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a key role in addressing the community’s needs and in helping DHBs deliver on the government and local health priorities. Essentially, the structure of the DHB can be summarised by describing three: levels that of governance, management and service provision.

The governance remains the function of the board of the DHB. This board is advised by various councils and committees, including the three core advisory committees, as dictated by the New Zealand Public Health and Disability Act (2000). The management function is overseen by the CEO, with the service provision including the provider division. This division provides community, secondary and tertiary health services and it is the division of the DHB with which most members of the public will have had interaction. The provider division encompasses hospital and community health settings, which members of the public may need to access through any one given health episode. Within the provider arm, there are differing management positions but the structure encompassing the role of the CNL can fall within either a hospital setting or community setting. The position of CNL is a number of management layers away from the board of directors that govern this DHB and are responsible for working within apportioned resources from the government. Although significantly removed from the board, Chief Executive and general management, it could be argued that the people of the district may perceive this head nurse, the sister, the CNL of the ward, clinic or department, community setting as a recognisable face in such a structure.


The CNL Within the District Health Board

The role of the CNL in the DHB and the recognition this role carries for the public, is largely due to the CNL being the conduit to the delivery of health services within a multiplicity of settings. For example, all members of the multidisciplinary team operating within their specific clinical area such as doctors, physiotherapists, social workers, and dieticians can relay various pieces of information to the CNL sometimes all within an eight hour shift. The CNL is the clinician with whom the patients and families may communicate in respect to a health care episode, expecting them to be possessive of all facets of the admission. It could be assumed within the context of a health-related episode


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