**Abstract**

Managing the complex healthcare facility in a lower middle-income country (LMIC) such as Ghana can be challenging and demands management principles that would enable the leader to be conscious of the significant role of the environment. Nurses and midwives constitute majority of the health workforce, play pivotal role in healthcare delivery, consuming most of the resources in managing patient care, and promote the corporate image of the facility. Nurse leaders should exhibit practical leadership skills that would enable effective utilization of the capabilities of staff to achieve organizational goals and prominence in the environment. Long-term viability and competitiveness of the healthcare system demands cost-effective strategies using organizational competencies to take advantage of the opportunities within the environment. Leadership, therefore, becomes essential by initiating a vision that harnesses the potential of staff and stakeholders to this commitment. To withstand time and change, strategic leadership principles such as setting high standards of excellence, demonstrating exceptional performance, and constantly delivering value are imminent. Strategic leadership in nursing ensures provision of leadership strategies that would enhance effective teams and mitigate existing challenges confronting the health system. The paper finds that nursing as a profession is incessantly evolving and, hence, requires strong and dynamic leadership.

**Keywords:** strategic leadership, strategic management, relationship management, nursing management, transformational leadership, laissez-faire, transactional leadership, healthcare, leadership continuum, nursing administration
