There is a call for nursing leadership to rebuild the nursing workforce as documented in the Institute of Medicine report The Future of Nursing. The leader that has the greatest impact on nurse satisfaction, nurse retention and patient outcomes is the nurse manager. It is imperative to have managers who possess the leadership style that results in high nurse satisfaction, which impacts retention of staff and positive patient outcomes. Organizations can no longer afford to have mediocre managers leading their facilities. The cost of poor or marginal management is too high. Therefore nurse executives need to hire and promote nurses into management positions who have the leadership attributes that will produce positive outcomes for their organization.