In using mentoring, coaching and action learning interventions, the focus should be on each participant's current role and everyday practice and on helping the participant to develop and demonstrate clinical leadership skills in these contexts.

Public discourses concerning older people are available in a variety of texts, including popular media, and these discourses position older people with particular age identities. This study examined discursive formations of ageing and age identities in print media in Ireland. Constituting a single media event, newspaper texts concerned with revised welfare provision for older people were subjected to critical discourse analysis and revealed particular ways of naming and referencing older people and distinct constructions of ageing and age identities. The use of nouns and phrases to name and reference older people positioned them as a distinct demographic group and a latent ageism was discernible in texts that deployed collective names like ‘grannies and grandads’ and ‘little old ladies’. Five distinct identity types were available in the texts, variously constructing older people as ‘victims’; ‘frail, infirm and vulnerable’; ‘radicalised citizens’; ‘deserving old’ and ‘undeserving old’. The discourses made available subject positions that collectively produced identities of implied dependency and otherness, thereby placing older people outside mainstream Irish society. The proposition that older people might be healthy, self-reliant and capable of autonomous living was largely absent in the discourses. Newspaper discourses betray taken-for-granted assumptions and reveal dominant social constructions of ageing and age identity that have consequences for older people's behaviour and for the way that society behaves towards them.

Overcoming the barriers to clinical leadership development requires attention to interdisciplinary relationships in the practicum and to the actual and perceived degree of relative influence that nurses and midwives have at wider departmental and organisational levels.

This discursive paper synthesises empirical evidence and expert professional opinion on the factors that enable or hinder the development and sustainability of specialist and advanced practice roles. Providing a critical appraisal of current knowledge, it provides a reference source for disciplinary debate and policy development regarding the nursing and midwifery resource and informs clinicians of the myriad issues that can impact on their capacity to expand their scope of practice.

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casey m., mcnamara m., fealy g. & geraghty r. (2011) Nurses’ and midwives’ clinical leadership development needs: a mixed methods study. Journal of Advanced Nursing67(7), 1502–1513. Abstract Aim.  This paper is a report of a descriptive study of nurses’ and midwives’ clinical leadership development needs. Background.  Nurses and midwives are expected to fulfil a leadership role at all levels, yet efforts to strategically support them are often unfocused. An analysis of clinical leadership development needs can provide the foundation for leadership initiatives to support staff. Method.  A mixed methods design was used. A questionnaire was sent to 911 nurses and midwives and 22 focus groups comprising 184 participants were conducted. Data were collected between March and June 2009 across all promotional grades of nurses and midwives in Ireland. Repeated measures anova with Greenhouse–Geisser adjustment was used for post hoc pair wise comparisons of the subscale dimensions of clinical leadership. anova with Tukey’s post hoc method was used for comparison between grades on each individual subscale. Thematic analysis was undertaken on the focus group data. Results.  Results reveal that needs related to development of the profession were the highest for all grades. The staff grade expressed a higher need in relation to ‘managing clinical area’, ‘managing the patient care’ and ‘skills for clinical leadership’ than managers. Qualitative analysis yielded five themes; (1) clinical leadership and leaders from a nursing and midwifery perspective; (2) quality service from a nursing and midwifery perspective; (3) clinical leaders’ roles and functions; (4) capital and (5) competences for clinical leaders and leadership and the context of clinical leadership. Conclusion.  Clinical leadership concerns quality, safety and effectiveness. Nurses and midwives are ideally placed to offer the clinical leadership that is required to ensure these patient care outcomes. Development initiatives must address the leader and leadership competencies to support staff.

Clinical leaders are recognised as practice experts and as leaders in their particular fields. Recognition and influence in and beyond the immediate context of care depends greatly on their ability to articulate the distinct nursing contribution to patient care. This ability provides an essential resource to resist the ongoing blurring, effacement and dilution of nurses' roles.

There is international recognition of the need for workforce planning to meet the diverse population health needs and the move to person-centred as opposed to service-centred models of health care against the background of a largely physician-led health service model. Bryant-Lukosius, DiCenso, Brown, and Pinelli (2004) suggest that the difference between phrases such as "advanced practice nursing" and "advanced nursing practice" relates to whether one is referring to what nurses do, i.e. "advanced nursing practice", or referring to the level at which the roles are constructed, i.e. "advanced practice nursing". Evidence of nurses' and midwives' experiences in role expansion indicates that many embrace role expansion and that they function effectively in expanded roles; however, nurses and midwives may experience scope of practice as either enabling or restricting . As advanced practice is a level of practice rather than a specific role (Ryley & Middleton, 2016), one strategy to develop a more efficient Abstract Aim: To describe the enablers and challenges to the development and implementation of advanced nursing and midwifery practice roles in Ireland. Background:Leadership strategies need to be put in place to enhance the development and implementation of advanced nursing and midwifery practice roles. Method:A descriptive qualitative approach using semi-structured interviews with key stakeholders (n = 15) was undertaken with nurses and midwives working in specialist and advanced practice roles and participants from other areas such as legislative, regulatory, policy, pharmacy, medicine and education. Results: Participant's perspectives on the enablers and challenges to enacting specialist and advanced practice roles resulted in the generation of three themes: organisational factors; collegial, interprofessional and interpersonal support; and role clarity, economic and regulatory contexts. Conclusion: Addressing organisational factors, encouraging collegial and interprofessional support and establishing role clarity contribute to the effective development and implementation of the role of advanced practitioners.Implications for nursing and midwifery management: Managers of nursing services need to provide leadership in developing strategies to enhance the enablers and overcome the challenges to advanced practice role development in their own organisation. K E Y W O R D Sadvanced practice, barriers and challenges, midwifery, nursing