Nurses' perceptions of clinical leadership in the emergency department: A qualitative descriptive study

Aim: To understand and describe how clinical leadership practices in nursing are undertaken within the emergency department from the perspectives of experienced emergency nurses. Research Question: How do emergency nurses perceive and practice clinical leadership in the emergency department? Method: A qualitative descriptive design was used. Ten individual semi-structured interviews were conducted with registered nurses with experience working in Australian emergency departments. The data were analysed using thematic analysis. Result: Analysis of how clinical leadership was practiced in the emergency department resulted in the identification of four themes: leadership as coaching; leadership as supporting others; leadership by being where the department needs are; and leadership by sustaining and using hospital systems. Discussion: The findings highlight that clinical leadership is exercised in guiding and supporting less experienced staff through coaching. Clinical leadership is demonstrated through expertise and detailed understanding of hospital systems and is used to empower nurses to trust their clinical judgement. Through understanding hospital systems, clinical leadership is exercised to ensure staff are supported to perform their roles and cater for their departmental and hospital needs. Conclusion: Emergency nurses utilise clinical leadership skills in their everyday practice to coach and support less experienced staff. Emergency nurses who utilise clinical leadership dynamically use their knowledge of staff and systems to meet the constantly changing needs of their respective departments.