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role and they often judge the CNL by the ability of the CNL to work with them in the delivery direct nursing care.

In summing up this overview she had written:

So I guess in all this, my belief now is that the two key functions of our CNL role

are leadership and management and quite clearly [this goes]… with the expertise to overview/ supervise the provision of clinical care, not do it.

In addition, she shared a pictorial image (see Appendix 6) she had produced that represented the conflict between the leadership, management and direct patient care.

Following on from this direct comparison, a participant challenged the need to give up direct patient care resulting, in her view, in erosion of her clinical competency. One participant opposed this, seeing the Clinical Nurse Leader needing to be knowledgeable about the clinical standards without being clinically current. Another participant, however, was adamant that the CNL needed to be “on the floor”, expanding as follows:

I probably take it from the opposite view of you. You want your Charge Nurse on the floor work with the people. The typing, the setting up for appraisals a

lot of the paperwork background that you need to do, you could get someone

else to do it at $18.00 an hour where you take control. And my argument would be that you get someone who is reasonably junior because you get too many senior nurses trying to do the same role.

The group diverged and converged as they contested direct patient care as an element of the role. Convergence seeing general agreement that the typing involved in the role could be carried out by a purely administrative person. Two participants added that they saw the role of clinical nurse leader being involved in direct patient care as fulfilling the leadership by example and role model aspects of the role. Meeting six closed without general agreement as to whether direct patient care should be removed from the role responsibility.


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