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development afforded the role could be further developed and that the support needed to be continuous. The professional development model created from this research is based on a learning need analysis against the position description carried out by the CNL themselves. This arose from the group raising the lack of regular feedback on performance, particularly in the orientation stage. The yearly performance review was not seen as an effective tool to plan education and a suggestion was made to undertake an informal review at three months into the role. The position description would allow those already in the role, and those beginning, the ability to rate their understanding of the key functions of the role and develop, in conjunction with their manager, an individual plan. The details could include such topics as education around human resource management or around computer tasks or software necessary to function in the role in a large organisation. The nursing staff understanding of the role of CNL also was an area suggested for further development also.

This focus and partnership with those in the reality of clinical leadership practice was valuable. Significantly, the group agreed that the major components of the role are leadership, management and patient care. Conflict occurs between the management and leadership functions of the role but the group agreed patient care was still vital to the role. The CNLs defined the role and offered new solutions for the future community of CNLs in the DHB. These new solutions addressed the tension that occurred when there is both leadership and management accountabilities within the organisational expectation of the role. This tension is already described by existing literature aforementioned. The solutions included a specific professional support model and a scoping exercise to be applied to all clinical settings to see the feasibility of an Associate Clinical Nurse Leader. These outcomes were arrived at after the constructive distillation of data surrounding the role by the group and the focus on two aspects that surfaced when in the role in a DHB setting. The group listened and learned from each other and then coalesced for the future of CNLs. The situational context or environment of this research, the role of the CNL within the District Health Board and the DHB structure, was pivotal to and within the inquiry. The findings surfaced the strategies those in the role use for managing the organisational expectations of the role. When researching the role within this context with those in the role, I was and remain reminded of the tension that occurred in New Zealand between the


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