Nursing Leadership and Workplace Culture


Published: 04 December 2016

Nurse leaders are at the forefront of creating positive workplace cultures where nurses can thrive. There are many explanations for why nurses resign from positions, change employers or leave the profession altogether; nurturing favourable workplace environments is a powerful way to support nurses in experiencing optimal career satisfaction and productivity.

Culture is Crucial

Workplace culture may seem like a trendy 21st-century buzzword but the importance of culture cannot be overstated. Some cultures are stiff, formal, hierarchical and strictly businesslike whereas others are informal, creative, personable and less hierarchical. Communication, organisational structure, interpersonal relationships and transparency are all aspects of culture, and every organisation has its own cultural baggage to negotiate.

Tech. companies like Google and Facebook are known for having cultures where employees receive perks such as free childcare, meals, and on-site laundry. Moreover, these types of workplaces encourage creativity and out-of-the-box thinking, providing work spaces that naturally lead to sharing and collaboration.

Culture can make or break a workplace, and the most progressive organisations pay attention to the environments they create for their employees.

nursing leadership and workplace culture

Healthcare Culture and Nursing

In the healthcare space, it may be perceived that there is less room for creative approaches to hierarchy and decision-making, however, nurse leaders can use their influence to create cultures that bring out the best in nurses and other staff members.

In the 21st century, a great deal of attention is paid to the patient experience and, at least in the United States, hospital reimbursements for care are now being tied to patient satisfaction scores. While patient satisfaction is an important goal in the delivery of healthcare, staff satisfaction is also paramount. Forward-thinking nurse leaders keep their fingers on the pulse of staff members’ feelings related to the quality of the work experience.

In the nursing literature, bullying among nurses (also known as “lateral violence” or “horizontal violence”) is a scourge that eats away at nurses’ mental health and professional satisfaction. When a culture of bullying, intimidation or harassment is tolerated, nurses feel unsafe, unprotected, and vulnerable to attack by colleagues. A nursing administrator, manager, or executive who turns a blind eye to the existence of lateral violence in the workplace sends a signal that their silence equals complicity with such aberrant behaviour, thus a culture of fear and mistrust results. Needless to say, such an environment can lead to increased sick days, stress-related symptoms, and nurse attrition.

Nurse Leaders as Champions of Culture

Nurse leaders are in the position of setting an example for other nurses through their words and actions. A nurse leader who maintains positive contact with staff and encourages open communication sends a signal that the expression of one’s thoughts and opinions is welcome. When nurses are allowed to question processes or protocols and come forward with innovative ideas, it’s a clear message that the culture is one where everyone is valued for their intelligence and insight.

Nurses in positions of leadership can grease the wheels of communication between nursing staff and other disciplines, setting the stage for a collaborative culture steeped in respectful multidisciplinary practice.

While nurse leaders may not have the power to provide free childcare or lunch for staff nurses, he or she may have the ability to influence how nurses are cared for by the organisation; a workplace culture that nurtures its nurses may provide special recognition for nurses’ accomplishments, flexible work schedules, opportunities for advancement, nurse wellness initiatives, or mentoring and precepting programs focused on nurses’ success.

The purse strings may not be held by nurse leaders, but nurses in positions of power can exert their influence on the overall culture of an organisation, as well as the subcultures within individual units or nursing teams.


Portrait of Keith Carlson
Keith Carlson

Keith Carlson, RN, BSN, NC-BC, is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, speaker, author, and popular career columnist. With two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s two podcasts, RNFM Radio and The Nurse Keith Show, offer inspiration and practical support to nurses seeking to create meaningful, satisfying lives and careers. Keith’s message of savvy career management and professional satisfaction reaches tens of thousands of nurses worldwide. Keith can be found on many social media platforms---including Facebook, Twitter, Pinterest, LinkedIn, and Instagram - as well as at and Digital Doorway. See Educator Profile

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