The roles, relationships and leadership styles of leaders and managers of nursing education in the middle to late 20th century

This thesis is concerned with the observable tensions within, and about, leadership of the nursing profession. Specifically the tensions between the leaders of nursing service and of nursing education is the focus of the investigation. Although both groups within the profession have a shared experience of socialisation; learning professional nursing values; professional control, and leaders careers regularly embrace both segments, never-the-less conflict between the two has been a consistent feature of the profession for most of this century. In order to explore these tensions qualitative data collected via in-depth interviews with 51 people who held leadership positions in nursing education between 1948 and 1995 are presented. This thesis analyses those factors which have contributed to the current situation. An exploration of the career pathways of those interviewed is undertaken and the influences of their individual attributes, knowledge, beliefs and values on the way in which they undertook their leadership roles are examined. Also explored are the ways in which other people were significant in affecting their careers and their approaches to professional life and work. In addition the environment in which they performed was a notable feature of consequence to them in developing the techniques of management used. From an analysis of these factors the ways in which they responded to and coped with changes in health care delivery in the period studied, through developing or adopting different leadership styles, is derived. This analysis suggests that in the period studied nurse managers used one of three main styles of leadership to achieve their goals. Some nurse leaders acquired positions of power in order to shape and develop nursing and nursing education; some pioneered innovations in nursing and nursing education, especially in the higher education environment; and others sought to motivate colleagues and peers through education, enabling and empowerment. The current tensions within nursing leadership are attributed to differences between their conceptions of nursing; their caring values; and the styles of leadership they developed in order to achieve their aspirations to provide the best possible quality of care for patients and of education for students. One of the chief sources of tension appears to be the juxtaposition of these two, sometimes competing, aims. Finally recommendations which refocus nursing as a caring occupation, whose practitioners act in partnership and cooperation, rather than autonomously and in competition with its various stakeholders, and the implications of this on the future recruitment, selection, education and preparation of nursing leaders are made