Perceptions of policy and political leadership in nursing in New Zealand

Abstract
This qualitative study was focused on the landscape of nursing policy and political leadership in New Zealand. A volunteer sample (N=18) of nurse leaders (Fellows of the College of Nurses Aotearoa (NZ) Inc) drawn from across the country was interviewed with respect to issues that affect their interest in participating in political action and policy work. . The framework of stages of nursing’s political development published by Cohen and colleagues (1996) was used as an interview guide. Respondents were asked to describe their own stage of political development, their perception of the political development of New Zealand nurses and nursing organisations at large, and also their thoughts on what could be done to better position nursing in healthcare policy development. In general, respondents agreed that the major nursing organisations in New Zealand (the College of Nurses – Aotearoa and New Zealand Nurses Organisation [NZNO]) were moving toward increasing policy sophistication. Qualitative content analysis suggested five themes which, taken together, describe nursing’s policy/political development in New Zealand: languaging; succession /legacy planning; Tall Poppies and Queen Bees; “it’s a small country”; and speaking with one voice. Although limited by sample size, the information collected provides a beginning focus for discussion that can steer New Zealand nursing activities toward the wider involvement of nurse leaders in healthcare policy work on behalf of the discipline.  

Keywords
Nursing leadership; policy and politics; nursing organisations; qualitative study; New Zealand nursing 

Introduction
It is most common to think of leadership in nursing as positional leadership: individuals who take the helm of health sector institutions, professional organisations and nursing teams. There is, however, equally vital leadership required of those nurses who take the nursing disciplinary perspective into decision making fora within nursing itself and in the wider health policy environment. This paper considers “leadership” in the broadest sense. Nursing leadership may develop first in positions at the most local level, and then may evolve in sophistication, range and scope. In New Zealand, as in the US (Institute of Medicine, 2010) and the U.K (Front Line Care, 2010) there seems to bea gap in the discipline of nursing between emerging leadership by position and that which is required for the discipline to sit comfortably at policy tables. We use “discipline” rather than “profession” to connote “a branch of learning or scholarly instruction” rather than a vocation (as cited in Brown [Ed], 2002, p.693 [discipline], p. 2358 [profession]). For purposes of this study, politics is the art and acts of persuasion and policy is the set of values behind acts of government.