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“Isn’t that leadership leading your team?” and “It’s also about being there”. Another participant added: “To me I put that into the leadership bucket about leading the team knowing what’s happening making sure care is provided and all of that stuff”.

Meeting seven closed with the group agreeing that the remaining theme of professional development and support accorded to the role needed to be debated. This was to occur in meeting eight.

7.5. Summary

The period that covered meetings four to seven was a significant point in the research. The group analysed the conflict that occurs between the leadership and management accountabilities in the role of Clinical Nurse Leader. Leadership was seen as the role modelling of clinical standards for patient care, and management was attending to budget and generic organisational responsibilities. The group shared and learnt from each other, with examples from their daily practice, about how they managed this conflict. Some of the participants voiced their frustration at their inability to influence the development of the role especially in relation to this tension. As the researcher, I chose a non-canonical approach to illustrate the level of frustration at this point of the inquiry and wrote “The Race”. Some acknowledged that even though their position description included accountabilities like budget it was not a priority, patient care was. The group agreed that the title Clinical Nurse Leader was a misnomer as the role stood at that point and due to all the other accountabilities that there was no time to lead clinical practice. The role, some said, was “too big” and “too complex”. The role was “embedded in all this paper” and they were not “typists”. A comparison of position descriptions by one of the participants acknowledged the tension of trying to be a leader and a manager. The tension, she wrote, was due to the CNL attempting to retain direct hands-on patient care. Consensus was not reached within the group that ceasing direct patient care would solve the tension. Some saw direct patient care as attending the role modelling necessary to lead nursing staff in demonstrating clinical standards. Solutions however started to be created.


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