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Redefining Nursing Leadership: A Multilevel Competency Framework for Future Healthcare Challenges.

Aleix Fontanals-Jimenez1,2,3, Marta Trapero-Bertran2,4, Montserrat Gea-Sánchez1,2,5

  • 1Society, Health, Education and Culture Research Group (GESEC), Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.

Journal of Advanced Nursing
|April 6, 2026
PubMed
Summary
This summary is machine-generated.

Nursing leadership is often narrowly defined by management skills. A new hybrid model redefines leadership as a multidimensional practice, integrating visible skills with deeper attributes for enhanced development.

Keywords:
job satisfactionleadershipnurse administratorsnurse's rolenursing workforceprofessional competence

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Area of Science:

  • Nursing
  • Healthcare Management
  • Leadership Studies

Background:

  • Nursing leadership definitions are fragmented, often conflating leadership with management.
  • Existing frameworks overlook crucial non-managerial attributes like ethics and relational skills.

Purpose of the Study:

  • To address conceptual ambiguity in nursing leadership.
  • To propose a multilevel competency framework for nursing leadership.
  • To introduce the hybrid Iceberg-Alles model integrating observable and underlying attributes.

Main Methods:

  • Integrative review methodology.
  • Two-stage evidence identification process.
  • Literature search across major databases (PubMed, Scopus, Web of Science, CINAHL) and grey literature.

Main Results:

  • Current nursing leadership concepts are fragmented and managerially focused.
  • The proposed hybrid Iceberg-Alles model reconceptualizes leadership as multidimensional.
  • This model balances visible competencies with intrinsic drivers like motivation and values.

Conclusions:

  • Nursing leadership is a relational, value-based process across all practice levels, not just formal roles.
  • The model enhances conceptual clarity and offers a transferable framework for diverse healthcare settings.
  • Broadening leadership scope reduces ambiguity, elevates nursing's contribution, and strengthens professional influence.