Understanding leadership in community nursing in Scotland.

There is limited evidence concerning leadership in community nursing. NHS policy also fails to clarify and define what leadership is, though regarding it as key to developing safe and high quality care. This paper reports the findings of a research study that aimed to identify how leadership is perceived and experienced by community nurses, and to examine the interaction between recent policy and leadership development in community nursing. Mixed qualitative methods were used involving 31 individual interviews and three focus groups with community nurses and nurse leaders (n-39) in three health boards in Scotland. Findings indicate the leadership qualities valued by participants, including the importance of leaders' visibility. Team leaders in particular were recognised for their visibility and clinical leadership. Strategic and professional leadership was less evident, so acting as a barrier to the development of the profession. The strategic vision was often not clear to community nurses, and they engaged in differing ways with the strategies and action plans of senior nurse leaders. New leadership roles, like change, need time to evolve and new leaders need space and the education to develop leadership. Future leaders in community nursing need to focus beyond clinical leadership, ensuring that good leadership is a process requiring interdependence between leaders and followers.