title: Public health nurses perception of clinical leadership in Ireland: narrative descriptions.
abstract: OBJECTIVE
  The aim of the study was to identify how clinical leadership skills are perceived by Public Health Nurses in the course of their everyday work and the effectiveness and consequences of such skills in primary care delivery.
  
  
  BACKGROUND
  Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles.
  
  
  METHODS
  Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery.
  
  
  RESULTS
  Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective.
  
  
  CONCLUSIONS
  Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor. RELEVANCE TO NURSE MANAGERS: Public health nurses are well placed to shape and influence health service culture through effective clinical leadership.
authors.affiliation: School of Undergraduate Nursing, Royal College of Surgeons in Ireland, St Stephens Green, Dublin 2, Ireland. mariecarney@rcsi.ie
authors.forename: Marie
authors.initials: M
authors.lastname: Carney
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D007494:Ireland; D007857:Leadership; D017146:Models, Organizational; D009718:Nurse Administrators; D011634:Public Health / Q000191:economics*; D011637:Public Health Nursing / Q000191:economics*; D036301:Qualitative Research; D012938:Social Perception