Preparing nurse leaders for the future: views from Canada.

Preparing nurse managers for the present and nurse leaders for the future in the Canadian health care system is discussed from the perspective of service and education. The Canadian health care system is undergoing change, as the need to reduce and control costs comes in conflict with strongly held principles of the Canada Health Act. Nurse leaders will require knowledge and skill in transformative leadership to enable nurses to focus on the core of professional practice as clinical settings shift to self-directed, transdisciplinary teams. Nurse leaders also will need skills in building alliances within an increasingly consumer-controlled health care system, and competencies in work redesign and system design and redesign to enable nursing to smooth the "seams" in a high-functioning, but not necessarily well-integrated health care system. Judgment and clarity of vision are needed to embrace conflict when necessary and to prevent the initiation of practices and structures that run counter to the values embedded in the Canada Health Act, and nursing itself.