Book Review
Clinical leadership in nursing
Judith T Rocchiccioli and Mary S Tilbury
ISBN: 0-721654-42-8 1998 288 pages Harcourt Brace
Neil MacKinnon
Clinical Nurse Consultant, Westmead Brain Injury Service, Westmead NSW
Each of us can probably think of the one or two managers we have worked with who were inspirational in how they carried out their clinical and management roles. At other times the great sense of purpose and belonging in a really great team was memorable. Recently, the buzzword in many circles has become leadership. Perhaps what we are trying to be, or looking for, are those managers/clinicians who were also successful leaders. Productivity when things really click is memorable. My own perspective on leadership and management has undergone some rapid change in the last two years. I thought to be a clinician meant I could avoid management. Yet the clinical-versus-management split can lead to unfruitful confrontations and fail to drive change to meet the needs of stakeholders.
The book contains three units. Unit 1, Foundations of Contemporary Nursing Leadership, covers the health care system, organisational structure, practice models, managed care, fiscal and information management systems. Unit II, Critical Concepts in Contemporary Nursing, deals with motivational leadership theory and contains an outstanding chapter on clinical leadership. Unit III, Integrating Systems in Contemporary Nursing Leadership, looks further at the legal system, ethics, quality management and performance management.
Each chapter provides learning objectives, discussion questions and learning activities. Each chapter has many subheadings that all appear in the contents page.
The editors state that, 'the need for effective nurse leadership has never been greater' and that leadership and management are 'inexorably intertwined'. They emphasise the need for nurses to participate actively and advocate nursing services within the bureaucracy.
Chapter 8, headed 'Clinical Leadership in Nursing: The RN as Integrator', attempts to expand on this intertwining. The clinical nurse leader fulfills the roles of politician, planner, coach, educator, financier and diplomat. In this chapter each of these roles is expanded and practically discussed from the perspective of first-line management and unit staff. The overall clinical nurse leadership role is to build a culture to support exemplary practice.
Overall, the book provides discussion on a broad range of topics but falls short of describing and applying the intertwining of management and leadership for practical application. Topics such as communication, conflict negotiation and group dynamics are presented without a clear demonstration of application in a nursing unit and publications in these areas abound. In several chapters the content is explicitly devoted to the USA health care and legal system.
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