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Exploring senior nurses’ experiences of leading organizational change

Amunpreet Boyal (University Department of Anaesthesia & Critical Care Queen Elizabeth Hospital, Birmingham, UK)
Alistair Hewison (School of Health and Population Sciences, University of Birmingham, Birmingham, UK)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 1 February 2016




The aim of this paper is to explore Senior nurses’ experiences of leading organizational change. There is a substantial literature reporting middle-level nurse managers’ experiences of change; however, there is less evidence concerning senior nurses’ perspectives. In view of this, interview data collected from senior nurses, as part of a study of major organizational change, were analysed to redress this imbalance.


In-depth semi-structured interviews (n = 14) were conducted with senior nurses (between 2009 and 2012).


Senior nurses’ activity centred on leadership and workforce issues, internal influences and external pressures. In periods of change, appropriate leadership was vital, and “weak” leaders were considered to have an adverse effect on teams. Concerns were expressed about financial strictures and their impact on patient care and service provision. The senior nurses were striving to provide the best quality of service delivery with the limited resources available. Concentration on operational matters was necessary to maintain stability in periods of change. However, this prevented senior nurses from influencing strategic decision-making in their organizations.

Practical implications

If senior nurses are to realise their potential to operate at a strategic level, they need to be given time and support to lead, rather than just react to change. This research emphasises the importance of a “nursing voice” to inform board-level decisions and maintain a focus on patient care.


This research sheds light on the work of a key group of staff in health-care organizations. Understanding senior nurses’ experience of and contribution to change is a useful contribution to health services research.



The authors would like to thank everyone who participated in the study and the Theme 1 project team for their support. The views expressed in this publication are those of the authors and not necessarily of the NHS, the NIHR or the Department of Health. Author Contribution: AB was involved in the data analysis. AH was involved in the design of the study and the analysis. AB and AH drafted the paper and were involved at all stages of its production.

Source of Funding: This research was funded by the National Institute for Health Research (NIHR) Birmingham and Black Country Collaborations for Leadership in Applied Health Research and Care (CLAHRC-BBC) Programme.


Boyal, A. and Hewison, A. (2016), "Exploring senior nurses’ experiences of leading organizational change", Leadership in Health Services, Vol. 29 No. 1, pp. 37-51.



Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited

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