A study to investigate the challenges for Band 5 and 6 nurses when enacting leadership at the point of care

Student thesis: Doctoral ThesisDoctorate in Education


This thesis will investigate the potential challenges for Band 5 and 6 nurses when enacting leadership at the point of care, within the English NHS healthcare system. In the last twenty years leadership has come to be seen as an essential part of a nurse’s role which all qualified nurses are expected to fulfil regardless of their position or experience. However, the strategy of embedding leadership activity into all nursing roles seems to overlook a number of potential unacknowledged challenges. This work seeks to explore firstly, how band 5 and 6 nurses perceive leadership and whether they understand the relevance of leadership to their role. Second, whether they have been prepared appropriately to undertake leadership. Third, if the clinical context within which they work influences their adoption of leadership behaviours. Applying aspects of focused ethnography and Habermas’ critical social theory, this study focuses on Band 5 and 6 nurses not employed in formal senior leadership positions. Three stages of qualitative data collection were undertaken utilising three focus groups, eight interviews, and four critical incidents.
The study reveals how Band 5 and 6 nurses visualise their role as a leader and, how their seeming socialisation into the acceptance of hierarchy and current norms of practice, create tensions which stand in the way of their ability to be leaders at the point of care. It was also found that nurses working in specialist areas of care appear to undergo a degree of divergent socialisation, in which their identity and expression of self are altered and developed to have a more positive view of leadership and their ability to enact it. Utilising a new model of leadership, this study proposes four elements - Resilience; Relevance; Education and Empowerment – that might be addressed in order to lessen the challenges of adopting leadership for Band 5 and 6 nurses.
Date of Award1 Oct 2020
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorGerard Lum (Supervisor) & Alan Cribb (Supervisor)

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