sørensen e.e., delmar c. & pedersen b.d. (2011) Journal of Nursing Management19, 421–430
Leading nurses in dire straits: head nurses’ navigation between nursing and leadership roles
Aim The present study reports selected findings from a doctoral study exploring the negotiation between nursing and leadership in hospital head nurses’ leadership practice.
Background The importance of bringing a nursing background into leadership is currently under debate. In spite of several studies of nursing and clinical leadership, it is still unclear how nurses’ navigate between nursing and leadership roles.
Method An 11-month-long ethnographic study of 12 head nurses’ work: five worked at a first line level and seven at a department level.
Results At the first line level, leadership practices were characterized by an inherent conflict between closeness and distance to clinical practice; at the department level practises were characterized by ‘recognition games’. On both levels, three interactive roles were identified, that of clinician, manager and a hybrid role.
Conclusions Where clinician or manager roles were assumed, negotiation between roles was absent, leading to reactive, adaptive and isolated practices. The hybrid role was associated with dialectical negotiation of roles leading to stable and proactive practices.
Implications for nursing management Nursing leadership practises depend on leaders’ negotiation of the conflicting identities of nurse and leader. Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity.