Beyond profession: nursing leadership in contemporary healthcare

J Nurs Manag. 2008 Jul;16(5):535-44. doi: 10.1111/j.1365-2834.2008.00896.x.


Aim(s): To examine nursing leadership in contemporary health care and its potential contribution to health service organization and management.

Background: As the nursing profession repositions itself as an equal partner in health care beside medicine and management, its enhanced nursing standards and clinical knowledge are not leading to a commensurate extension of nursing's power and authority in the organization.

Method(s): An ethnographic study of an ICU in Sydney, Australia, comprising: interviews with unit nursing managers (4); focus groups (3) with less experienced, intermediate and experienced nurses (29 in total); and interviews with senior nurse manager (1).

Results: Inter- and intra-professional barriers in the workplace, fragmentation of multidisciplinary clinical systems that collectively deliver care, and clinical and administrative disconnection in resolving organizational problems, prevented nurses articulating a model of intensive and end-of-life care.

Conclusion(s): Professional advocacy skills are needed to overcome barriers and to articulate and operationalize new nursing knowledge and standards if nurses are to enact and embed a leadership role.

Implications for nursing management: The profession will need to move beyond a reliance on professional clinical models to become skilled multidisciplinary team members and professional advocates for nurses to take their place as equal partners in health care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropology, Cultural
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Intensive Care Units
  • Leadership*
  • Nurse's Role*
  • Nursing Care / organization & administration*
  • Nursing Staff, Hospital / organization & administration*
  • Nursing, Supervisory
  • Patient Care Team
  • Qualitative Research
  • Terminal Care*
  • United States