Sorbello, Barbara C.

The purpose of this study was to explore, through a descriptive method, views of registered nurses and unlicensed assistive personnel about their roles. Data sources included interviews with three registered nurses and three unlicensed assistive workers practicing in partnership on an acute patient care unit. Study findings supported role theory assertions that role strain and stress, manifested as role ambiguity, role confusion, role overlapping, and role overload occur when the role transition process and role expectations are not clarified or nurtured among role partners. Implications for nursing practice include the following: (1) Nurses in clinical and administrative practice need to be sensitized to the importance of nurses and ancillary personnel being active participants in the work redesign process, and must support the value of caring that transpires in the nurse-patient relationship. (2) Role theory can be utilized to understand dynamics that occur in work settings of nurses and assistive partners.

A new role has been developed in nursing named the Clinical Nurse LeaderSM (CNL®). This new role positions the masters prepared nurse at the patient's bedside to oversee care coordination and serve as a resource for the clinical nursing team, and to bridge the gaps in health care delivery to better meet the needs of patients in all health care delivery settings. Since this is a new role, there is a paucity of research that has been conducted surrounding these nurses. A phenomenological investigation examined the lived experiences of CNLs® to gain understanding about the meaning of leadership at the point of care and to discover the unique expressions of living caring that CNLs® experience as they embark upon this new role in the acute care hospital setting. Ten CNL® participants were interviewed for this study. Their stories about patient situations and relationships with other disciplines were shared with rich description and emotion. Hermeneutic analysis of the text revealed six essential themes. Six essential themes emerged revealing the essence of leading at the bedside and living caring in the CNL® role: navigating safe passage, pride in making a difference, bringing the bedside point of view, knowing the patient as person, helping nurses to grow, and CNLs® needing to be known, understood and affirmed. Taken as a whole through a synthesis of the themes, the understanding of the meaning of leading to CNLs® includes keeping their patients safe, being proud of their accomplishments and the respect gained from others, as well as being a helper and advocate for other nurses.