Managing the unmanageable? Nurse Executive Directors and new role developments in nursing

This paper offers a unique insight into the factors affecting the functioni ng of the Nurse Executive Director(s) and their views on the realities of n ursing management in the new National Health Service in England. It is base d on the findings of the Exploring New Roles in Practice (ENRiP) project wh ich was carried out for the Department of Health. As part of this project i nterviews were undertaken with Nurse Executive Directors from a 20% sample of acute hospital trusts in England. The interviews were designed to explor e the Nurse Executive's perceptions of the process of new role development. The findings highlight a tension between the drive for professional develo pment and the pragmatics of service delivery in a health care system which lacks dedicated funding for nursing development. It was evident that most N urse Executives vacillated between responding either in an ad hoc way to in ternal and external pressures or leading and supporting managed development .