Aim(s) To examine nursing leadership in contemporary health care and its potential contribution to health service organization and management. Background As the nursing profession repositions itself as an equal partner in health care beside medicine and management, its enhanced nursing standards and clinical knowledge are not leading to a commensurate extension of nursings power and authority in the organization. Method(s) An ethnographic study of an ICU in Sydney, Australia, comprising: interviews with unit nursing managers (4); focus groups (3) with less experienced, intermediate and experienced nurses (29 in total); and interviews with senior nurse manager (1). Results Inter- and intra-professional barriers in the workplace, fragmentation of multidisciplinary clinical systems that collectively deliver care, and clinical and administrative disconnection in resolving organizational problems, prevented nurses articulating a model of intensive and end-of-life care. Conclusion(s) Professional advocacy skills are needed to overcome barriers and to articulate and operationalize new nursing knowledge and standards if nurses are to enact and embed a leadership role. Implications for nursing management The profession will need to move beyond a reliance on professional clinical models to become skilled multidisciplinary team members and professional advocates for nurses to take their place as equal partners in health care.

Item Type:	Refereed Article
Keywords:	ethnography, health service organization, intensive care, leadership, management,
Research Division:	Medical and Health Sciences
Research Group:	Nursing
Research Field:	Nursing not elsewhere classified
Objective Division:	Health
Objective Group:	Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:	Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
UTAS Author:	Iedema, R (Professor Rick Iedema)
ID Code:	94364
Year Published:	2008
Web of Science® Times Cited:	21
Deposited By:	Health Sciences B
Deposited On:	2014-09-08
Last Modified:	2014-09-08
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