Past, Present and Future: A Historical Analysis and Reflection of 100 Years of Nursing Leadership

This paper critically examines the evolution of nursing leadership over the past century, exploring how changing historical, social and professional contexts have influenced styles and their ongoing relevance to contemporary nursing practice. Using a historical analysis guided by Lewenson and Hermann's framework, primary sources, including archival materials and foundational texts, were examined alongside secondary scholarly literature and historical commentaries. Leadership approaches were reviewed by decade and mapped against key nursing theories, healthcare developments and broader social movements to construct a timeline of leadership discourse. Findings demonstrate a progression from predominantly hierarchical, autocratic and bureaucratic leadership models characteristic of the early and mid-20th century, particularly during wartime and post-war periods, toward more relational, collaborative and adaptive approaches. Transformational leadership emerged alongside nursing professionalisation during the 1980s, while servant and authentic leadership gained prominence in response to growing emphasis on equity, inclusion and person-centred care in the 2010s. More recently, adaptive, emotionally intelligent and ambidextrous leadership styles have become increasingly important for addressing healthcare complexity, workforce resilience, innovation and change. The analysis highlights nursing leadership as a dynamic, context-dependent and deeply relational construct. Understanding its evolution can support nurse leaders, educators and other healthcare providers to critically reflect on practice, foster inclusive and resilient teams and apply evidence-informed leadership strategies that promote sustainable, patient-centred care in rapidly changing healthcare environments.