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Don't let leaders fall through the net

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VOL: 98, ISSUE: 06, PAGE NO: 31

Ami David, MSc, RGN, RM DNT, RNT.

Pay modernisation and the recently announced pay award appear to be high on the current nursing agenda. However, pay is not the only effective way to increase nurse recruitment and retention at all levels. Most nurses say career progression opportunities are as important in ensuring job satisfaction and self-esteem.

Pay modernisation and the recently announced pay award appear to be high on the current nursing agenda. However, pay is not the only effective way to increase nurse recruitment and retention at all levels. Most nurses say career progression opportunities are as important in ensuring job satisfaction and self-esteem.

Over the past decade we have seen greater opportunities for career advancement and more routes to excel in clinical practice. For example, the creation of nurse consultant posts, modern matrons and clinically active nurses on primary care trust executives and boards. Remuneration for these new posts also recognises the key contribution clinically skilled nurses can make at both strategic and operational levels in the NHS.

However, by virtue of statute one of the groups mentioned, nurses on PCT executives and boards, do not have a well-defined career path.

If they are not re-elected by their peers at the end of their three-year term in office they cease to be board members and face a return to clinical practice. This seems a waste of the strategic insight and experience gained in office, which is something nurses have fought long and hard to achieve.

Nurse leadership, as opposed to management, in most PCTs is provided not only by experienced heads of nursing but also, more importantly, by nurses on the elected executive committee or board who carry an active clinical caseload.

This latter group is described in a recent study as 'clinical strategists' (Dawes and Dobson, 2001). And strategic nursing leadership and advice is crucial at a time when the NHS is changing.

In a PCT such nurse leadership comes from a network of leaders: from the head of nursing and elected nurses on the executive committee through to team leaders, nurse consultants and nurse practitioners. This 'network' leadership model is one we need to promote.

Gone should be the days when we assumed that leadership rested with the nurse at the top of the organisational tree. The concern in nursing should be about the future of PCTs' elected clinical strategists when their terms end.

Nurses elected to first and second wave primary care groups and PCTs will soon be facing re-election. What will happen to those who lose their seats? Not only will the NHS lose out on valuable skills, but the nurses involved may also find it difficult to secure positions that compensate adequately.

While it could be said that these nurses should take some responsibility for their career pathways, there should be a consistent approach to this dilemma or the NHS will lose strategic insight and nursing leadership skills.

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