Understanding nursing 'nous' in the context of service improvements.

Nurse managers face the challenges of how best to improve healthcare services in ways that can be evaluated readily by patients and that engage nurses. They also need to demonstrate how staff resource has been successfully deployed. This article ventures that a better understanding of 'nous' - the organisational ability of nurses to combine skills to clear purpose and patient benefit - may assist nurse managers to achieve these aims. It explores what staff nous consists of and examines critically more traditional modes of thinking about staff as intellectual capital. The reader is shown how staff nous might feature in new patient evaluations of care, nursing staff appraisals and the design of care initiatives.