Clinical leadership and effective nursing teams

Jean Rankin


Abstract—Health-related policy and its implementation into everyday practice is complex. The key challenge facing contemporary healthcare is to nurture cultures through effective leadership that continually improve high quality, safe and compassionate care. In the role as guardians of patient safety and quality, clinical nurse leaders are ideally situated to influence the performance of nursing teams through positive leadership qualities, strategies and behaviors. Leaders are effective when they are confident and competent, aware of their own behaviours, strengths, areas for development. Effective leaders can establish positive relationships between individuals helping them to make sense of change, implications for poor performance, successes and the future.
This present study focuses on clinical leadership and nursing teams and involves a synthesis of findings from qualitative studies to gain further insight into key characteristics of leadership and the reasons why nursing teams are functional or dysfunctional. Using a systematic framework for qualitative data analysis, three distinct themes were revealed. These relate to factors involving individual aspects of leaders, team members and the working environment for clinical teams. The dominant theme was the characteristics of the clinical leader and the impact these have in relation to effectiveness of clinical nursing teams and the culture of the working environment. Clinical leaders demonstrating positive characteristics were described as being ‘authentic,’ ‘inspirational’ and ‘transforming’ leaders for the team. These characteristics were regarded as being the essence of effective leadership. In contrast, others were described as being ‘toxic’ or ‘poor’ leaders. ‘Toxic’ leaders displayed negative personal characteristics, behaviours and conduct which were destructive to the culture and damaging for teams. ‘Poor’ leaders did not display the required knowledge, ability or characteristics. Findings contributed to current evidence that key characteristics of teams include commitment, coordination, communication, cohesion, decision making, conflict management, social relationships and performance feedback. The effectiveness or ineffectiveness of nusing leadership was strongly associated with the impact it had on individuals and teams, their performance and on the culture of the working environment which could have long-lasting effects.


leadership; team working; nursing teams; professional development; motivation; nurse leader; communication; positive cultures; inspirational leader; toxic leader.

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