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have to let that go so I find that quite difficult on a day-to-day basis and you don’t consciously always think about it like that but that is how it is actually.

At this point there was an emergence of not only conflict of budget responsibility versus management but also that of clinical leadership versus management. This tension between clinical leadership of nurses versus management of nurses was to remain a constant thread on one of the “24 needles” (p. 323) that Wadsworth (2006) refers to when facilitating an action research project.

There was general agreement that the actual title of Clinical Nurse Leader was a misnomer. One participant acknowledged that the title was “brilliant” but that the CNL had to do more than lead clinical practice. The reason given for why the CNL could not devote all their time to such leadership was because time had to be spent fulfilling the management expectations of the role, as the role was “embedded in all this paper”. This comment was followed by a participant asking “where do you go?…. One person can’t do all this”. Another added:

What are we? We’re nurses and to lead the nursing practice is what I’m passionate about and to be expert, expert of excellence. I’m not a secretary,

I’m not a typist, I’m not a finance person …. but I want to pass on my passion

about this craft of nursing, and this paperwork does that make any difference

to the quality of care to the patient?

The three others in the group considered this question and agreed they personally didn’t make as much difference to the quality of care of the patients as they would like with one stating: “I don’t think I make any difference to the patient much at all”. Another participant agreed and was adamant that the focus of the role should return to standards of practice.

No, I absolutely agree, I think that is the bit we should focus on, coming back to

being Clinical Nurse Leaders because we are passionate about nursing and about standards of practice and maybe being able to make a difference to the patients.

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