Beyond profession: nursing leadership in contemporary healthcare.
OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
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.


CONCLUSIONS
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.
Sorensen
Roslyn
R
Centre for Health Services Management, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, NSW, Australia. roslyn.sorensen@uts.edu.au
Iedema
Rick
R
Severinsson
Elisabeth
E
D000884:Anthropology, Cultural; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units; D007857:Leadership; D024802:Nurse's Role; D009732:Nursing Care / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D009745:Nursing, Supervisory; D010348:Patient Care Team; D036301:Qualitative Research; D013727:Terminal Care; D014481:United States