Leader-Member Exchange in Nursing Essay

Introduction

Leader-Member Exchange (LMX) is a rather innovative and comprehensive approach to leadership, which was the first to attempt to explain the effects of leadership by analysing the mutual, reciprocal relationships between leaders and members (Goldberg & McKay, 2015). It appears to have a very extensive potential from the point of view of individual and organisational outcomes, and it is a useful tool that can provide the framework for the development and analysis of leader-member relationships, which makes it of interest for nursing.

The present essay is devoted to an analysis of LMX in general and within the context of nursing. In particular, the work considers the definition of LMX and its key features, reviews the key research topics related to LMX, and it discusses its value and significance. After that, the paper applies the information to the context of nursing while introducing additional research dedicated specifically to nursing settings. The value of LMX for nursing is described together with the current and potential issues of LMX in nursing, after which LMX improvement solutions for nursing leaders are offered, and a conclusion about the use of LMX in nursing is made.

LMX: Basis and Importance

LMX Definition

LMX can be defined as an approach to leadership, which is predominantly characterised by its focus on the reciprocal relationship between leaders and members, which is used to understand the specifics of the effects of leadership (Barbuto, Wilmot, & Story, 2011; Bauer & Erdogan). This relationship is continually created “through a series of social exchanges between leaders and employees,” and with the exchanges being reciprocal, both groups can contribute to the development of the relationship (Goldberg & McKay, 2015, p. 733).

In particular, a member that demonstrates exceptional performance typically enjoys more support (more high-quality relationship) with the leader due to having contributed his or her high-quality performance to the exchange (Kam, Vegt, Janssen, & Stoker, 2014; Wang, Kim, & Milne, 2017).

A person with a less impressive performance may enjoy a less trusting and positive relationship with the leader, which constitutes a poor, low-quality mutual exchange and results in a somewhat contractual relationship between the two (Han & Jekel, 2010). The former employee is likely to become a member of the in-group, while the latter would, as a part of the out-group from the point of view of the character and quality of their relationship with the leader (Gibb & Zhang, 2017; Kozlowski, Mak, & Chao, 2016).

The approach of LMX was novel in multiple ways: it shifted the focus from one of the participants of the exchange to both of them while also highlighting the fact that leaders develop different relationships with different members and that these relationships are dynamic (Bauer & Erdogan, 2015; Ospina, 2016). Apart from that, LMX has a long history: it began its development in the 1970s as Vertical Dyad Linkage theory, grew into a major, mature field of investigation, and it proceeds to rapidly develop even nowadays (Bauer & Erdogan, 2015, pp. 29-30; Gooty & Yammarino, 2016). As a result, it is necessary to investigate the key aspects of the contemporary understanding of LMX and related research.

Key Aspects of Contemporary LMX Research

Characteristics of the members

Throughout its development, the theory of LMX appears to have changed its direction a couple of times. Initially, the characteristics of the leader and the member were of particular importance to LMX researchers (Schyns & Day, 2010). For example, given the process of LMX relationships development, hard-working people with a need for personal growth are more likely to be engaged in high-quality exchanges. Another feature that is of importance both for the leaders and the members from the point of view of LMX is communicative skills (Erkutlu & Chafra, 2012; Schyns & Day, 2010).

Indeed, communication is central to leadership in general and LMX in particular (Bakar, Mustaffa, & Mohamad, 2009). LMX is predominantly related to interpersonal communication (that between the leader and the member), but intrapersonal communication also appears to be of significance for the approach (Litano, Major, Landers, Streets, & Bass, 2016). Intra-communication (intra-personal communication) refers to a person’s communication with oneself (Kam et al., 2014).

The expectations of both the employee and the leader are of significance for the development of LMX, which makes the person’s ability to understand oneself as important as the ability to communicate this understanding to another person (Goldberg & McKay, 2015).

Intra-communication is also connected to intrapersonal emotional intelligence, which is another significant feature for LMX. Emotional intelligence presupposes the ability to understand the feelings of oneself and other people (Erkutlu & Chafra, 2012). When viewed from the point of view of LMX, this skill can be helpful for the leader and the member in developing their relationship. Finally, it is noteworthy that the diverse features of employees can decrease the effectiveness of LMX activities because of the differences in perceptions, cultures (Brunetto, Shacklock, Teo, Farr-Wharton, & Nelson, 2014), and other specific characteristics (Goldberg & McKay).

Apart from the characteristics of the members, various styles of leadership have been investigated from the LMX perspective. For example, Pellegrini, Scandura, and Jayaraman (2010) consider the paternalistic (benevolent and authoritarian) style and show in their study with the sample of 420 people that it is appropriate for LMX, but its effectiveness depends on the cultural specifics of a country. Moreover, Schyns and Day (2010) mention the characteristics of the environment, for example, strict rules, which can hinder the development of relationships. To sum up, a variety of factors that can have an impact on LMX seem to be researched quite extensively.

Beyond dyadic level

Nowadays, LMX research seems to be moving towards the investigation of areas “beyond the dyadic level” (Bauer & Erdogan, 2015, p. 35). Indeed, companies are complex systems, in which multiple forms of exchange can occur, and any of them can be of importance for leader, employee, team, and organisation outcomes (Buch, 2014). For instance, Vidyarthi, Erdogan, Anand, Liden, and Chaudhry (2014) discuss the topic of an employee working with two leaders, which results in the overlapping of the two exchanges. They demonstrate that the effect of the combination of the two relationships offers a more comprehensive explanation of employee outcomes than the consideration of each relationship on its own.

Even LMX can occur on various levels, but it is not the only type of exchange that is possible (Karanika-Murray, Bartholomew, Williams, & Cox, 2015). For example, Buch (2014) concentrates on the member-organisation exchange and team-member exchange, both of which can affect turnover intention. Moreover, the various exchanges that occur on the side of the member can interact: for instance, a negative LMX can be mediated by positive team-member exchange (Karanika-Murray et al., 2015). Thus, LMX appears to be aiming for a more comprehensive approach.

The effects of LMX

One of the key LMX findings consists of the fact that leaders tend to form relationships of different quality with various members; in other words, these relationships vary in the level of closeness, trust, respect, the amount and value of communication, and some other features (Bauer & Erdogan, 2015).

As a result, LMX can be used to explain varied leadership effects: in the view of the approach, the outcomes of leadership extend by the varied quality of leader-member relationships. This phenomenon results in limited positive outcomes for the members with low-quality relationships and extensive positive outcomes for those with high-quality LMX. In fact, modern-day LMX theory and research are especially engaged in the investigation of the consequences of LMX (Bauer & Erdogan, 2015, pp. 34-35). The present paper also intends to investigate the outcomes of LMX, determining its importance and value.

LMX Importance and Value

LMX is capable of affecting work outcomes of the members (Karanika-Murray et al., 2015), and this effect is apparently achieved through both extrinsic and intrinsic motivation (Breevaart, Bakker, Demerouti, & Heuvel, 2015). For example, LMX can be subdivided into economic and social LMX, which refers respectively to the economic element of the relationship between leaders and members and the social one (Buch, 2014). The former (salary, bonuses) is likely to provide extrinsic motivation, but the latter (positive, trusting, supportive relationships) are more likely to function as intrinsic motivation. In general, the following results of LMX can be singled out from research-based articles.

The quality of LMX is correlated with attitudinal and behavioural outcomes (Goldberg & McKay, 2015, p. 736; Gooty & Yammarino, 2016, p. 916). An example of the former is the commitment of the employee (Hanse, Harlin, Jarebrant, Ulin, & Winkel, 2015; Vidyarthi et al., 2014), and reduction of conflict engagement and can be viewed as an example of the latter (Cropanzano, Dasborough, & Weiss, 2016). In fact, Bakar et al. (2009) demonstrate that LMX quality can affect (improve or decrease) team-oriented commitment.

A negative relationship is found between high-quality LMX and work-family negative experiences (in particular, the interference of the former and the latter) (Litano et al., 2016). This factor is significant on its own, and it can also contribute to the psychological comfort of an employee. Also, the perception of the job’s characteristics can be affected by LMX (Karanika-Murray et al., 2015). In general, LMX quality can affect the employees’ well-being (for instance, in terms of tiredness) and psychological health (for example, burnout), which Karanika-Murray et al. (2015) demonstrate tin their quantitative research with 337 workers as a sample.

Self-efficacy of the employees develops as a result of high LMX (Walumbwa, Cropanzano, & Goldman, 2011). Also, positive, high-quality LMX fosters the development of leadership in employees, and in-group members are more likely to acquire influence and take leadership positions (Vidyarthi et al., 2014). Improved creativity can be fostered by LMX (Cropanzano et al., 2016). In general, LMX is expected to have a positive impact on members’ professional and personal development and careers (Qu, Janssen, & Shi, 2017; Zivnuska, Kacmar, & Valle, 2017).

Apart from that, Goldberg and McKay (2015) report that the existence or absence of a role conflict can also depend on the quality of LMX. All these factors contribute to the quality of the employees’ performance and can have positive impacts on their productivity and customer satisfaction (Jaiswal & Dhar, 2016; Srivastava & Dhar, 2016). Thus, the organisation can also benefit from LMX.

It should be pointed out that the specifics of LMX effects on employees are non-linear. Boon and Biron (2016) carry out a longitudinal study which suggests that person-organisation fit can affect person-job fit in case LMX quality is high. However, the same study also indicates that high LMX can be correlated with greater turnover intent in case the employees’ demands-abilities fit inadequate. The authors also received similar results when regarding the relationship between performance and turnover intentions, demonstrating that high LMX could result in greater turnover intention in highly performing persons (Biron & Boon, 2013).

Apart from that, multiple features that can mediate of affect LMX outcomes were mentioned above (for example, specific features of the members of the environment). Thus, the relationship between LMX and employee and organisational outcomes are rather complex (Trybou, Gemmel, Pauwels, Henninck, & Clays, 2013).

The extensive development of the field of LMX research indicates that modern researchers and practitioners find the approach useful (Bauer & Erdogan, 2015). Given the mentioned outcomes, which are admittedly vast (Zivnuska et al., 2017), it is not surprising that a prescriptive approach to leadership was developed, in which leaders were encouraged to form high-quality relationships with all employees (Metcalf & Benn, 2013; Schyns & Day, 2010). Such an approach made the investigation of LMX particularly significant. To sum up, LMX is a rapidly developing and rather popular framework, which is why it may be of use for nursing, The following section is going to consider this supposition.

LMX in Nursing: An Interpretation

Key Findings

There appears to be a number of studies that attempt to determine the application and effects of LMX in nursing settings. For example, the paper by Portoghese, Galletta, Battistelli, and Leiter (2014) with the sample of 935 nurses demonstrates that LMX can affect job satisfaction and result in improved motivation and reduced turnover intention in nursing settings. Similarly, Han and Jekel (2010) carry out quantitative research with the sample of 400 nurses, which showed that LMX indirectly reduced turnover intention by increasing job satisfaction while reduced job satisfaction had the opposite effect. There is also a correlation between LMX and educational opportunities for nurses (Brunetto et al., 2014). Also, LMX has been shown to foster personal knowledge transfer in nursing settings (Davies, Wong, & Laschinger, 2011).

The studies of nursing LMX also incorporate other features of LMX research mentioned above. For example, Hanse et al. (2015) carried out quantitative research with a sample of 240 nurses to check the appropriateness of servant leadership for LMX. The authors found that there was a strong correlation between certain elements of servant leadership, which typically focuses on serving the community and empowering the members, and LMX quality. The authors demonstrate that humility and empowerment are particularly significant for LMX. In general, the attempts at applying LMX to nursing settings seem to be possible.

However, the general tendency for non-linear, complex relationships and effects is applicable to nursing LMX as well. For example, the study of Trybou et al. (2013) demonstrates that the relationship between LMX and nurses’ outcomes is rather complex and the desired outcomes are not always guaranteed. Similarly, Brunetto et al. (2014) provide a survey-based report that involved the surveying of over 1300 nurses; it finds that LMX is capable of affecting organisational commitment in nurses. However, the authors also discover that the results can be affected by culture, which can reduce the effectiveness of the approach.

A complex relationship has also been discovered in the determination of the elements of LMX that can influence the engagement of nurses. In particular, respect and contribution seem to have a positive relationship with engagement but affect relationships have a negative relationship (Rodwell, McWilliams, & Gulyas, 2016). To sum up, the nursing LMX research seems to be developing in the general direction of LMX providing sufficient evidence to the approach being useful in the settings.

Importance and Value in Nursing

The general potential of LMX that is described above as well as the evidence of this potential being transferable to nursing settings implies that LMX should be of importance for nursing. However, several specific features of nursing and LMX seem to be particularly appropriate for each other. The role of managers in nursing settings is exceptionally important (Han & Jekel, 2010), but nursing leaders need specific tools that could improve their ability to lead (Rodwell et al., 2016).

LMX provides rather sound and logical explanations of the factors that define the outcomes of leadership and constitute relationships, which makes it relatively easy to analyse and develop both. Apart from that, LMX’s focus on empowering is in line with nursing leadership guidelines, and so is LMX’s ability to foster leadership and autonomy (Farr-Wharton, Brunetto, & Shacklock, 2011; Hanse et al., 2015).

The motivational and supportive aspects of LMX are of particular relevance to nursing due to its ongoing resource crisis and generally high levels of burnout and turnover intention (Cummings et al., 2010). LMX’s quality improvement features are exceptionally important for the sphere of human activity which literally involves saving human lives. As a result, LMX can be regarded as valuable for nursing both due to its evidence-proven qualities and the fact that it is a convenient tool, which nursing leaders can employ to improve their practice.

LMX Issues in Nursing Workplaces

A significant theoretical issue of LMX is the problem of discrimination, which seems to sprout from the theory’s admission of leaders forming special, more supportive relationships with some of the members (Gooty & Yammarino, 2016). Moreover, Rodwell et al. (2016) show that the perception of discrimination of this kind reduces trust and increases turnover intention in nurses. Thus, a significant flaw of LMX (its tendency to favour one group of people over others) can diminish the effectiveness of LMX in nursing settings.

Apart from that, diversity management appears to be challenging for LMX (Goldberg & McKay, 2015, p. 730). Nowadays, diversity of the workforce is a fact that needs to be taken into account by the managers to ensure the protection of minorities from discrimination and their engagement in leadership, which they have been historically denied. In fact, in nursing, diversity can be regarded as a positive feature because it plays a role in reducing healthcare disparities by engaging more minority representatives in disparities research (Phillips & Malone, 2014). However, LMX does not appear to encourage diversity.

According to Goldberg and McKay (2015), the typical exclusion of minorities from supervisory posts results in them being supervised by people with backgrounds that are different from theirs. Modern LMX research indicates a positive correlation between background similarities in leaders and members and the quality of exchange between them when compared to the leaders and members that lack similarities (Goldberg & McKay, 2015, p. 135).

Therefore, the differences can affect the quality of relationships, potentially worsening it. In turn, the quality of relationships can result in negative outcomes for the employees (that is, discrimination), and the relationships are likely to sustain themselves, remaining low-quality (Goldberg & McKay, 2015).

In the end, legal issues can ensue, or the turnover intent can increase in the discriminated group, and they might leave, which would further reduce the diversity of the settings. Goldberg and McKay (2015) do point out that additional research is required, in particular, for certain minority groups: current research predominantly contains information on gender and ethnicity without any consideration of co-influence. Still, the possibility of increased discrimination is a very significant concern, especially in nursing settings, which are dedicated to improving the diversity of their workforce (Phillips & Malone, 2014). To sum up, while offering multiple solutions, LMX can also have rather crucial drawbacks, which nursing leaders need to take into account.

Practical Strategies to Improve the Quality of LMX

Solution for the Issue

From the point of view of the discrimination issue that is discussed above, the prescriptive approach to leadership might be recommended (Metcalf & Benn, 2013; Schyns & Day, 2010). It is a rather difficult method of achieving the desired results, but it has certain advantages when considered from the nursing perspective. First, it attempts to resolve the issue of discrimination, which, as was mentioned above, is unacceptable in nursing settings. Second, such an approach allows employing human resources, which are rather scarce and overworked in the field (Cummings et al., 2010), in a more efficient way than the alternative option.

This factor includes the absence of adverse effects and the presence of positive ones, especially those related to self-efficiency, empowerment, and professional development. The quality of care is of primary importance in nursing settings (Phillips & Malone, 2014), and the engagement of every nurse in self-development is the most positive outcome. However, the process is unlikely to be simple, which is why the following section considers the strategies for efficient use of LMX in nursing settings.

Strategies for LMX Development

This section does not intend to recite all the potential strategies for the improvement of LMX use in nursing settings, but it provides several suggestions. First of all, it is important to remember the specifics of LMX relationships: they are reciprocal, dynamic, and usually require extensive intra- and interpersonal communication. The establishment of the contact can be regarded as the duty of the leader, but the characteristics and skills of the employees are also of great importance, which is why it is necessary to promote appropriate behaviours. For instance, Schyns and Day (2010) mention the habit of seeking out feedback as a very significant one, and it can be promoted by the leader.

It is also noteworthy that while being dynamic, LMX tends to be self-sustaining. Indeed, Goldberg and McKay (2015) point out that a high-quality relationship, which is the result of deep, meaningful exchanges, contributes to more meaningful exchanges; an example of the latter can include enriching and creative tasks (Qu et al., 2017). Similarly, a low-quality LMX would be expected to sustain itself, resulting in an ongoing lack of trust and understanding and multiple negative outcomes. From this perspective, it becomes apparent that the leader needs to be active and find the means for detecting and addressing issues in relationships as soon as possible. From the point of view of detection, LMX itself provides an appropriate framework. As for the resolution of the issues, customised approaches are likely to help.

Indeed, it is important to take into account the specifics of the settings, including the individual and group characteristics of the members. For example, it is established that for nurses, social LMX is shown to be of particular importance from the point of view of positive job perceptions (Trybou et al., 2013). In other words, while economic measures should not be neglected, it is important to specifically work on the supportive, trusting, friendly element of the relationship with the employees in nursing settings. Similar specifics may be found in psychological groups or even individual persons. The customization of approach is likely to enhance the positive outcomes of LMX, and while it is likely to require many resources (predominantly, time), the goal appears to be worthwhile.

Conclusion

The present essay has reviewed the topic of LMX from general and nursing perspectives, which allows making the following conclusions. LMX is a comprehensive framework, which emerged by considering two participants of the leader-member relationships instead of one. Nowadays, LMX appears to extend its perspective to even more complicated networks of relationships. In any case, the focus of LMX on the specifics and mechanics of relationship development and its understanding of the variability and dynamic nature of relationships make it an appropriate relationship analysis tool, which can be employed by nurse leaders.

Moreover, the application of LMX to a variety of settings, including nursing ones, is evidenced to result in multiple positive outcomes, some of which include improved psychological comfort, greater commitment, reduced turnover intent, improved quality of work, professional and personal development, and so on. From the point of view of nursing, as well as any other field of activities, LMX appears to be a very valuable leadership approach as well.

LMX has at least one noticeable flaw: it does not have safeguards against discrimination and can, in fact, support disparities. Indeed, relationships tend to be self-sustaining: high-quality relationships tend to remain high-quality and, possibly, improve, but negative ones tend to remain negative or become worse. As a result, employees with better-quality LMX tend to be “favoured” over those with lower-quality LMX. Since discrimination in nursing settings is inappropriate, the present essay suggests using the prescriptive approach: that is, ensure the development of positive relationships with all employees.

While difficult to complete, this task is appropriate for nursing due to multiple positive outcomes as well as more efficient employment of human resources. As for the strategies that should enable a nursing leader to develop the relationships, they include taking into account the process of relationship development, actively analysing and improving the relationships, and customising the approach to the needs of particular people. In the end, LMX appears to be most appropriate for nursing both as a tool for leadership analysis and a leadership approach, and its flaws seem to be manageable, which is why its promotion in nursing settings seems to be most appropriate.

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