For many years nursing practice has found its foundations in nursing theory. A review of theorists such as D. E. Orem, C. Roy, B. Neumen, V. Henderson, M. E. Rogers and others reveals a focus on the management of patient care, not leadership. This has provided most nurses with a solid foundation in 'management', but little in terms of 'leadership.' In more recent years, theories such as the Deming Management Method, Managers as Developer Model, Shared Governance and Transactional Leadership have been introduced, none of which are nursing theories. This article discusses the conceptualized differences between management and leadership theory arguing that there is a difference between 'leadership and management'. A leadership theory is proposed utilizing Ida J. Orlando's model for nursing. This theory provides a nursing foundation for nursing leaders to utilize both in the management of patient care and in leadership.