JONA
Volume 42, Number 11, pp 507-512
Copyright B 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
THE JOURNAL OF NURSING ADMINISTRATION
Authentic Leadership
Becoming and Remaining an Authentic Nurse Leader
Lin G. Murphy, PhD, RN
This article explores how chief nurse executives be-
came and remained authentic leaders. Using narra-
tive inquiry, this qualitative study focused on the life
stories of participants. Results demonstrate the im-
portance of reframing, reflection in alignment with
values, and the courage needed as nurse leaders prog-
ress to authenticity.
The nurse executive bears significant responsibility
for the creation of a healthy work environment
(HWE).1 Authenticity, described as being oneself,2
has been identified as the single most important qual-
ity of leadership.2,3 Shirey4 suggested that authentic
leadership establishes a HWE. There is evidence that
increased job satisfaction and improved job per-
formance happen in organizations that have authen-
tic leaders.5 To prepare nursing leaders who are
authentic and committed to the creation of HWEs,
it is important to understand how they become au-
thentic and sustain authenticity under pressure.4,6
Authentic leadership emphasizes the character of
the leader, thus departing from the conventional view
describing leadership in terms of traits or behaviors.
Authentic leaders are genuine, freely expressing feel-
ings and motives,7 are driven by a desire to make a
difference,8 and are guided by values transcending
self-interest.9 Viewing authentic leadership and fol-
lowership as state-like, or open to development,
Walumbwa et al,5 Luthans and Avolio,9 Avolio et al,10
and Gardner et al11 published 4 models of authentic
leadership development, the latest one building on
and refining previous models. Authentic leaders
demonstrate, through words and actions, high levels
Author Affiliation: Assistant Professor, Department of Nurs-
ing, Gonzaga University, Spokane, Washington.
The author declares no conflict of interest.
Correspondence: Dr Murphy, Gonzaga University, 502 E
Boone Ave, Spokane, WA 99258 (murphyl1@gonzaga.edu).
DOI: 10.1097/NNA.0b013e3182714460
JONA  Vol. 42, No. 11  November 2012
Copyright @ 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
of self-awareness and self-regulation, 2 core con-
structs of the model. Relational transparency, bal-
anced processing of information, and an internalized
moral perspective are dimensions of self-regulation.
A positive organizational climate and the positive
psychological capacities of hope, resilience, confi-
dence, and optimism were viewed as important, but
not essential, to authentic leadership development.5
It has been suggested that authentic leaders come
to understand their values, convictions, and the pur-
pose of their leadership through constructing a life
story.8,12 Through ongoing reflection on the signifi-
cant people and experiences influencing them, these
leaders frame and reframe their stories, giving them
new meaning with each reiteration. In constructing
their life stories, authentic leaders discover the true
purpose of their leadership.
About the Study
The purpose of this inquiry, which had institutional
review board approval, was to explore the experi-
ences of hospital chief nurse executives (CNEs) in
becoming and remaining authentic nurse leaders. It
was guided by the following research question: What
can the life stories of hospital CNEs, examined
through narrative inquiry, tell us about the develop-
ment of authentic nurse leaders and the challenges to
sustained authenticity?
Research Methods
Narrative inquiry was the research methodology used
for this study with a focus on the life stories (lived
experiences) of the participants as they described key
individuals and experiences that shaped them as au-
thentic leaders.13 All narrative approaches, whether auto-
biography, biography, autoethnography, oral history,
507
or life story, share the assumption that storytelling
is essential to understanding ones life.14 Although
narrative inquiry begins with a researcher listening
to a participants story, the researcher becomes in-
volved in a shared narrative construction and recon-
struction through the inquiry.15(p5) Life story research
focuses on the essence of an individuals entire life as it
is remembered and constructed by that person, whether
in factual, metaphorical, poetic, or other creative form.
What is emphasized provides clues to a persons tri-
umphs and struggles, values, and, essentially, who they
are at the core.16
participants told their stories, focusing on key in-
dividuals and experiences they believed were influen-
tial in their development as authentic nurse leaders,
and shared their views about authenticity and leader-
ship. The 2nd interview, conducted 1 to 12 days after
the 1st, was used to explore the meaning of partic-
ipants experiences as CNEs and how they maintained
their authenticity despite pressures to do otherwise.
Personal identifiers were changed to pseudonyms to
protect confidentiality. Participants verified the accu-
racy of the transcripts or changed or deleted portions
they did not want shared.

Participants
Selected because of reputations as authentic nurse
leaders, 1 current and 2 former hospital CNEs (Carole,
Stefani and Ellen) from the western region of the
United States participated in the study. Each had been a
CNE for at least 3 years. If no longer in the position
when the study began, the time since leaving the po-
sition had not exceeded 3 years. The participants were
female and had been nurses for more than 30 years,
and each had a masters degree in nursing. The indi-
viduals who recommended the participants reviewed
the criteria for authentic leadership (Table 1) and af-
firmed that the CNEs demonstrated most, if not all, of
these characteristics. The participants provided writ-
ten consent.
Data Collection
Semistructured interview guides were used in con-
ducting 2 recorded interviews, each lasting approx-
imately 2 hours, with each participant. Interviews
were transcribed verbatim. In the 1st interview, the
Findings
The life stories of the study participants are unique,
yet share common themes. Carole and Stefani de-
scribed tightly-knit families with parents who had
close ties to church and community. Much of Ellens
support and role modeling came from parents of
friends because her divorced mother worked long
hours to support her, a sister, and an ill grandmother.
Carole chose nursing as a career because of her
desire to be in service. For Ellen and Stefani, nurs-
ing initially provided a means to support themselves
financially. However, for all of the participants, nurs-
ing became more than a job. It became a mission.
Carole works at the medical center where she
began her nursing career, initially on a medical-surgical
unit, later as nurse manager of the coronary care unit,
and now as CNE. Ellens 1st nursing position was as
a commissioned officer for a government service.
After 20 years in the same agency, initially as a staff
nurse, then a nurse manager, and later as director of
critical care, she made the very difficult decision to

Table 1. Authentic Leadership Criteria

1. Self-awareness & Self-reflective
& Cognizant of ones thoughts and behaviors and their impact on others
2. Self-regulation & Relational transparency
& High levels of openness and appropriate self-disclosure in close relationships
& Willing to share and discuss vulnerabilities and limitations and to
admit mistakes
& Committed to being held accountable for actions
& Balanced processor of information
& Objectively analyzes all relevant data before making decisions
& Actively solicits diverse viewpoints that challenge own deeply held positions
& Does not ignore, exaggerate, or distort evaluations of self by others
& Internalized moral perspective
& Guided by internal moral standards and values as opposed to group,
organizational, or societal pressures
& Makes decisions and acts in a manner consistent with personal values
& Has the courage to make difficult decisions
3. Committed to the development of & Develops personal and enduring relationships with close followers
authentic followers and associates

Sources: Walumbwa et al,5 Luthans and Avolio,9 Avolio et al,10 and Gardner et al.11

508 JONA  Vol. 42, No. 11  November 2012

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leave. Ellen served for 2 years as the interim CNE at a
private-sector hospital. After just 4 years, she left her
second horrendous CNE position because of top-
down, oppressive management, an experience she now
considers a gift and a key turning point in her lead-
ership development. Stefanis initial positions were in
psychiatric and surgical services, and in just 3 years,
she was appointed nurse manager of an orthopedic
unit. Her first CNE position was at a state mental
health facility. Although she was in the position for
only 18 months, she stopped some practices she found
ridiculous, such as standing for physicians and strip-
ping patients who did not behave as expected. After
teaching for a few years, Stefani accepted a clinical nurse
specialist position at a state mental health hospital where
she became the CNE, a position she held for 18 years.
In telling their stories, the CNEs reflected on the
meaning of certain people and experiences. Com-
ments such as the following from Ellen were typical:
That story is important in my career because it taught
me, in retrospect, a huge lesson about grace. Carole
shared several patient stories that had deep meaning
for her. After overhearing a patient describe her as
having a bad attitude, she was horrified that she had
let her emotions over a breakup with a boyfriend af-
fect her patient care. She reflected on how powerful
the relationship with a patient is and that it is not to be
taken for granted.
Each CNE began to see themselves as leaders
early in their careers. They were promoted to manage-
ment positions within a few years of becoming nurses
and quickly advanced to positions with greater levels
of accountability. For Carole, The assignments were
given. The assignments were not asked forI. I had
great coaches who could see strengths and needs for
the organization. For her, leadership was never about
the position; however, she quickly realized that she
could have a greater impact on clinical care without
having hands-on care. Ellen thinks daily of an espe-
cially powerful experience with a boss who challenged
her desire to always be right. According to Ellen, this
boss was the 1st person to show her that the good
leader isnt the person who gives you a perfect eval-
uation and youre out the door. The good leader and
boss is the person who smacks you on the head and
says, FYoure better than this. Instead of seeing
herself as a disappointment, she reframed the encoun-
ter as a story about good leadership. When discussing
authenticity, Stefani reflected on the meaning of the
word: Authenticity and leadership would mean true
to oneself within a leadership framework and I
thought, authorVyou generate something that is
authentically yours that you claimI you might au-
thor a book, but you could also author a leadership
style, your own.
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These leaders were guided by their core values.
For Carole, the patient comes first in her unrelenting
pursuit of excellence. She maintains her authenticity by
being out on her units with staff to better understand
the work they do and barriers they face. Stefani de-
scribed her purpose as transforming the care of mentally
ill patients from purely custodial supervision to humane
and therapeutic care. Her own value system was always
that the patient comes first and then the staff. Although
still in her first management position, Ellen created a
personal vision that continued to be meaningful to her
through her tenure as CNEVto create an environment
where staff could do the best job they were capable of
doing. She emphasized putting patients and their
families first, which was evident in her commitment
to hold staff accountable for quality patient care. Ellen
sustained her authenticity by being clear about her per-
sonal values and knowing what was important to her.
Each CNE discussed the importance of courage
in her role as CNE and patient advocate. Determined
not to be a wimpy leader, a trait she observed in some
nurse managers, Ellen committed herself to pull the
ripcord and let staff and managers who were not will-
ing or able to meet expectations go. Initially reluctant
to stand up to a panel of physicians sent to investigate
claims of surgeon incompetence in her organization,
Ellen admitted she didnt feel that courageous going
into it. She believes leaders need a balance between
kindness and courage. She added, Youve got to be
able to be honest with people. Your people need to
grow under your leadership, and they can grow only
if you give them honest feedback and then help them
figure out what to do with that feedback. Carole re-
peatedly demonstrated her commitment to quality patient
care by questioning systems that put patients at risk and
holding her nursing leadership team accountable. When
the nursing union resisted a policy designed to protect
patients, she was the public symbol of her organiza-
tion in ensuing legal battles. Likewise, Stefani advo-
cated for safe staffing levels, staff education, and more
humane, respectful treatment of the mentally ill despite
the threat of being fired, harassment from the unions,
and physical threats.
Discussion
Becoming an Authentic Nurse Leader
Two themes related to becoming an authentic leader
characterized the stories of the participants: construct-
ing life stories of authenticity and authoring their own
authentic leadership.
Constructed Life Stories of Authenticity
The CNEs described the impact of parents, grand-
parents, teachers, patients, and colleagues in facilitating
509
their development as authentic nurse leaders. However,
it was not the people and the accumulated experiences
that made them authentic leaders. Their ability to
look back and reflect on the meaning of these people
and experiences, to move forward and to look back
again and reflect later for new meanings, and then to
create their own coherent life stories as authentic
persons is what made the difference. This is evident
in Ellens reflections on her 2nd CNE position: I was
so lucky, and I didnt even know itVand to have to
live through an incredibly disappointing employment
situation and struggle with thatI it was just a gift.
This finding is consistent with what George12
learned from interviews with more than 100
authentic leaders. What made those leaders stories
different from the stories of other people was the
way they framed them, meaning their stories were
like tapes that played over and over in their heads.
As they replayed important events and experiences,
they began to make sense of them and to use them to
find their purpose in the world.
A core component of authentic leadership devel-
opment theory5,9,11 is that of self-awareness on the
part of the leader. It is a process whereby the au-
thentic leader comes to understand his/her sense of
purpose, beliefs, and core values through introspec-
tion and reflection. In essence, life stories express
the identities of the storytellers, which are the prod-
ucts of the relationships between their experiences
and the stories told of them. To be authentic is
literally to be your own author.17(p50)
Authored Their Own Authentic Leadership
Authentic leaders are characterized as individuals
who keenly identify with and express themselves
through their leadership roles,8 meaning they exhibit
high person-role merger. They believe they have not
only the ability to lead, but also the right. It is
through an individuals life experiences and the way
they are organized into a life story that he/she de-
velops the self-concept of leader that justifies a lead-
ership role. Shamir and Eilam8 contrasted authentic
leaders whose self-concepts were intertwined with
and justified their leadership with managers who
were never able to construct coherent leadership
stories. For those individuals, it was as if their lead-
ership roles were external rather than integral to
their core self-concepts, whereas the stories told by
authentic leaders were constructed rather than just
remembered events.
This distinction that authentic leadership emerges
more from the construction of a leaders life story and
the meaning given to it than from the specific and
unique people and events in the story8,12 seemed evi-
dent in the stories of the study participants. Although
510
Copyright @ 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
they were each selected for a variety of early leader-
ship experiences and acknowledged that others often
saw in them potential they had not yet seen in
themselves, their self-concepts as leaders seemed to
be reinforced by their own gradual discovery of the
purpose and impact of their leadership. Caroles
intense desire to improve the quality of care for pa-
tients led her to accept greater levels of responsi-
bility. Stefani, who was tapped for leadership as a
fairly new nurse, described the significance of author-
ing or designing ones own leadership. These CNEs
strongly identified with the ideal of being patient ad-
vocates, and their leadership roles provided a means
to have a significant impact on the quality of patient
care in their organizations. Consistent with Georges12
findings, their leadership seemed to evolve from their
life stories, and it was reinforced by authentic actions.
Maintaining Authentic Leadership
Two themes provide insight into how the study par-
ticipants maintained their authenticity and authentic
leadership.
The Importance of ValuesVIts About the Patient
To stay the course as authentic leaders despite pres-
sures to take an easier path requires leaders to have a clear
moral compass guiding them to their true north.12
According to George,12 values are what define a leader,
and once internalized, values become integral to a per-
son.11 To be authentic, a leader must be true to self,
meaning ones internalized core values, and have a
clear understanding of these values and their prior-
ity in his/her life.
For the study participants, there was a continual
pull that brought them back to the purpose of their
leadership: the patient. Carol experienced a good fit
with her organization because of a common mission
to safety-proof patient care. Stefani saw her purpose
as transforming the care of mentally ill patients. Her
vision was that educated nurses understanding that
mental illness is a disease and not a character defect
could make a difference for patients. Ellen saw her
role as removing barriers to practice so that staff
could provide high-quality patient care. One way the
CNEs maintained their authenticity and authentic
leadership was by continually clarifying and being
true to their values and the purpose of their leader-
ship. These values influenced their hiring and firing
decisions, budget decisions, and interactions with
staff and colleagues. The patient was their true north.
Having the Moral Courage to Do the Right Thing
It is one thing to espouse a set of values, but to live out
those values under pressure is the real challenge. George2
claimed that, once a leader has discovered his/her
JONA  Vol. 42, No. 11  November 2012
core values, that person then has to be tested in the
crucible of lifes experiences.(p37) Courage is a crit-
ically important quality for leaders as they navigate
uncertainty.12 The life stories of the participants re-
vealed strong commitments to act morally and to do
the right thing for patients and staff. Ellen remained
true to her values around protecting patients when
facing a tribunal of physicians investigating claims
of surgeon incompetence. Stefani continued to advo-
cate for safe staffing levels, staff education, and more
humane and respectful treatment of the mentally ill
despite harassment and threats. These CNEs exhibited
a strongly developed internalized moral perspective
that translated into truly authentic behavior.5,9,11
Moral courage requires a person, often acting
alone, to take a stand for what is right, even risking
shame or disapproval for doing so.18 Kidder19 de-
scribed the leader who can make the tough but cor-
rect choices on the spot as ethically fit, a quality that
requires lifelong and disciplined training not unlike
physical fitness. One way that ethical fitness is es-
tablished is through the habit of reflection on ones
values. The ongoing development of ethical fitness
enables a leader to respond with the right answer
when the tough decision needs to be made and there
is little time for reflection.
Limitations of the Study
The small number of participants in this study was a
limitation. However, the intent of narrative research
is to capture detailed experiences of a single life or of
a small number of persons.20 Because of the length
of the interviews, the number of participants satis-
fied the need for in-depth details about [the] lived
experience14(p135) of authentic leadership. Using
reputation as an authentic leader as a criterion for
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JONA  Vol. 42, No. 11  November 2012
Copyright @ 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
participant selection is another limitation. Another
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rately recall significant events, although achieving his-
torical truth is not the purpose of narrative research.
Implications
The value of patient-centeredness21 is instilled into
nurses just beginning their nursing education and is
nurtured through subsequent interactions with
patients. Doing the right thing for patients becomes a
nurses true north, whether that nurse is practicing at
the bedside, teaching, or leading other nurses. A
major implication of this research for nurse leaders
is the critical importance of not compromising
decisions about cost containment and efficiency by
losing focus on their core value of patient care.
Those who can keep their balance in making these
decisions and stay focused on key priorities and core
values are the ones most likely to become and remain
authentic nurse leaders who can be trusted to act
with courage and integrity when the tough decisions
must be made.
A major premise of the theoretical models5,9 on
authentic leadership development is that the core
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state-like and can be developed. This is good news
for those concerned with the development of authentic
nurse leaders. One-on-one sessions with a mentor or
coach who assists the individual to examine his/her
decisions and actions in light of articulated values
and convictions may be one way of developing ethical
fitness19 and moral courage.18 Coaching and reflec-
tion may complement other methods and programs
in developing the authentic nurse leaders we will need
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