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delivered but need support mechanisms and role expectations made clear at the outset (Stanley, 2006). He states: “The result can be conflict, confusion, challenges to the clinician’s values and beliefs, or ineffective leadership and management, leading to diminished clinical effectiveness, or even dysfunctional ward or units, and therefore poor quality patient care” (p. 31).

One of the participants summarised similarly: What are we? We’re nurses, and to lead nursing practice is what I’m passionate about and to be expert, expert of excellence. I’m not a secretary, I’m not a

typist, [and] I’m not a finance person. (Meeting 5)

Professional development is deemed important in support of the CNL role (Cook, 2001; Sullivan et al., 2003; Connelly, Nabarette & Smith, 2003). Education, commencing at undergraduate level, needs to include leadership, management, finance and quality assurance (Williams, 2004; Mills, 2005). Cook and Leathard (2004) deem preparation of the role inadequate. They conclude: “much learning about leadership is undertaken once a person has been designated as a clinical nurse leader, rather than in preparation for the position” (p. 440). They add current clinical leadership programmes are in the main disconnected from the wider organisational direction. Thorpe and Loo (2003) suggest that not enough attention is given to meeting the individual needs of nurse managers (Canadian term to generically describe those in roles similar to the clinical nurse leader). They propose that nurse managers should be involved in their education planning. Spence- Laschinger, Purdy, Cho and Almost (2006) suggest that organisational support plays a role in retaining nurse managers.

The current research uncovered the lack of preparation and ongoing support experienced by the seven CNLs. This research again added more knowledge not only about the suitability of the professional development afforded the role but also the content, timing and self assessment by the CNL about what education is needed. In the interviews, the limited feedback about how they were doing when first in the role was highlighted, as well as the varying levels of access to professional support, for example a mentor. The action research group were clear that the present preparation, support and professional


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