Role conflict: leaders and managers

It should come as no surprise to most nurses that the best and most experienced clinical members of wards or unit teams do not necessarily make the most effective managers. Yet employers persist in appointing senior clinical staff into ward or unit managerial posts, or worse, encourage clinical staff to take up managerial posts and then burden them further by asking them to retain clinical responsibilities (Stanley 2006a, 2006b). Some modern matrons and consultant nurses have taken up these positions, as have many ward managers, senior ward leaders and ward sisters (Stanley 2006a, 2006b). The result can be conflict, confusion, challenges to the clinicians' values and beliefs, or ineffective leadership and management, leading to diminished clinical effectiveness, or even dysfunctional ward or units, and therefore poor quality care (Stanley 2006a, 2006b). It appears that the drive to place clinicians in key leadership roles (Department of Health 1999, 2000) is hindered by a commonly held misunderstanding about the difference between leadership and management. This article examines the literature on differences between leadership and management, and discusses the results of a study undertaken by the author that shows that nurses are aware of both these differences and the problems that arise from them.