Knowing how to get things done: Nurse consultants as clinical leaders

Background: Clinical leaders drive healthcare performance in the provision of safe, high-quality patient care by influencing others and augmenting change. Clinical leadership features strongly in nurse consultant roles and holds potential to strengthen the nurse consultant’s place in healthcare teams, making their contribution as clinical leaders more recognisable. This study explores how clinical leadership is enacted through the nurse consultant role, providing understanding of the elements that influence their effectiveness as clinical leaders.

Design: This study presents qualitative findings from a larger sequential mixedmethod study conducted in a large Local Health District in New South Wales, Australia.

Methods: Focus groups were held with nurse consultants, managers and other stakeholders from a variety of context including acute, primary and community care settings across metropolitan and rural locations. An online discussion forum was provided for nurse consultants unable to attend focus groups. Transcript data were analysed using iterative theming techniques.

Results: A total of 26 nurse consultants, 20 managers and 16 other stakeholders participated in focus groups and 22 nurse consultants contributed to the discussion forum. The role of the nurse consultant as clinical leader was a dominant feature, manifested through the following four themes: knowing and being known, being a collaborator, being a utility player and working across and within.

Conclusions: Nurse consultants are cogent clinical leaders, recognised and valued for their contribution to interprofessional teams and service delivery. The nurse consultant role is seen as having a broad sphere of influence and is able to action change through clinical leadership.

Relevance to clinical practice: Findings give organisational leaders and other healthcare professional’s greater understanding of nurse consultants as clinical leaders. This informs how nurse consultants are appointed and positioned and how they can be supported in fulfilling their clinical leadership potential.