Discussion
The significance of these findings might not at first be
evident, with many of the attributes from the definitions
above being represented in the characteristics and
qualities identified in this author’s study. However, there
is one significant difference, and this points toward a new
perspective that can be brought to the consideration of
clinical leadership. In both this author’s study and the
definitions given previously, clinical expertise, effective
communication, empowerment and a desire to provide
quality care can be identified. However, at no point in the
author’s research was vision identified as an attribute for
which clinical leaders were identified or followed. It is not
suggested that clinical leaders have no vision, only that it is
not their vision that motivates their followers. Instead, it is
the demonstration and translation of their values and beliefs
into the actions and the functions of their role for which
they are admired and followed. Both the questionnaire and
interview results confirmed this perspective.
These findings also question the appropriateness of
transformational leadership (House, 1976; Burns, 1978;
Bass, 1985, 1990) as a leadership theory able to support an
understanding of clinical leadership (NHS Confederation,
1999; Lett, 2002; Welford, 2002; Thyer, 2003; Stanley, 2004).
Transformational leaders are described by Leithwood et al
(1999) as being able to set direction, establish a vision, develop
people and build relationships. Transformational leadership
involves emotions, motives, ethics and incorporates visionary
leadership (Northouse, 2004). However, visionary leadership
was not identified as a characteristic sought or identified
in clinical leaders. The main features of transformational
leadership are set out in Table 1.
This author’s research indicates that clinical leaders were
recognized as visible, highly skilled or expert clinical nurses.