NURS 750 Week 7 Servant Leadership Paper with a Personal Growth Plan Example

First Among Fourteen: A Servant Leadership Growth Plan for a New Lead Neonatal Nurse Practitioner Who Rescues Instead of Empowering

Introduction

At three in the morning last March, a nurse practitioner on our team was admitting a 24-week infant whose blood pressure would not stay up. I was the senior practitioner on call. I walked into the room, took over the line placement and the medication orders, and stabilized the baby within the hour. I left feeling that I had served the team. A week later the same colleague, eighteen months out of school, told me quietly that she had been about to try the next step herself and that my taking over had confirmed what she feared: that the team did not trust her. She was right that I had not asked.

This summer I was named lead neonatal nurse practitioner for the fourteen practitioners who cover our level IV NICU, responsible for schedules, onboarding, quality work and the professional growth of the group. This paper applies servant leadership to my growth in that role. It explains servant leadership and its biblical foundations, reviews evidence for it in nursing, reports an assessment of my own leadership by colleagues on a validated instrument, and sets out a twelve-month personal growth plan.

Understanding Servant Leadership

Greenleaf's Idea

Robert Greenleaf introduced servant leadership in an essay first published in 1970, proposing that the great leader is a servant first: the desire to serve comes before the aspiration to lead. Greenleaf (2002) proposed judging a leader by the people led: do they grow, gaining health, wisdom, freedom and independence, and do they in turn begin to serve others? By that test, my three in the morning rescue failed. The baby was served, but the colleague did not grow; she became less autonomous, not more.

Spears's Ten Characteristics

Spears (2010), drawing on Greenleaf's writing, identified ten characteristics of the servant leader: listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people and building community. The list is useful because it turns a philosophy into behaviors a leader can practice. Persuasion, rather than positional authority, is how a servant leader moves a group; commitment to growth means caring about each person's development beyond the tasks they perform.

A Research Definition

Eva et al. (2019), in a systematic review of 285 articles over twenty years, characterized servant leadership by its orientation toward others: the leader attends personally to what each follower needs and turns concern away from personal advancement and toward colleagues, the institution and those beyond its walls. Their review separated servant leadership from transformational leadership by its primary focus: the follower's well-being rather than the organization's goals. It also called for better measurement, which made the short-form scales described below more useful to me.

Biblical Foundations

For a Christian nurse, servant leadership did not begin in a business school. It is the pattern Jesus set. When James and John asked for the seats of honor and the others grew angry, Jesus contrasted the way rulers of the nations exercise authority with the way of His followers, whose greatness shows in serving, and offered His coming death, a ransom for many, as the proof (English Standard Version Bible, 2001/2016, Mark 10:35-45). On the night before His death He washed His disciples' feet and told them to do as He had done (English Standard Version Bible, 2001/2016, John 13:14-15). Paul called believers to count others more significant than themselves and to look to the interests of others (English Standard Version Bible, 2001/2016, Philippians 2:3-4).

These passages correct my instinct in a specific way. Jesus served the disciples, but He did not do their work for them; He sent them out, two by two, with authority to preach and heal while He was still with them (English Standard Version Bible, 2001/2016, Mark 6:7-13). Serving, in His pattern, included entrusting. O'Brien (2018) describes nursing as a ministry grounded in a calling to care, and a nurse leader who sees leadership the same way will measure service by what the people led become able to do. A leader who always steps in may be serving the patient while starving the colleague of the chance to grow.

Servant Leadership in Nursing: The Evidence

Research in nursing generally supports servant leadership, with one important qualification. Saavedra et al. (2025) gathered fourteen studies covering more than seven thousand nursing professionals and reported that servant leadership went along with better nurse attitudes and conduct, closer relationships between nurses and their leaders and a greater sense that it was safe to speak, concluding that it strengthens the work environment. Waseem et al. (2026), surveying 269 Pakistani hospital nurses at two points in time, found that servant leaders' teams innovated more, partly because these leaders were trusted and that trust led nurses to pass on what they knew. That sequence matters for my plan: trust has to come before a team will share what it knows.

The qualification comes from a study of 306 hospital nurses in Japan. Hontake et al. (2026) modeled the ward's climate and the manager's servant leadership side by side; climate predicted how safe nurses felt, and that safety predicted their engagement, while the leadership measure made no significant difference after climate was accounted for. Their advice to managers is to build the kind of ward where asking for help and voicing doubt feel normal. I read this not as evidence against servant leadership, but as a warning that individual leader behavior is not enough. A servant leader has to change the climate of the unit, not only relationships one at a time.

Nursing has begun to measure servant leadership in its own terms. Hall and O'Malley (2026) developed the 13-item Healthcare Servant Leadership Scale with 200 nurse leaders in three Magnet-designated hospitals, aligned with the Magnet model, with reliability above 0.85 for every component. The instrument is self-administered, so I chose a follower-rated scale for my own assessment, but it shows that servant leadership is now treated as a core expectation of nurse leaders.

The setting adds one more consideration. In a qualitative study of twenty neonatal nurses in three NICUs, nurses described seeing risk before harm, deciding whether to speak, working within hierarchy and carrying responsibility after they spoke; their sense that speaking up was legitimate depended on hierarchy and on how leaders responded, and concerns left unspoken left moral residue (Ramadan et al., 2026). Bedside nurses often see first what nurse practitioners miss. Whether they tell us depends on whether we have made it safe to do so.

Self-Assessment

To assess my leadership, I used the SL-7, the seven-item short form of the 28-item servant leadership scale, which Liden et al. (2015) validated across samples as a substitute for the full measure. Each item stands for one of the seven dimensions in the longer scale, from ethical behavior and conceptual skill to empowerment, emotional healing, putting followers first, helping them grow and succeed, and adding value to the wider community. Followers rate the leader on a seven-point scale. I asked six colleagues, four nurse practitioners and two charge nurses, to rate me anonymously through a survey link, and I rated myself.

Two findings stand out. First, my colleagues rated my ethics and clinical judgment highly, which suggests a foundation of trust. Second, the largest gap between my view and theirs was in empowering: I rated myself a 6 and they rated me 3.8. I believe I give colleagues freedom to handle hard situations their own way; they experience me as stepping in. The three in the morning admission was not an exception. Helping others grow and creating value for the community, which includes service beyond the unit, were also low. Putting followers first scored well, which fits the pattern: I put the team first by doing things for it, not by equipping it.

Emotional healing, at 5.3, sits in the middle. Two colleagues added comments: one wrote that I am "the person you want next to you on a bad night," and another that I "move on to the next thing before anyone has had a chance to feel what just happened." Both are true. After a death in the unit, I tend to restart the work quickly, which helps the shift run but leaves little room for the grief the team carries. O'Brien (2018) gives real attention to the spiritual needs of nurses themselves, and a leader who skips past loss teaches the team to do the same. I have not made emotional healing a separate goal, because its rating is acceptable, but I will fold one practice into the plan: after any infant death on my shift, I will call a five-minute pause with whoever was involved before we return to the work.

The ratings also carry limits. Six raters is a small group, and they knew I had asked for the ratings, which may have softened them. Two of the six report to me now, and their ratings may change as the relationship does. I will therefore read the numbers as an opening to talk with colleagues, not a final judgment, and I will share the results and the plan with the whole team at our next meeting, which is itself a small act of the accountability servant leadership asks for.

Personal Growth Plan

The plan runs for twelve months from my first day as lead. Its three goals come from the three lowest dimensions, with the third goal joining the community dimension to the climate concern raised by the evidence.

Goal 1: Empower the Team

Objective: By month six, colleagues' mean rating on the empowering item will rise from 3.8 to at least 5.0, and by month twelve to at least 5.5.

Actions: I will adopt a rule of asking before acting: when I enter a room where a colleague is managing a crisis, my first words will be "What do you need from me?" unless the infant is in immediate danger. I will delegate three decisions I now make alone, the monthly call schedule, the choice of the next quality project and the orientation plan for new nurse practitioners, to small groups of team members, and accept their decisions unless they are unsafe. In weekly one-on-one huddles with the two newest practitioners, I will ask them to present their plans first and will speak second.

Measure: The SL-7 repeated at six and twelve months, and a simple count, kept in my own log, of times I took over a procedure or decision that a colleague was managing safely, with a target of none after month three.

Goal 2: Help Each Colleague Grow

Objective: By month four, every nurse practitioner on the team will have a written development goal agreed with me, and by month twelve at least ten of fourteen will report progress toward it.

Actions: I will hold an unhurried forty-five-minute career conversation, away from the unit, with each colleague in the first four months, asking what they want to be doing in three years and what would help them get there. I will connect each person to one opportunity: teaching residents, joining the transport team, presenting at the regional perinatal conference or starting a DNP. I will pair our two newest practitioners with experienced mentors other than me, so that their growth does not depend on my presence. This goal builds directly on the commitment to the growth of people that Spears (2010) lists among the ten characteristics and on the evidence that trust leads to knowledge sharing (Waseem et al., 2026).

Measure: Development goals on file, progress reported at twelve months, and the SL-7 item on helping followers grow and succeed, with a target of at least 5.5.

Goal 3: Make It Safe to Speak and Serve Beyond the Unit

Objective: By month nine, bedside nurses will report concerns to nurse practitioners through a defined pathway, with every concern answered and closed within one shift, and the team will begin one service project for families beyond the NICU.

Actions: With the nurse manager and charge nurses, I will create a two-question escalation script for bedside nurses to use with any nurse practitioner, and a practice of telling the nurse what was done about the concern before the end of the shift, reflecting the call for credible escalation pathways and visible closure of concerns from the NICU voice study (Ramadan et al., 2026). I will model it by thanking every nurse who raises a concern on rounds. For community, I will invite the team to partner with our hospital's follow-up clinic and a local church's ministry to bereaved parents to offer an annual remembrance service for families whose infants died in our unit.

Measure: A three-item survey of bedside nurses on whether they feel safe raising concerns with nurse practitioners, given at baseline and month nine; the number of concerns raised and closed; and the SL-7 item on creating value for the community.

Barriers and Accountability

The main barrier to this plan is my own temperament. Stepping in feels like competence and like care, and in a unit where infants deteriorate quickly, the line between a true emergency and my impatience will not always be clear. A second barrier is time: career conversations and project groups take hours away from clinical work, and the schedule will push back. The evidence that ward climate can outweigh any one leader (Hontake et al., 2026) is a third, reminding me that I cannot change the unit alone and must work with the nurse manager and charge nurses.

For accountability, I have asked a senior nurse practitioner from another hospital to meet with me monthly and review my takeover log and progress. Spiritually, I intend to begin each shift with a short prayer for the people I lead by name, a practice O'Brien (2018) would recognize as attending to the nurse's own spiritual life so that care for others flows from it. The washing of feet was an act of humility before it was an act of service, and humility is what letting others lead requires of me.

Conclusion

Servant leadership asks whether those I lead grow, become more capable and become servants themselves. My colleagues' ratings say I serve them by doing for them, and that I am weakest at empowering, developing and building community. The evidence suggests that servant leadership supports trust, knowledge sharing and better work environments, but also that a leader must change the climate of a unit, not only individual relationships. Jesus's example of entrusting His disciples with real work shapes the plan: to ask before acting, to invest in each colleague's growth and to make it safe for bedside nurses to speak. In a year, the test will be whether the practitioner I took over from last March is leading the next admission, and whether I let her.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Eva, N., Robin, M., Sendjaya, S., van Dierendonck, D., & Liden, R. C. (2019). Servant leadership: A systematic review and call for future research. The Leadership Quarterly, 30(1), 111-132. https://doi.org/10.1016/j.leaqua.2018.07.004

Greenleaf, R. K. (2002). Servant leadership: A journey into the nature of legitimate power and greatness (L. C. Spears, Ed.; 25th anniversary ed.). Paulist Press.

Hall, H., & O'Malley, P. (2026). Development and psychometric testing of an instrument to measure servant leadership behaviors in Magnet nurse leaders. Worldviews on Evidence-Based Nursing, 23(5), Article e70178. https://doi.org/10.1111/wvn.70178

Hontake, T., Nishi, M., Kuzushima, S., & Kamizawa, N. (2026). Effects of organizational climate and servant leadership on work engagement among Japanese nurses: The mediating role of psychological safety. Journal of Nursing Management, 2026(1), Article e5755950. https://doi.org/10.1155/jonm/5755950

Liden, R. C., Wayne, S. J., Meuser, J. D., Hu, J., Wu, J., & Liao, C. (2015). Servant leadership: Validation of a short form of the SL-28. The Leadership Quarterly, 26(2), 254-269. https://doi.org/10.1016/j.leaqua.2014.12.002

O'Brien, M. E. (2018). Spirituality in nursing: Standing on holy ground (6th ed.). Jones & Bartlett Learning.

Ramadan, O. M. E., Alruwaili, M. F., Samy, R., Eldesoky, H. A. M., & Elsayed, G. E. A. (2026). Neonatal nurses' moral agency in raising medication and treatment safety concerns in high-risk NICUs. Nursing Ethics. Advance online publication. https://doi.org/10.1177/09697330261480342

Saavedra, S., Ruiz-Palomino, P., Pérez-Contreras, R., & Gonzalez-Sanz, J. D. (2025). Impact of servant leadership on the work environment and the attitudes and behavior of nursing professionals as a function of gender: A systematic review. Journal of Nursing Management, 2025, Article 8825138. https://doi.org/10.1155/jonm/8825138

Spears, L. C. (2010). Character and servant leadership: Ten characteristics of effective, caring leaders. The Journal of Virtues & Leadership, 1(1), 25-30.

Waseem, M., Hassan, R., Habiba, U., Khan, K., & Malik, M. H. (2026). Servant leadership and nurses' innovative work behavior: The serial mediation role of trust-in leadership and knowledge sharing. Journal of Nursing Scholarship, 58(2), Article e70081. https://doi.org/10.1111/jnu.70081