Final Arete - Volume 4, No 1 Fall Winter 2026

Αρετή (Arete) Journal of Excellence in Global Leadership | Vol. 4 No. 1 | 2026

Introduction Hospitals are among the most culturally complex institutions in modern society. They bring together scientific precision, ethical uncertainty, and human vulnerability, often in the same room and within the same hour of the same day. While clinical guidelines and technical skills determine the care patients receive, the informal rules governing how doctors, nurses, and other caregivers treat each other and their patients are equally vital. Culture is more than a byproduct of hospital operations. It shapes whether frontline workers speak up when they see something go wrong (Edmondson, 1999, 2018), whether patients with different cultural and religious backgrounds experience competent and respectful care (Kleinman & Benson, 2006), and whether moral responsibility for clinical decisions is shared or borne individually (Epstein & Hamric, 2009). Two mature scholarly fields should be well equipped to account for how these cultures arise and change. Global leadership theory has studied the actions of leaders within culturally complex environments for 40 years (House et al., 2004; Mendenhall et al., 2017; Reiche et al., 2017). Organizational culture scholarship has documented how cultures work, especially in healthcare settings (Cameron & Quinn, 2011; Mannion & Davies, 2018; Schein & Schein, 2017). Both fields, however, share the same blind spots. Global leadership theory has historically treated cultural complexity as a matter of geography, assuming that leadership becomes global only when a leader crosses a national border (Mendenhall & Bird, 2013; Mendenhall et al., 2012). Organizational culture theory presents a different challenge. Schein (1990) treats founders and senior executives as the primary architects of culture, and that perspective remains the field’s most cited, despite its founder-centric bias. While an interpretive stream has located culture-making in the meanings members construct, it typically theorizes this work as a collective output, a product of subcultures, occupational communities, or coalitions (Bechky, 2003; Kellogg, 2009; Martin, 2002). Neither literature accounts for a particular kind of practitioner. This practitioner holds no rank, belongs to no occupational community within the organization, and works through relationships that cross every such community without settling in any of them. Such work contributes to the culture in which care happens, yet the practitioner has no collective through which to make it. This article introduces non-positional cultural leadership as a theoretical construct to describe this practitioner. The practitioner in question shapes culture from a position the organization chart treats as insignificant, and board-certified hospital chaplains serve here as the primary test case. Chaplains were chosen for this inquiry because their conditions are extreme. An extreme case is selected for what it reveals rather than for how well it represents a population, and it earns its place when the mechanism under study runs at unusual intensity there (Flyvbjerg, 2006; Seawright & Gerring, 2008). Chaplains hold no positional power, yet they work at the juncture where a hospital’s unspoken norms come briefly open to renegotiation. If cultural leadership without rank exists anywhere, it should be visible here. The article makes three arguments. First, it extends global leadership theory downward into domestic healthcare microsystems via the nested competency argument. Cultural complexity is present in these systems in concentrated, high-stakes forms, and the competencies identified in global leadership are thus pertinent to

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