Leadership self-perception of clinical nurses at the bedside: A qualitative descriptive study

Abstract

Aim & objective: Explore leadership self-perception of clinical nurses at the bedside and their perception of leadership on patient care and outcomes.

Background: According to Institute of Medicine Future of Nursing Report, nurses are called to exhibit leadership at every level. Published research on nursing leadership is primarily focused on formal leaders. Research examining leadership at the clinical nurse level has either tested application of a particular leadership model or studied nurses who have been identified as informal clinical leaders. We took an inductive approach without any prior knowledge if participating clinical nurses viewed themselves as leaders.

Design: Descriptive qualitative method was used.

Methods: Four focus groups were conducted with a total of 20 clinical nurses from 2 hospitals within an integrated health system using a convenience sampling method until saturation was reached. The Consolidated criteria for Reporting Qualitative research (COREQ) was used to report findings.

Results: All participants identified qualities they admired in leaders. Fifty percent did not initially view themselves as leaders until they realised that they often demonstrated those same leadership qualities in providing nursing care to patients and families. Participants struggled to make a connection between their leadership at the bedside and patient outcomes.

Conclusions: Clinical nurses assume a formal title is required to be a leader. Findings from this study imply that leadership attributes required at point of care are embedded in the nursing practice and look similar to servant leadership.

Relevance to clinical practice: Leadership is in the nature of nursing practice, and more work is required to increase awareness that every nurse is a leader. Further efforts need to be pursued to help clinical nurses become self-aware they are leaders in order to impact patient outcomes and transform health care from bottom-up and inside-out.

Keywords: bedside practice; clinical leadership; clinical nurses; leadership; nursing practice; self-perception; servant leadership.