3.4 Characteristics of leaders
Four groups of leaders evolved in the analysis, built on diverse patterns of performance and fundamental values among the
informants; the patient guardian, the manager, the climber, and the unconscious. These groups of leaders were unified in
the experience of the leader role as an ‘in-between’ position, which was described as two-sided. The position was seen as
rewarding and stimulating with opportunities for influencing changes in the ward, and the emphasis on good collaboration
with superiors and loyalty to their decisions was prominent. The other side concerned feelings of being trapped by loyalty
towards different levels, groups and interests. These negative experiences were described in terms of heavy burden,
loneliness, frustration and guilt. Shared in common was also the experience of a great responsibility which widely
exceeded the authority and power to act in accordance with what was regarded the best. Despite the negative experiences,
the freedom in the leader role was stressed as a reason for job satisfaction in all groups. With the exception of the climber,
the leaders had not chosen the leadership role actively, but had come into it merely by chance, had been asked, induced or
persuaded to apply for the position.
3.4.1 The patient guardian (n = 17)
This group, which most nurse leaders from all contexts fitted in included leaders with both a nurse and a leader identity. A
distinct professional awareness and knowledge was prominent in thinking and acting. Patient care was a deep concern, and
the leaders saw themselves as role models. Having full authority and involvement in decisions in their own field of
responsibility was stressed as important.
3.4.2 The manager (n = 3)
This group found in Norwegian community care included leaders who saw administration and budget issues as their main
responsibility. They stressed their interest in economic and administrative issues and were satisfied with this content in
their job. The necessity of being a nurse for the leader role was questioned, but in the case of a non-nurse in the bedside
leader position, a co-leader was seen as necessary in order to cover nursing concerns.
3.4.3 The climber (n = 2)
This group was found in Swedish hospitals and included highly self-aware, self-confident and knowledgeable leaders, who
saw career development as a driving force in the leader role. A continuous contact with superiors and being involved in decisions about ’the greater whole’ in the organisation gave a position of power and authority, which was stressed as
important in order to achieve success in the leader role and for their own job satisfaction.
3.4.4 The unconscious (n = 2)
This group was found in the Swedish community care and included leaders who were somewhat unaware of expectations
related to the leader role, and with low professional awareness, knowledge and ambition. Patient wellbeing was stressed as
an important part of the responsibility but seemed to concern social more than professional issues. The medical focus was
predominant, and they saw themselves as a link between the physician and the nursing personnel.