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development offered to nursing leaders is drawn from recent non-nursing leadership management theories such as transformational leadership. Texts indicating the curriculum to be used in nursing leadership education draw on such theories. I had also questioned whether this defining of leadership style and education based on mainstream non-nursing management and leadership was particularly useful for clinical nursing leaders and I was interested in whether my claims and assumptions were reasonable to make. My continued interest, my observations, my lived experience and, in parallel, my awareness of this trend for restricted research focus and subsequent professional development all informed my objective for the research. To reiterate, this was how can the evolution of the CNL role be further informed and how can the support of the role be further improved? Questions encompassed in this include what is the role and who should define it?

This literature review therefore concentrated on describing what literature was already informing the evolution of the role and what support was recommended. In addition, who was involved in these studies, how were they involved and what were the reference points or framework that knowledge claims were made from are referred to where appropriate. If there were studies shifting the focus away from non nursing leadership theory to unique nursing related recommendations I was interested in their aims, design and usefulness for nursing leaders in a clinical setting.


Search Strategy

The purpose of the review was therefore to draw on the literature that sought to define and advise on nursing and clinical leadership against such personal beliefs and my ongoing inquiry. The dates 1993 to 2004 were significant in that that they covered the period of notable change to the health care delivery model in New Zealand in which I had also observed and studied the changing role of the CNL. I was interested in literature that linked to nursing leadership in general, not only literature that specifically stated the term clinical nurse leader, thus at the outset a broad search was undertaken. The databases accessed were Cumulative Index in Nursing and Allied Health Literature (CINAHL), Proquest, Medicine and Allied Health collections. The keyword ‘nursing leadership’ combined with the time frame and full text availability resulted in 1084 hits. Leadership and nursing both


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