{"title":"The Exercise of Nurses' Clinical Leadership in Hospital Care Units: A Qualitative Multiple Case Study.","authors":"Geneviève Boutin, Jacinthe Pepin, Isabelle Brault","doi":"10.1111/jocn.17468","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>This study aims to describe the exercise of clinical leadership by nurses within hospital care units, identify the factors influencing it and explore how nurses perceive its impact.</p><p><strong>Design: </strong>Qualitative multiple case study.</p><p><strong>Method: </strong>The study involved 36 interviews, 120 h of observation and documentary analyses with nurses across various roles within three nursing teams to capture collective leadership. Thematic and cross-case analyses were also conducted.</p><p><strong>Results: </strong>Nurses' clinical leadership was manifested in five distinct forms, irrespective of their role: (1) initiating actions involving reflective thinking and intervention, (2) influencing others through coaching, (3) actively participating in and mobilising efforts to enhance the quality of care, (4) fostering optimal synergy and team cohesion, and (5) leveraging personal and collaborative capacities. Factors influencing this leadership included clinical, human and material resources, time, a work environment that promotes autonomy and a positive work climate. Nurses perceived their leadership as having a positive impact on patients, themselves, the interdisciplinary team and the organisation. These findings were integrated into a modellisation of the exercise of nurses' clinical leadership based on Le Moigne's (La Théorie du Système Général. Théorie de la Modélisation. Paris: Presses Universitaires de France, 2006) philosophical approach.</p><p><strong>Conclusion: </strong>This study provides a perspective on nurses' collective clinical leadership in hospital care units, emphasising its leverage effect and the achievement of positive impacts. The proposed model serves as a valuable tool for nurse managers to better understand and support the exercise of clinical leadership.</p><p><strong>Implications for the profession: </strong>The model can guide nurse managers in supporting clinical leadership within teams, assist individual nurses in associating clinical leadership with their practice and assist with mobilising their leadership skills.</p><p><strong>Impact: </strong>This study explores how nurses across various roles within a hospital care unit exercise clinical leadership. The findings reveal five active forms of nurses' clinical leadership, perceived by nurses to positively impact patients, the interdisciplinary team and the organisation. Nurses and managers can use these five forms to foster a collective approach to clinical leadership.</p><p><strong>Patient or public contribution: </strong>None. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER COMMUNITY?: This study introduces an innovative model for understanding and promoting nurses' clinical leadership. It provides insights into the positive impact of this leadership approach and the significance of promoting it.</p><p><strong>Reporting method: </strong>Standards for Reporting Qualitative Research [SRQR] (O'Brien et al. Academic Medicine, 89, 2014 and 1245).</p><p><strong>Trial and protocol registration: </strong>Not registered.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.17468","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: This study aims to describe the exercise of clinical leadership by nurses within hospital care units, identify the factors influencing it and explore how nurses perceive its impact.
Design: Qualitative multiple case study.
Method: The study involved 36 interviews, 120 h of observation and documentary analyses with nurses across various roles within three nursing teams to capture collective leadership. Thematic and cross-case analyses were also conducted.
Results: Nurses' clinical leadership was manifested in five distinct forms, irrespective of their role: (1) initiating actions involving reflective thinking and intervention, (2) influencing others through coaching, (3) actively participating in and mobilising efforts to enhance the quality of care, (4) fostering optimal synergy and team cohesion, and (5) leveraging personal and collaborative capacities. Factors influencing this leadership included clinical, human and material resources, time, a work environment that promotes autonomy and a positive work climate. Nurses perceived their leadership as having a positive impact on patients, themselves, the interdisciplinary team and the organisation. These findings were integrated into a modellisation of the exercise of nurses' clinical leadership based on Le Moigne's (La Théorie du Système Général. Théorie de la Modélisation. Paris: Presses Universitaires de France, 2006) philosophical approach.
Conclusion: This study provides a perspective on nurses' collective clinical leadership in hospital care units, emphasising its leverage effect and the achievement of positive impacts. The proposed model serves as a valuable tool for nurse managers to better understand and support the exercise of clinical leadership.
Implications for the profession: The model can guide nurse managers in supporting clinical leadership within teams, assist individual nurses in associating clinical leadership with their practice and assist with mobilising their leadership skills.
Impact: This study explores how nurses across various roles within a hospital care unit exercise clinical leadership. The findings reveal five active forms of nurses' clinical leadership, perceived by nurses to positively impact patients, the interdisciplinary team and the organisation. Nurses and managers can use these five forms to foster a collective approach to clinical leadership.
Patient or public contribution: None. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER COMMUNITY?: This study introduces an innovative model for understanding and promoting nurses' clinical leadership. It provides insights into the positive impact of this leadership approach and the significance of promoting it.
Reporting method: Standards for Reporting Qualitative Research [SRQR] (O'Brien et al. Academic Medicine, 89, 2014 and 1245).
目的：本研究旨在描述医院护理单元中护士行使临床领导力的情况，确定影响因素，并探讨护士如何看待其影响：设计：多案例定性研究：研究包括 36 次访谈、120 小时观察和文献分析，访谈对象为三个护理团队中不同角色的护士，以了解集体领导的情况。研究还进行了主题分析和跨案例分析：护士的临床领导力表现为五种不同的形式，无论其角色如何：（1）发起涉及反思和干预的行动；（2）通过辅导影响他人；（3）积极参与并动员提高护理质量的努力；（4）促进最佳协同作用和团队凝聚力；以及（5）利用个人和协作能力。影响这种领导力的因素包括临床、人力和物力资源、时间、促进自主性的工作环境以及积极的工作氛围。护士们认为自己的领导力对病人、自己、跨学科团队和组织都有积极影响。根据 Le Moigne（La Théorie du Système Général.Théorie de la Modélisation.Paris：结论：本研究为医院护理单元的护士集体临床领导力提供了一个视角，强调了其杠杆效应和积极影响的实现。所提出的模型是护士管理者更好地理解和支持发挥临床领导力的宝贵工具：该模型可指导护士管理者支持团队内的临床领导力，帮助护士个人将临床领导力与其实践联系起来，并协助调动其领导技能：本研究探讨了医院护理单元中不同角色的护士如何发挥临床领导力。研究结果揭示了护士临床领导力的五种积极形式，护士认为这些形式对患者、跨学科团队和组织产生了积极影响。护士和管理者可以利用这五种形式来培养临床领导力的集体方法：无。本文对更广泛的社会有何贡献？本研究引入了一种创新模式来理解和促进护士的临床领导力。报告方法：《定性研究报告标准》（Standards for Reporting Qualitative Research）：报告方法：《定性研究报告标准》[SRQR]（O'Brien et al. Academic Medicine, 89, 2014 and 1245）：未注册。
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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