title: Leading change: a three-dimensional model of nurse leaders' main tasks and roles during a change process.
abstract: OBJECTIVE
  This paper is a report of a qualitative study which explored how nurse leaders described and understood their main tasks and roles during a change process.
  
  
  BACKGROUND
  During a database search for literature, no actual research that highlighted the main tasks and roles of nurse leaders during a change process was found. Earlier research has indicated the need for different leadership styles and the importance of strategies and values.
  
  
  METHODS
  In-depth interviews with 17 nurse leaders took place in 2004. A phenomenological-hermeneutical approach was used for data analysis.
  
  
  RESULTS
  The findings resulted in a model of leading change in health care that focuses on good patient care and consists of three dimensions: leading relationships, leading processes and leading a culture. In addition to leading relationships and processes, nurse leaders, as role models, greatly impact caring culture and its inherent ethical behaviour, especially about the responsibility for achieving good patient care. Nurse leaders are also instrumental in leading ward culture.
  
  
  CONCLUSIONS
  Nurse leaders need guidance and knowledge of what is expected of them during a structural change process. They play different roles by directing, guiding, motivating, supporting and communicating without losing their cultural ethos of caring and use various leadership styles to bring about actual change, which, in turn, requires learning so that the thought patterns, values and attitudes of personnel can be changed.
authors.affiliation: Department of Social Sciences, Åbo Akademi University, Vaasa, Finland. susanne.salmela@vshp.fi
authors.forename: Susanne
authors.initials: S
authors.lastname: Salmela
authors.forename: Katie
authors.initials: K
authors.lastname: Eriksson
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Fagerström
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004645:Empathy; D005260:Female; D005387:Finland; D018166:Health Care Reform / Q000458:organization & administration; D006273:Health Facility Merger / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008875:Middle Aged; D008962:Models, Theoretical; D009718:Nurse Administrators; D024802:Nurse's Role; D015401:Nursing Administration Research; D015279:Organizational Culture; D009936:Organizational Innovation; D036301:Qualitative Research; D011787:Quality of Health Care