Health care leadership continues to run under a transactional style that may be causing nurses to leave the system. Nurses no longer wish to stay in the profession perhaps because they struggle ideologically with the system in which they work. However, nurses may hold the key to transforming health care and dragging it into the 21st century in terms of work practices and reform. This is because nurses are visionary, creative, involved in decision making at patient level and have gender based qualities, and communication strategies that the health care sector needs. In contrast to transaction leadership, transformational leadership and team development has a positive affect on communication and team building. The later style is ideologically suited to nurses and may ensure the future of nurses and nursing in the health care sector. The case study described in this paper was an actual working environment and one that I came across all too often as a registered nurse and clinical educator.