# Registered nurses and what may constitute their leadership in the home healthcare context

## TL;DR

This study explores how registered nurses demonstrate leadership in home healthcare through their daily interactions, even without formal leadership roles.

## Contribution

The study identifies three critical aspects of leadership in home healthcare nursing: accountability negotiation, overview management, and time-constrained task management.

## Key findings

- Leadership in home healthcare nursing involves negotiating accountability for nursing activities.
- Gaining an overview of nursing activities is a critical leadership aspect.
- Managing nursing activities within limited time is essential for leadership in this context.

## Abstract

Registered nurses who are not employed in formal leadership positions are assumed to practice leadership, yet there is limited knowledge of what this entails. This study aimed to identify what may be recognised as critical aspects constituting leadership in registered nurses’ daily interactions in the home healthcare context.

A qualitative study design with a hermeneutical approach was employed. Data were collected through individual interviews with registered nurses working in three home healthcare contexts in three Norwegian municipalities. Data were analysed using thematic analysis.

The results are presented as three critical aspects that seem to be recognised as constituting leadership in the home healthcare context: (1) Negotiating accountability for nursing activities, (2) Gaining an overview of nursing activities, and (3) Managing nursing activities within a limited time.

In this study, leadership appears to emerge when the registered nurses act as meaning-makers in daily interactions with their colleagues. The nurses act as meaning-makers to achieve a specific goal: to accomplish nursing activities to care for patients needing help. Acting as meaning-makers involves the nurses being aware of and actively recognising negotiating accountability for nursing activities, gaining an overview of nursing activities, and managing nursing activities within a limited time. These are critical aspects that may constitute leadership in their daily interactions.