Nurse Managers' Strategies to Navigate Clinical Leadership and Managerial Responsibilities: A Scoping Review

To systematically map evidence on how nurse managers (NMs) balance clinical and managerial responsibilities of their role.

Complexity of the NM role arises from its dual focus on both clinical and managerial responsibilities. Clinically, NMs must maintain expertise to guide, support delivery of high-quality care and ensure care practices align with evidence-based guidelines and organisational standards. On the managerial side, NMs are responsible for administrative tasks such as budgeting, staffing, performance monitoring and strategic planning. Given their significant impact on healthcare delivery, patient safety and organisational effectiveness, understanding how NMs balance their roles is essential to improving the overall quality of care in healthcare settings.

Scoping review guided by the Joanna Briggs Institute (JBI) framework for evidence synthesis was conducted. Data were analysed using Braun and Clarke's (2022) approach.

Studies were identified through seven electronic databases without restrictions on publication dates: CINAHL, Medline, PubMed, Embase, ProQuest Central, Scopus and Web of Science and search engine Google Scholar.

This scoping review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) to ensure transparency and rigour.

Forty-nine studies were included, identifying three main themes: key challenges faced in fulfilling clinical and managerial responsibilities, strategies used to balance roles and factors influencing prioritisation.

Demands of dual roles often cause role ambiguity, conflict and overload, contributing to stress and job dissatisfaction amongst NMs. How they integrate clinical and managerial responsibilities remains underexplored, leaving a gap in understanding processes that guide their prioritisation and decision-making. Understanding their challenges will help better prepare nurses for their roles.

NMs are crucial links between clinical care and organisational management. Further research will inform advancements in nursing leadership, healthcare management and policy development.