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One CNL referred to her strategy of refocusing on the patient to sustain herself in her practice as a Clinical Nurse Leader. “I take it back to the patient and that’s what really keeps me on track in my role as a Clinical Nurse Leader”. The same CNL described also:

It’s all about going back to your patient care …. because your role is to educate patients and if we don’t know how can we go ahead and explain it to patients.... and getting patients to be more responsible and manage a lot more and understand their medications and their health and to prevent them from readmissions to hospital …we can make a difference and keep them really well.

Another CNL, summarising her thoughts, commented “to me the biggest priority will always be patients”.

Complex

Five CNLs described the role as a complex one. They spoke of the complex nature of the role, balancing the demand for acute response to admit patients as core business of a health care provider and patient needs. One CNL described:

so it makes the role very very complex…we have a lot more complex patients. People [patients] are a lot older coming into the organisation a lot sicker so their discharges are a lot more complex, the pressure on the beds is absolutely

huge ... you come to work in the morning and your focus is merely on discharges and beds.

One CNL recognised the need to continually communicate through the complexity of service delivery. “We don’t have extra staff to manage [bed numbers] so its coming and going and how long you know you’re always anticipating and that can be quite hard”. The same CNL referred again to this communication later in the interview. She described how the role involved

being the hub of the ward or the speciality …. being a link into all different services and at some stages you’re linking all the different teams in making sure that people know what the right hand and left hand are doing so to speak.

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