They had their actions and principles based on a foundation
of care and their values and beliefs on show. They were role
models for the finest attributes of care and nursing. They
were open and approachable, communicated well and most
definitely were not ‘controlling’ others. They were themselves
empowered and able to motivate their colleagues and others
because they had the ability to help others feel confident,
supported and encouraged.
The clinical leaders identified in this study, when approached,
often did not recognize themselves as clinical leaders. They
came from a wide spectrum of grades and, where present,
in reasonable numbers. The common assumption, that the
clinical leader in a ward or unit, is the most senior nurse,
nurse manager or ward sister, was not evident in the research
and indeed those nurses with any significant degree of
management function within their role were commonly not
recognized as clinical leaders.
The research pointed to a gap in the available leadership
theories that failed to explain why clinical leaders were
identified or followed. To fill this gap, congruent leadership
is proposed. The author describes congruent leadership as
where the values and beliefs match the leader’s actions, deeds
and involvement in care. The main features of congruent
leadership are set out in Table 2.
Congruent leadership is based on the leader’s values, beliefs
and principles and is about where the leader stands. Congruent
leaders (clinical leaders) are followed because their values
and beliefs are matched by (congruent with) their actions.
They are often not the most senior nurse and commonly
fill no formal, structured leadership role. Often, nurses have
been promoted away from the bedside, into ‘leadership’ or
‘management’ roles. These posts or roles, affiliated with a
leadership or management function commonly placed nurses
in positions of potential conflict (Firth, 2002) with their core
nursing values. However, by accepting that clinical leadership
is more to do with values and beliefs (not vision) nurses can