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When I asked what the group wanted to retain and remove from the CNL role there was general agreement that the patient and ward staff focus remain. As one participant said: “I want to retain the patient focus and the ward staff focus”. Others added, “I want to let go of the budget stuff…. some of the generic quality stuff some of the generic infection control stuff” and “the health and safety stuff”. One participant, however, wished to retain the quality and risk initiatives.

The budget was again raised with a further general acknowledgement that it was not a priority for Clinical Nurse Leaders. One participant rated it as the lowest priority at this time and another responded: “It’s interesting though, because I believe that while that’s

how we view it, I don’t believe other people view it quite like that for us”. This statement seemed to bring the meeting to a natural close with an action point for one of the participants. The participant was to compare the change in the position description and bring her findings back to the group at meeting six.


Meeting Six

Meeting six was held in May 2006 with the aforementioned participant presenting her findings on the comparison of the two position descriptions of the clinical leadership role. The present day conflict, she wrote, within the role of Clinical Nurse Leader, was caused by trying to lead, manage and carry out direct patient care. If the direct patient care was relinquished by those in the role then dual leadership and management accountabilities could be met more easily. The participant had drawn up a written overview of her findings and the next quotation is part of that:

I believe we all have a passion for clinical input inherent in us and this seems to give us more satisfaction than other aspects of our role and we tend to do this in support of both patients and staff. There is or can be pressure from staff and an expectation that we will assist with clinical care when workloads are heavy or staff cannot be replaced. Some of them [nurses] believe that’s also part of our role. Staff are not always aware of the wider aspects of the CNL


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