Being conductor of the orchestra: an exploration of district nursing leadership
The purpose of the present study was to gain insight into how district nurses understand their leadership role. Data were generated through interviews and audio-journals and analysed using interpretive phenomenological analysis. Findings suggested that district nurses managing teams and caseloads experienced a burden of responsibility. Being creative problem solvers, they adopted facilitative ways of engaging with patients but directive approaches to team management. District nurses sharing leadership with multidisciplinary colleagues did not appear to experience this burden. Their leadership drew on their facilitative approaches to care-giving. If nurses enabled, rather than directed teams, they could create a context for developing autonomy and growth, easing the burden of responsibility.
The role of community nursing is receiving increased attention across the globe due to increasing demands for home- and community-based services. In many countries, there is a reliance on undergraduate programmes to equip nurses for multiple work contexts, whereas in others, such as the UK, Iceland and Sweden, community nurses require post-registration preparation. This paper focuses on research on district nursing in the UK, although the findings will be of interest in other countries as well, since despite the increasing demand for care delivered at home, there is a growing community workforce shortage that has been blamed on a number of factors, including professional appeal, preparation and a lack of leadership (While, 2016; Maybin et al, 2016; Van Iersel et al, 2018). A lack of leadership has implications on quality care delivery (Haycock-Stuart and Kean, 2012; Mosadeghrad, 2014).
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