Transforming mediocrity to excellence: a challenge for nurse leaders.

A grounded theory study of nursing leadership in Western Australia was undertaken to shed light on complex contextual and individual variables associated with nursing leadership. By applying the constant comparative method of data analysis, the core problem facing nurse leaders was identified as overcoming and compensating for disadvantage related to a repressing context which impeded the movement of nursing from retardation and mediocrity, through turbulence and toward excellence. Following a long period of stagnation (reflecting mediocrity in the nursing system) and a shorter evolutionary phase, revolutionary changes were being implemented, creating an extremely turbulent environment. Findings revealed that nurse leaders used a core process labelled optimising to deal with the core problem and to achieve influence and advancement. This process had progressive phases identified as surviving, investing, and transforming. Failure to optimise led to floundering. Transforming reflected exceptional performance or excellence and involved using the optimising strategies of reversing negative situations and creating additional resources to achieve influence and significant advancement or change in the nursing system. This study has implications for leadership practice, for the development of future leaders and for future research and theory development.