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Leading change: a three-dimensional model of nurse leaders’ main tasks and roles during a change process

Authors

  • Susanne Salmela,

    1. Susanne Salmela MNSc MLT PhD Student Department of Social Sciences, Åbo Akademi University, Vaasa, Finland, and Director Nursing, Vaasa Central Hospital, Vaasa, Finland
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  • Katie Eriksson,

    1. Katie Eriksson PhD RN Professor Department of Social Sciences, Åbo Akademi University, Vaasa, Finland and Head of Nursing Hospital District of Helsinki and Uusimaa, Finland
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  • Lisbeth Fagerström

    1. Lisbeth Fagerström PhD RN Professor Department of Health Sciences, Buskerud University College, Oslo, Norway and Assistant Professor Department of Social Sciences, Åbo Akademi University, Vaasa, Finland
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S. Salmela: e-mail: susanne.salmela@vshp.fi

Abstract

salmela s., eriksson k. & fagerström l. (2012) Leading change: a three-dimensional model of nurse leaders’ main tasks and roles during a change process. Journal of Advanced Nursing 68(2), 423–433.

Abstract

Aim.  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.

Method.  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.

Conclusion.  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.

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