The way things are done around here: perceptions of clinical leadership in mental health nursing

Abstract

Clinical leadership is the cornerstone to improved health outcomes and workforce development (Graham, 2003; Mental Health Workforce Development, 2005). This research project explored nurses' perceptions of clinical leadership in mental health nursing practice. Within New Zealand no research exists that evaluates the role and impact the clinical leadership has in mental health nursing practice. From personal experience and discussion with colleagues I argue that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses. The prime objective of this study was to increase knowledge about clinical leadership in mental health nursing practice. This research used a quantitative descriptive methodology, utilising survey design. A questionnaire was used to rank the attributes of the person the respondents identified as a clinical leader. The data was collected from 30 registered nurses working in mental health settings within the central region of New Zealand. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) Version 10, including descriptive statistics and group correlations. Three open-ended questions sought the respondents' opinion of how clinical leadership influenced their nursing practice, what clinical leadership skills were useful for assisting and retaining nurses and what barriers existed to prevent effective leadership. Responses to the three open-ended questions were analysed for their thematic content. Findings indicate that there is room for improvement with regard to clinical leadership in mental health nursing practice. Clinical leadership is perceived to be more effective by nurses in their second year of practice and in community settings. A statistically significant difference was indicated between nurses in their second year of practice and nurses in their third year of practice in terms of their ranking of clinical leadership abilities. Overall the respondents perceived poor communication and poor attitude as the biggest barriers to effective leadership. Support and good role models were said to influence nursing practice positively and the skills that were identified as being helpful in assisting and retaining nurses were mentorship and good communication. The results of the study are discussed in relation to the literature on transformational leadership skills. Finally, the general limitations of the study are outlined and implications for future research are discussed.