Leadership in British nursing: a historical dimension

Abstract

A historical overview of nurse leadership in the late 19th and late 20th centuries is presented, supported by relevant material from the literature. The 19th century material revealed the following main themes: emphasis on practical and domestic aspects of management; prominent input of religious ideals and social conscience and, autocratic and feminized style of leadership. The main themes in the contemporary literature examined were: role models in history, dysfunctional leadership styles, importance of knowledge, gender as an influencing factor on nurse leadership and threats to the autonomy of nurse leaders. It was concluded that formal nurse professionalization has progressed steadily during the past hundred years with associated evolution of nurse leaders to fit in with contemporary needs. It is hoped that future policies for nursing will encourage decision-making nearer the 'bed-side', more resource-driven care and value-based leadership.

A nursing theory for nursing leadership

“…For many years nursing has struggled with the concept of leadership. In letters written mainly to nursing students, Nightingale advocated that nurses should be responsible for the internal management of patient care (Lorentzon 1997). Bureaucratic health care organizations have adhered to this concept, at least in title, by continuing to use such terms as ‘Nurse Manager.’ A review of nursing theorists such as Orem (1980), Roy (1976), Henderson (1966), Rogers (1976), and Neuman (1982) reveal strong theoretical basis for effective management of patient care.…”

Consultant nurses in mental health: a discussion of the historical and policy context of the role

“…The historical influences can be both positive and negative forces, able to drive and suppress development in role profiles for consultant nurses. The late 19th century saw nursing begin to emerge as a profession, marked by the struggle for registration and the development of autocratic styles of female leadership in the form of matron and sister roles, characterized by religious and military ideals (Abel‐Smith 1960, Lorentzen & Bryant 1997, Moiden 2002). Although the 1960s and 1970s saw the loss of these traditional roles, hierarchical nursing structures were preserved, with the development of various grades of nursing officers.…”

Leading nurses in dire straits: head nurses’ navigation between nursing and leadership roles

“…Nursing leadership in the late 19th century in the UK was characterized as being governed by a mixture of autocratic, professional, religious and military ideals, which materialized in the hospital matron figure (Lorentzon & Bryant 1997). The classic matron role had undergone a gradual transformation in moving from housekeeping in the 1960s to clinical leadership in the 1990s in order to ensure high‐quality care, good nutrition and appealing, clean departments for the public (Royal College of Nursing 2003).…”