A Portrait of Success: Exploring Best Leadership Styles in Middle Management through a Descriptive Qualitative Approach

Abstract

Aims: This study explored how nurse middle managers perceived effective leadership, supervised nurses with differing levels of clinical competence, and developed preferences for standardised or personalised leadership through managerial experience. Methodology: A descriptive qualitative study was conducted in a community-based National Health Service (NHS) trust in Central London. Six Filipino nurse middle managers holding Band 6 or Band 7 posts were purposively selected. Individual semi-structured interviews, lasting approximately 30–60 minutes, were conducted through online conferencing platforms. Interview recordings were transcribed verbatim and analysed thematically. Results: Four themes were identified: adaptive and relational leadership; leadership development as an experiential process; competency-based leadership; and personalised leadership. Participants described effective leadership in terms of compassion, flexibility, cultural sensitivity and responsiveness to individual staff needs. They reported that managerial experience informed their leadership judgements and that supervisory approaches varied according to nurses’ competence and developmental readiness. Novice nurses were perceived as requiring structured guidance and preceptorship, whereas experienced nurses were considered able to exercise greater autonomy while retaining access to support. Participants favoured adapting leadership practices to staff needs rather than applying a uniform style. These themes informed the proposed LEAD-Nurse Leadership Development Program. Conclusion: The findings offer context-specific insights into adaptive and individualised leadership practices among nurse middle managers. They do not establish the comparative effectiveness of leadership styles or demonstrate effects on staff, organisational or patient outcomes.