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CHAPTER 7. IN THE THICK OF IT – SHARING AND LEARNING FROM EACH OTHER HOW WE MANAGE AND LEAD

7.1. Introduction

This chapter describes the content and actions of meetings four to seven, where the analysis of the theme relating to the conflict that occurs between the leadership and management aspects of the Clinical Nurse Leader (CNL) role took place. This was a significant, almost turbulent, stage of the research where the group shared and learned from each other as to how they actually manage and lead, describing the reality of practice. Figure 5 represents this stage of the research. During these meetings there were times of, as Heron and Reason (2006) describe, “research cycling” (p. 150), “chaos and order” (p. 151) and what Wadsworth (2006) terms “transformative moments” (p. 330). These moments being when resolution was achieved through the action research group process as to what should be included in the representation of the CNL role. There were also times when some of the group felt powerless as to a way forward.

The excerpts included in this chapter illustrate all the above points. Discussion on budgetary, cost centre responsibilities as well as overall clinical care featured prominently in the meetings as examples of the conflict that occurs between the leadership and management functions. The tension caused by the administrative responsibilities of the CNL, such as writing of appraisals, processing incident forms and attending to the generic organisational requirements was raised. There were repeated references by the participants of the importance within the role of patient care and subsequent clinical leadership. General agreement was reached that the role should dispense with the administrative duties tied to the use of a computer and the actual typing of long documents that need to be completed to satisfy management, and regular appraisal of nursing staff. Solutions were proposed.

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