ABSTRACT
Since the end of the 1990s the ‘modernization’ of health services and demands for ‘cost-effective care’ have emphasized the need for the effective management of nurses. This chapter discusses how, historically, nurses have worked within organizational cultures characterized by autocratic and hierarchical management. This bureaucratic approach is contrasted with leadership, which is underpinned by a more responsive, creative and trusting way of working with people. This leadership approach has been recognized as being a more productive form of organizing staff and developing clinical services, by organizational and nursing theorists alike.
