Experiences of Rebel Nurse Leadership in daily work: a qualitative study

Abstract

Background Life expectancy and the demand of healthcare is increasing, as well as the shortage of nurses which creates risks for the safety and quality of patient care. This can be reversed by increasing nurse leadership, which contributes to better nursing outcomes and patient outcomes such as improved safety outcomes and patient satisfaction. A leadership practice which is mostly practiced ‘under the radar’ is rebel nurse leadership. This is an intentional and honourable behaviour, with elements of creativity, adaptability and innovation, and has a positive impact on the continuous improvement on the quality of patientcare. However, literature about rebel nurse leadership in daily work is still scarce.

Aim To gain insight in experiences of nurses with rebel nurse leadership practices in their daily work.

Methods Four focus group interviews were held in two hospitals and a long-term care organisation. A thematic analysis according to Braun & Clarke was carried out.

Results For all the participants, rebel nurse leadership was a new concept and few examples were mentioned. A wide variation of leadership practices appeared in nurses daily work. Four themes emerged from the data: (1) On rebels, clinical leaders and wallflowers; (2) Improving quality of life; (3) Initiating continuous change; and (4) Influencing others. Rebel nurses improve the quality of life of patients and the quality of care by deviating from protocols, going against existing structures and taking risks.

Conclusion and implication of key findings Rebel leadership practices are still unknown and scarce in daily work, but have a positive impact on the quality of life of patients and the continuous improvement of care. Stimulating rebel nurse leadership practices could be one of the answers to meet the needs of patients in the increasing demand of healthcare.