Advanced clinical roles: investigating dilemmas and changing practice through action research.

A new career structure for clinical nurses was implemented in 1987 in Victoria with the intention of providing clinical advancement and material rewards for nurses in clinical settings. This paper explains how participatory action research was used to explore some of the issues inherent in the role of the associate charge nurse. The clinical/management tension and the role expectations formed within the taken-for-granted rituals and routines of the ward and the hospital managerial structure are examined.