Transformational, Transactional, and Laissez-Faire Leadership Styles: Their Influence on Leader–Member Exchange and Employee Morale among Private Healthcare Nurses

Leadership effectiveness in private healthcare nursing is increasingly shaped by relational dynamics rather than formal authority alone. Nurses operate in environments characterised by high clinical complexity, emotional labour, and performance-driven organisational demands, rendering leadership behaviours and leader–nurse relationships critical determinants of employee morale. Despite extensive scholarship on leadership styles in healthcare, limited theoretical integration exists explaining how transformational, transactional, and laissez-faire leadership styles influence nurse morale through relational mechanisms, particularly within private healthcare contexts. Drawing on the Full-Range Leadership Model and Leader–Member Exchange (LMX) theory, this conceptual paper advances an integrated, theory-driven framework that positions LMX as a relational mechanism through which leadership styles are enacted and experienced in daily leader–nurse interactions. Drawing on a systematic review of 30 peer-reviewed studies published between 2020 and 2025, this paper synthesises evidence from the fields of nursing, healthcare leadership, and organisational behaviour to explore how different leadership styles influence the quality of leader–nurse exchanges and subsequently affect employee morale. The analysis demonstrates that transformational leadership is most strongly aligned with the development of high-quality LMX relationships characterised by trust, socio-emotional support, and reciprocal influence, thereby sustaining nurse morale in demanding private healthcare environments. Transactional leadership provides functional value by reinforcing structure and role clarity but predominantly generates moderate-quality exchanges that are insufficient to support morale in isolation. Laissez-faire leadership emerges as a destructive leadership pattern that undermines relational quality, intensifies stress, and erodes nurse morale through persistent leader disengagement. By reconceptualising LMX as an embedded relational process rather than a peripheral mediating variable, this paper contributes a nuanced theoretical explanation of how leadership styles translate into nurses’ psychological and emotional work experiences. The proposed framework offers important implications for leadership development and organisational sustainability in private healthcare institutions and establishes a foundation for future empirical research examining relational leadership processes and nurse morale.

Leadership styles, leader-member exchange, employee morale, private healthcare, nursing leadership

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