Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Setting a Course: A Critical Review of the Literature on Nurse Leadership in Australia

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Setting a Course: A Critical Review of the Literature on Nurse Leadership in Australia

Article excerpt

As the nursing profession pushes back the boundaries of the professional roles it undertakes there is an equally pressing need for nurses to be more capable of leading themselves, other professional staff and in leading on care delivery packages. An excellent example of this is the growth of nurse practitioners who as well as being capable of initiating and delivering complex health care, are simultaneously expected to be dynamic role models for others to emulate (Watson, 2008). However the very concept of what leadership is, how to assess leadership capability, or how to empirically quantify leadership has arguably resulted in a minor explosion of leadership models and approaches (Stanley, 2008). Diversified understandings of what leadership is, and what it is not, will impact upon how leadership is taught within universities and how leadership will be role modeled or mentored within practice settings. A dissonance between taught nurse leadership theory and the applied workplace leadership may also result. These dilemmas within nursing in identifying what leadership is are further highlighted by Stanley (2006) who found that clinical nurses identified leaders as being people who gave committed high quality nursing care, rather than the transformational leadership characteristics promoted within policy and education (Northouse, 2004). Given the connection between effective high quality nursing care provision and effective leadership (Stanley, 2011), the imperatives for achieving a cohesive and effective approach to develop nurse leadership in Australia are clear.

Leadership theory within nursing contexts will generally acknowledge that leadership is a part of and yet is distinguishable from managing (Daly, Speedy, & Jackson, 2003; Stanley, 2006). Leadership might be found throughout an organization structure, while management will tend to be embedded within middle to upper hierarchical echelons. Nursing has historically fused management and leadership, with only more recent times suggesting an increased interest in exploring leadership as being a distinct entity (O'Grady & Malloch, 2010). The historical beginnings of nursing to religious and military contexts, each grounded in structured hierarchical leadership can also be forwarded as having a lasting impact on the professions' attitudes and approaches to managing and leading (Stanley & Sherratt, 2010).

A literature search was undertaken to examine the question of 'what are the recent trends in Australian nursing leadership?' EBSCOhost MegaFILE Complete was searched with the terms of 'leadership + nursing + Australia 2001-2011'. One hundred and twenty-three hits were hand searched for papers examining general trends of leadership rather than focus papers on particular clinical interventions, to exclude brief opinion papers, and to exclude papers not relevant to Australian nursing leadership. Sought were papers reporting on Australian nurse leadership or papers forwarding models of leadership to be applied into Australian contexts.

OVERVIEW OF NURSING LEADERSHIP IN AUSTRALIA

Within an Australian context, nursing leadership offers a complex picture in terms of understanding its impact on the nursing profession, or identifying current and future trends. Halcomb, Davidson, and Patterson (2008) highlight governmental priorities toward developing nursing leadership that stem back a decade to include the need for the workplace to act as a fostering environment to grow nurse leaders. These health care workplaces are far from simple environments with multi-disciplinary influences, discontinuous change and multiple priorities ranging from governance to care provision. Multidisciplinary factors in particular have been noted as a barrier to nurses achieving consistent clinical leadership within Australian acute health care settings (Sorensen, Iedema, & Severinsson, 2008). However, nursing culture and historical practices can also be identified as being problematic. …

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