Two of the primary aims of leadership in healthcare are improving patient outcomes and increasing nursing satisfaction. One of the most effective ways of doing this is to improve clinical nurse autonomy, giving nurses more control over nursing practice (Weston, 2010). Nurses that have the ability and the freedom to work autonomously are often more satisfied with their role, and autonomy can also help them to develop skills in decision-making (Blais, 2015).

Whilst working to guidelines and using evidence-based practice is key, healthcare is a constantly changing environment and nurses need to be able to adapt their practice to these changes. Giving nurses autonomy in some areas can help promote this flexibility and adaptability and therefore has positive effects on nursing skills and outcomes. Autonomy does not mean encouraging nurses to avoid the rules, but to having the ability to act according to personal knowledge, experience, and judgment (Weston, 2010).

To put this into context, one leadership concern in healthcare is nurse staffing. The United States is facing a nursing shortage, and nurse leaders are often conflicted when making decisions about accurately staffing departments. Nurse leaders may also be challenged by attempting to supervise and advise all of the RNs that they work with, especially if there is only one nurse leader available at a time. Giving nurses more autonomy and flexibility in the workplace can help to overcome some of these challenges. If nurses can use their skills and making decisions based on their skills and experienced, it can make the healthcare provision run more smoothly because nurses are not constantly referring to supervisors. Ensuring that nurses are trained in autonomous decision-making also increases their flexibility and their ability to deal with new problems, which can have a positive effect on understaffed departments.

Justice is another ethical concept that is integral to nursing practice. The term justice refers to the idea that nurses have a responsibility to follow law and ethics in terms of individualized patient care. Justice has also been used to highlight that there are certain health discrepancies and nurses have a duty to address various social conditions that undermine community health outcomes (Johnstone, 2011). In leadership roles, health care providers have a duty to treat all patients fairly and equally, and this extends to the treatment of other staff members. Leadership teams will usually have to make decisions for patient care that involve the rights of both the patient and other staff members, and one of the ethical principles that most affects these decisions is justice – leaders need to have an ability to make fair judgments.

One example of how justice can affect leadership is through the provision of donated treatments. The leadership of an organization may decide that they will donate a certain number of free hearing exams to elementary school children. Those involved with the scheme then have to decide on a fair and unbiased approach to designating these free appointments based on the knowledge that they have of their patients (Grohar-Murray et al., 2016). Justice is an approach that can help to highlight which children will benefit the most from these free hearing tests, and using it as an ethical principle will make the decision-making processer both easier and fairer.

This type of scenario highlights the importance of justice in healthcare leadership as it shows how it can be used to solve a problem that unfairly affects a certain population – in this case, parents and children that cannot afford hearing tests at the hospital. It is a way of ensuring that nurse leaders are providing the fairest service to all patients in the community that they serve.