-making is concerned. When it comes to decision-making, leaders entirely dominate. There is a dictation by group leaders on how work would be done. There is also no trust of group members when it comes to decision-making or tasks, which are important (Kisner, 2013).

Individuals who use this form of leadership are viewed as being dictatorial, bossy as well as controlling. This is most cases result in resentment and dissatisfaction among the members of the group (Buisman, 2009). The performance of the group is likely to be lowered as creative ideas to the problems are not available. Studies have shown that dissatisfaction among nurses is one of the leading factors that nurses leave their work. Job dissatisfaction predates nurses' intention to leave their jobs (Doran, 2004).

Several strategies have been put in place and are aimed at helping nurse leaders to retain their nurse staff. They include:

Participation in Decision Making

One of the leading causes of nurses' lowered satisfaction in the job is the failure of leaders to allow them to participate in decision-making (Kisner, 2013). Leaders have the responsibility of cultivating an environment, which allows nurses to participate in decision making. Their opinions should be respected. This form of leadership enhances job satisfaction unlike autocratic leadership (Doran 2004).

Nurses should be included in the governance of the institution. Transformational leadership is the best form of leadership in the hospital setting. This is because it enables the staff to be proactive. This form of leadership inspires others. Leaders using this style are visible and engage the staff in communications aimed at meeting the organization's set objectives (Romey, 2002). Unlike autocratic leadership where the nurse is demotivated, this form of leadership keeps the nurse motivated all the time.

Transformational leadership is charismatic, motivation-oriented, provides an ethical base, which is strong, and it also ensures that the institution is creative. On the other hand, autocratic leadership is full of problems. Leaders use an approach, which is passive as well as reactive.

Respect and Satisfaction

Job satisfaction among nurses is determined by nurses' respect perception. Respect occurs when individuals' dignity, as well as worth, is valued (Buisman, 2009). Recognition of the achievements of the staff is critical in ensuring a rise in job satisfaction. To achieve this, leaders can send congratulatory messages to them telling them how important they are to the institution. Giving nurses awards for good performance acts as a source of motivation for them. This can enhance job retention. Leaders should also be at the forefront, helping nurses in their jobs. This can range from coaching them as well as training them to improve their performance (Hayes et al., 2005).

Improved Access to Communication

Communication between nurses and the administration of the hospital is very critical. Nurses will feel satisfied if they are allowed to access communication channels within the institution (Doran, 2004). Communication can be enhanced through various channels, which include departmental meetings, training, nurse rounds as well as meetings between nurses and their leaders.

Negative Effects of Autocratic Style of Leadership

Autocracy and working pressure. Nurses who are under autocratic leaders have increased pressure. This is because they are required to provide high-quality care. This is unlike the participatory style of leadership where leaders are allowed to participate (Kisner, 2013). This form of leadership allows nurses to build trust and is associated with high retention of nurses. Leaders must thus build relationships, which are both collaborative as well as utilize a participatory leadership style. Job satisfaction increase is the best way to ensure the retention of nurses (Doran, 2004). Nurse empowerment through involving them in decision-making is critical in ensuring that their morale, as well as performance, is boosted. The performance of their duties will be superb and they will do this with competence and confidence.

Autocratic Leadership and Conflict

Studies have shown that the autocratic style of leadership is linked to the rise in conflicts. This is because the staff feels left out in major decision-making about the running of the affairs of the hospital. Owing to this, the level of satisfaction among these nurses is greatly reduced. Conflict results in the reduction of creativity, thus reducing productivity (Buisman, 2009). Conflicts are also associated with the reduction of workers' morale.

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Autocratic leadership at times reduces tension, but this only occurs when the leader chooses a certain line. However, this form of style is comparable to tyranny or dictatorship. The only time this form of leadership is necessary is when the work needs to be completed within a short period. This is to ensure that everybody participates in the task assigned. The autocratic style of leadership has been shown to cause poor performance of employees as well as negative results (Buisman, 2013).

Relationship between autocratic style and stress. Stress reaction decreases when using both transformational as well as transactional styles of leadership. Opposed to this is the autocratic leadership style, which leads to a high level of stress among nurses (Hayes et al., 2005). This style of leadership provides an unfavorable working environment as nurses are not supposed to question decisions made by their leaders. Such an environment does not allow a healthy sharing of information. There is no proper condition of work while using this style of leadership as all orders have to come from the leader himself.

Autocracy as a demotivating factor. The autocratic style of leadership fails to consider contributions made by nurses. This and several other factors lower job satisfaction among nurses (Romey, 2002). The retention of nurses is also low while using this style of leadership. Communication between leaders and the staff is critical as it creates an avenue for improving the organization. Since all decisions are made by the leader without consulting other staff members, there is a likelihood of low performance (Doran, 2004).

Workers experience pressure from autocratic leaders as they are expected to perform their duties with the least expected time. This has in many instances led to the low retention of staff members. However, workers will be more satisfied when allowed to participate in decision-making. This is only possible through the use of transformational as well as transactional styles of leadership (Buisman, 2009).

Autocracy and dictation. Autocratic leaders dictate what to be done. This style leads to frustrations. The environment of fear, as well as resentment, is thus generated through the use of this style of leadership (Doran, 2004). Owing to this, there is a high rate of absenteeism as well as low turnover from the workers. Progress in the organization or institution is thus hindered. This form of leadership also creates a hostile environment between the leader and the staff. Autocratic leaders are in most cases more hated than loved ones (Kisner, 2013).

Job satisfaction is thus decreased when using this style. Because the nurse is demotivated, they are likely to perform poorly in the hospital and this leads to reduced patient satisfaction. Teamwork, as well as co-operation among nurses, is likely to miss if leaders are using the autocratic style of leadership (Romey, 2002). There is also a rise in interpersonal conflicts while using this style. As the nurses become dissatisfied, there is low retention of the job.

Autocracy and the working environment. Leadership style influences group cohesion as well as turnover. When it comes to autocratic leadership, there is no consideration of nurses. Such leadership fails to provide a good working environment, thus nurses are not empowered. Apart from that, they are not given a chance to participate (Doran, 2004). Autonomy, as well as control of their work, is dependent on their leaders. In short, nurses have no say when it comes to decision-making. Leaders who practice this style are only interested in seeing the results from nurses. There is no intellectual stimulation from them and they emerge especially when a worker has made a mistake (Kisner, 2013).

While working, the leader does not monitor the performance of the staff. There is a direct relationship between nurse satisfaction and the satisfaction of patients (Doran, 2004). The facilitation of patient care is hindered while the autocratic leadership style is utilized. This is because task clarification, working procedures as well as expectations are not taken into consideration by these leaders (Hayes et al., 2005). Autocratic leaders are never there to give guidance to nurses. Studies have shown that there is high anxiety as well as emotional exhaustion among staff whose leaders use this style. The outcome of nurses is negative when this form of leadership is used unlike when the leadership style is either transactional or transformational.

Recent studies have shown that the leadership of the hospital has a great influence on the satisfaction of nurses (Romey, 2002). The empowerment of nurses in the hospital determines their satisfaction. According to studies, nurses who are empowered are likely to collaborate with the leadership (Buisman, 2009). He/she is also able to improve job ownership as well as trust. Hospital leaders thus have a duty of using a leadership style that encourages collaboration as well as high performance among nurses. To ensure retention as well as the satisfaction of nurses, there is thus a high need to use transformational leadership.

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Many researchers have concluded that transformation leadership is the best style as it brings about the much-needed organizational commitment (Hayes et al., 2005). In addition, it ensures good working relationships between nurses and their leaders. It contributes a lot to the empowerment of nurses. The result of this is job satisfaction. Leaders who use the transformational leadership style are visionary as well as inspirational. Owing to this, the staffs are likely to show their highest level of efficiency as well as satisfaction.

Empowerment of nurses not only provides them with the opportunity for growth but also promotes autonomy (Doran, 2004). The transformational leader believes that the achievement of organizations' goals and objectives can only occur when every staff member is involved. Involving the staff in management makes leaders gain power rather than lose it. The staff can gain autonomy, job satisfaction as well as self-esteem (Krisner, 2013). Productivity is prone to increase and this is to the benefit of the leader.

According to the research, autocratic leadership can occur as a result of mechanistic bureaucracy. The relations between employee satisfaction, leadership style as well as organizational commitment are vital in a hospital. Recent studies show that nurses dislike leaders who are autocratic (Buisman, 2009).

Autocratic leaders require absolute compliance to the leader by the nurse (Doran, 2004). It is also referred to as authoritarian or paternalistic. Decision-making revolves around the leader. These leaders are opposed to any initiatives from junior staff. There is low trust from group members (Hayes et al., 2005). Job satisfaction studies have been done by several researchers. Employee satisfaction is a clear indication that they are treated with respect as well as with fairness.

The stressful working environment is a result of using the autocratic style of leadership. Nurses do not perform on their best level as they operate under threat. There is a common belief that employees do not leave their job, but rather their bosses (Buisman, 2009). The characteristics of a leader influence the satisfaction level of nurses. When an employee feels that he/she cannot cope with the employer, he/she starts developing a negative attitude towards the work. As time goes, he/she feels unworthy and thus cannot perform the work well.

A recent study shows that the employee feels unsatisfied owing to the failure of the leader to offer support. This can also occur when the leader accord favors to other staff members. It is clear that transformational, as well as transactional leadership styles, are associated with increased satisfaction of nurses. On the other hand, the autocratic style of leadership does the opposite (Kisner, 2013). The satisfaction of nurses is directly related to the satisfaction of patients. While transformational leadership is associated with a rise in turnover, the autocratic style does the opposite.

Job satisfaction among nurses as well as unit turnover is positively influenced by transformational leadership (Kisner, 2013). Leaders using this style can provide support, positive feedback as well as encouragement to the nurse staff. Unlike the autocratic leadership style where nurses feel that they are not recognized, this style of leadership employs a participatory approach where the views of nurses are respected. The leader treats everyone with respect and there is a direct dialogue with the staff as relating to the management of the hospital (Romey, 2002). When a nurse is recognized for doing a noble job, she/he feels satisfied with that job. Lack of recognition is common in the autocratic style of leadership as the leader is less likely to associate with his/her junior staff.

The autocratic style of leadership results in a reduction in the labor efficiency of nurses. Such leaders are not sensitive when it comes to the feelings of employees. Though they usually require perfection from the staff, it is not usually the case (Kisner, 2013). Lack of trust for other members of the staff is the main reason why such leaders do not allow their opinion or suggestion, though aimed at improving the operations of the organization (Kisner, 2013). Opinions of other staff members have no meaning according to autocratic leaders. Some nurses whose leaders act using this style wish to see the downfall of such leaders (Doran, 2004). There are those members who go to the extent of failing to turn up for work simply to avoid contact with their leaders.

How to Cope with Autocratic Leaders?

One way to avoid trouble with these leaders is never to correct them. Since they value their point of view, it is advisable to avoid making utterances aimed at attacking them as this will bring trouble to you. However, it is essential to understand what is expected of you so that you do not cross the line with these leaders (Hayes et al., 2005). The leaders are result-oriented. thus one must ensure that they work to perfection. This however reduces the satisfaction of workers as they only work to satisfy their leaders. Autocratic leaders are known to capitalize on individual weaknesses and this further makes workers feel dissatisfied (Kisner, 2013). As the leader demoralizes the staff, the overall performance is greatly affected.

Alternative to Autocratic Leadership Style

Transactional leadership. This is a form of leadership where a leader assigns tasks, does the specification of procedures, and clarifies expectations. Like transformational, this style of leadership is associated with high job satisfaction among nurses (Doran, 2004). Unlike autocratic leadership, which is associated with emotional exhaustion, transactional leadership is the opposite of this. It does not only reduce emotional exhaustion but also decreases role ambiguity as well as increases nurses' job satisfaction.

Transformational leadership. The transformational leadership style is favored among most nurses. This style is associated with a reduced turnover of nurses (Doran, 2004). Retention is also enhanced while using this style of leadership. Reduced turnover of the staff means that the hospital will spend less on both hirings as well as orienting new staff members. The quality of care among nurses is also bound to increase as they are satisfied (Buisman, 2009). Currently, there are few nurses in the hospital, thus it is the responsibility of the management to avoid using the autocratic style of leadership as it leads to low retention. Each day, there is a high demand for nurses owing to the rising population.


Job satisfaction is dependent on leadership style. The use of the autocratic style of leadership has been associated with a lot of problems, among them reduced job satisfaction among nurses (Hayes et al., 2005). Transformational leadership is the best style of leadership as the leader allows nurses to participate in decision-making. Leaders need to avoid using the autocratic style if they desire to see a positive outcome from the staff. In hospital settings, leaders should avoid using the autocratic style of leadership as it is associated with reduced job satisfaction (Doran, 2004).

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