Nurse Leaders' Perceptions of Existing Leadership Practices and Development Needs: A Descriptive Qualitative Study

To explore nurse leaders' perceptions of leadership practices and development needs.

Nursing leadership has gained increasing attention due to the growing complexity of healthcare systems and the need to ensure high-quality patient care, staff retention and job satisfaction. However, recently many nurses assume leadership roles with limited preparation, highlighting the need to strengthen leadership development, education and training. Despite growing interest in nursing leadership, limited research has explored how nurse leaders perceive their roles, competencies and educational needs across different organisational contexts.

An explorative, descriptive, qualitative design was adopted. Data were collected through face-to-face interviews from 28 nurse leaders working in hospital and primary care settings and analysed using reflexive thematic analysis following Braun and Clarke's approach.

Four themes emerged: perceptions and meaning of the nurse leader role; leadership and management practices and competencies; leadership development pathways; and the role of leadership in care delivery and organisational processes. Across these themes, participants highlighted significant gaps in preparation for managerial and leadership responsibilities, particularly in areas such as communication, team motivation and staff development. These gaps were perceived as affecting job satisfaction, staff retention and the delivery of high-quality patient-centred care.

The findings suggest that nurse leaders perceive leadership as a complex relational and organisational practice that extends beyond operational management. However, the predominance of experiential learning and perceived gaps in formal education indicate that current educational and organisational structures may not adequately prepare nurses for leadership responsibilities.

Nursing organisations and educational institutions should implement structured leadership development programmes, mentoring initiatives and competency-based leadership training within undergraduate and continuing professional education to better prepare nurses for leadership responsibilities.