The Process of Entrustment: A Grounded Theory of Leadership Development Among Emerging Nurse Leaders in Clinical...

This study sought to develop a grounded theory that explains how emerging nurse leaders (ENLs) are prepared for and supported in assuming leadership responsibilities in clinical settings.

A Classical Grounded Theory design was employed. Between December 2020 and November 2022, in-depth individual interviews were conducted with 18 ENLs and 18 senior nurse leaders (SNLs) in a tertiary hospital in Singapore. Data were collected through open-ended interview questions and analyzed using constant comparative methods to generate a theoretical model grounded in participants' experiences.

Entrustment emerged as the core category that characterizes how ENLs cultivate leadership capability through the interrelated processes of responsibility, reflection, and relational affirmation. This developmental trajectory unfolded across three cyclical phases: Being positioned, Being exposed, and Being reshaped, each marking a shift in how leadership identity and confidence were negotiated. A concurrent process, withdrawing under pressure, was defined as a temporary withdrawal in response to emotional or contextual strain. Leadership growth occurred through repeated entrusted responsibility, relational support, experiential learning, and reflective recognition.

Leadership development among emerging nurse leaders is a trust-mediated, iterative process of being positioned, supported, and transformed. Intentional mentorship structures, relational affirmation, and emotional scaffolding are pivotal for sustaining emerging leadership capacity within clinical organizations.