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Universities are in a highly competitive environment, needing strong academic leadership. Some heads of departments have been appointed into leadership positions in a healthcare faculty after having been mere academics for a few years. They are more likely to experience challenges. This study aimed to explore the views and understanding of heads of departments in a healthcare faculty on being appointed as academic leaders in a higher education context in South Africa. A qualitative design using 12 individual unstructured interviews was conducted with all the heads of departments in a health sciences faculty. Open coding was conducted and two themes emerged, focusing on the varied skills needed for academic leadership positions and developing leadership skills amongst senior academics. The findings indicated that development of senior academics in leadership should be undertaken by a knowledgeable professional in formal or informal settings, to encourage mentorship and more regular group meetings, while addressing the core role of a leader. Implications of these findings for a faculty of health sciences and suggestions for leadership succession in future are discussed.

Background: Passing of a close family member is one of the foremost traumatic occasions in a person's life. The way in which this misfortune unfolds, shifts from individual to individual, and depend on how close you were with the deceased. It was unclear on what were the support measures provided to youth after the loss a family member to HIV/AIDS. Aim: The aim of this article is to understand the support measures for the youth following the unexpected loss of a family member to HIV/AIDS. Setting: Khayelitsha, Western Cape province, South Africa. Method: A descriptive phenomenological design was followed, with an accessible population of youth who lost a family member to HIV/AIDS. Individual semi-structured interviews were conducted with 11 purposively selected participants after obtaining written informed consent. The sessions held with an interview schedule, did not take longer than 45 minutes to conduct until data saturation was reached. A digital recorder was used and field notes held. Open coding followed after transcribing interviews. Results: Youths did not know how to manage themselves as a result of a lack of therapeutic sessions, which could provide emotional support and help them with their healing process. Conclusion: Support measures for the next of kin were needed. Grieving influenced the emotions of an individual who experienced the burden of not having someone to speak to about their feelings. Contribution: The context-based information in this study addresses the important of support measures to be provided or implemented for the next of kin after they had lost a family member. [ABSTRACT FROM AUTHOR]

Background: Globally, critical care outreach services (CCOS) were implemented in health care facilities; however, compliance with guidelines is poor. The authors have noticed that a gap exists in the literature on how self-leadership might influence nurses' implementation of CCOS. Self-leadership is about leadership applied to oneself. Critical care outreach services assist nurses with the nursing care of a patient whose health is declining. Leadership is needed for the successful implementation of CCOS. Aim: This article aims to outline the method the authors followed for developing the conceptual framework for how self-leadership amongst nurses influenced the functioning of CCOS. Setting: The research was conducted at a private hospital in Pretoria. Methods: A qualitative approach was followed to provide an accurate description of nurses' experiences on their self-leadership in a CCOS. The practice-oriented theory of Dickoff (1968) was the reasoning map for developing and constructing the conceptual framework. Results: Bedside nurses experienced the following self-leadership strategies: constructive thought patterns, natural rewards and behaviours focused on their implementation of CCOS. Conclusion: The conceptual framework was part of another study and provided the authors with a rationale that guided the authors with the development of self-leadership strategies in a CCOS. Contribution: The conceptual framework provided the authors with an understanding of how nurses' self-leadership influenced the implementation of CCOS. The conceptual framework can also assist in developing training programmes for nurses to improve their self-leadership and ultimately improve nurses' competence in providing quality nursing care to patients. [ABSTRACT FROM AUTHOR]

Background: Death of a close family member is one of the most traumatic events in a person's life. The way, in which this loss unfolds, varies from person to person and depends on how close you were with the deceased. It was unclear how youths experienced it to manage themselves during different stages of the bereavement process, after losing a near-family member to human immunodeficiency virus (HIV). Aim: The aim of this study was to understand the self-management of youth following the unexpected loss of a family member to HIV. Setting: Khayelitsha, Western Cape province, South Africa. Methods: A descriptive phenomenological design was followed, with an accessible population of youth who lost a family member to HIV. Individual semi-structured interviews were conducted with 11 purposively selected participants after obtaining written informed consent. The sessions, held with an interview schedule, did not take longer than 45 min to conduct until data saturation was reached. A digital recorder was used and field notes held. Open coding was followed after transcribing interviews. Results: Individuals had different experiences during different stages of the bereavement process, not necessarily similar or following the same sequence. Individuals had to manage their guilt of being unable to do more before the family member passed away, struggling to realise that they have a future purpose, and hardship having fond memories. Conclusion: Youth find it difficult to view death as a natural loss of life and to manage themselves after the loss of their loved one to HIV. Contribution: The context-based information in this study confirms the importance of youth and self-coping and self-continuation to plan, organise and direct their future after the loss of a family member. [ABSTRACT FROM AUTHOR]

Background: Youth can be a positive force for development when provided with the knowledge and opportunities they need to thrive, yet they continue to experience insurmountable challenges, such as poverty and absentee fathers, that prompt them to resort to risk behaviours such as substance use. In rural South Africa, women tend to be the breadwinners and more involved with parenting than men. Objective: The primary objective of the study was to explore perspectives of rural youth on factors influencing youth participation in substance use. The secondary objective was to obtain the perspectives of adult women on factors influencing substance use among young people. Methods: The qualitative study, informed by a social‐ecological framework, utilised a semi‐structured interview protocol in focus group discussions in rural South Africa. Seven focus group discussions, each with between 8 and 15 individuals were conducted with 79 youth. The eighth discussion was with nine adult women. Data were audio recorded and transcribed verbatim, manually coded and further analysed into themes using NVivo 12. Findings: Four themes emerged: hopelessness and lack of motivation, lack of adult role models such as father, lack of built environment for recreational activities and lack of educational opportunities. The social‐ecological model provided a useful framework to understand the findings. In line with this model, rural youth in South Africa described a variety of factors that influenced youth substance use and other risk behaviours. These related to the individual, relationships with others, community and societal norms and values factors of the social‐ecological model. Conclusions: The broadening spectrum of substances available to an increasing youth population bulge in Africa suggests a strong threat of social and disease burden due to substance use disorders. Given this threat, this study provides awareness to a multi‐systems approach needed to support the rural South African youth. [ABSTRACT FROM AUTHOR]

Midwives are expected to meet the demands of their ever-expanding roles without having a voice to contribute to the decision-making process in developing the protocols to be followed in implementing HIV/AIDS testing and counselling. The aim of the current study was to describe nurse managers' support to midwives in implementing HIV/AIDS testing and counselling within protocol at an antenatal clinic located in the Central Region of Cape Town, Western Cape, South Africa. The study followed a qualitative design to gain insight into midwives' experiences in implementing HIV/AIDS testing and counselling at an antenatal clinic and how nurse managers support midwives in this regard. In-depth individual interviews were conducted with eight (n = 8) purposively sampled professional midwives to understand the implementation of HIV/AIDS testing and counselling within protocol from the midwives' perspectives and field notes were taken. All the interviews were digitally recorded, transcribed verbatim and coded using the thematic approach. The study findings indicated that ongoing education, coaching and mentoring, and constructive feedback are all necessary support mechanisms for midwives to implement HIV/AIDS counselling for better client care outcomes. It was recommended that nurse managers should intensify their efforts in an antenatal clinic, supporting midwives with practice relevant information on HIV, to address the needs of pregnant women and the larger community. Well-informed competent midwives are needed to apply the latest protocols and trends in midwifery practices that will uplift the health status of pregnant women in the community. [ABSTRACT FROM AUTHOR]

Background: Diabetes is considered one of the largest global health challenges of this century and one of the top 10 causes of death across the world. Studies indicate an increased economic burden in relation to diabetes, not only on government revenue but also within private industries. Exploring the perceptions of employees with diabetes mellitus as related to their self-management practices could assist in encouraging behaviours that are associated with positive management outcomes. Aim: The purpose of this study was to explore and describe the perceptions of employees with diabetes mellitus, seen by professional nurses in selected occupational health clinics, about the self-management of their disease. Methods: A qualitative, exploratory, descriptive contextual design was followed through 17 individual interviews with 17 employees working in various industries in Cape Town, using a semi-structured interview schedule. Open coding of the data followed, and four themes emerged. Measures to ensure trustworthiness were also adhered to in the study, and approval for the study was granted. Results: The study findings gave insight into the manner in which employees perceived their behaviour changes in terms of their self-management practices. Various emotions were expressed by employees relating to the disease as well as the lifestyle adaptations required for self-management thereof. Employees noted that knowledge acquisition and greater understanding of the motivators for lifestyle changes could improve aspects of their day-today living as well as the disease outcomes. Conclusion: Employees expressed an awareness of the changes and lifestyle adaptations needed but found aspects thereof to be an ongoing challenge. The areas of challenge varied amongst employees. A consciousness of the possible consequences of poor self-management practices and self-modification behavior to address these was observed. [ABSTRACT FROM AUTHOR]

Aims This paper describes the perceptions of nurse managers about their dual role in nursing units as cost centres. Background The tertiary hospital in the Limpopo province is the first institution to appoint nurse managers with a dual role in cost centres. The development of a conceptual framework for a context-specific programme for Cost Centre Managers is the first of its nature in South Africa. Method A qualitative, exploratory, descriptive design was followed. The target population included nurse managers ( n = 35) formally appointed as cost centre managers with a dual role of delivering quality care and cost management. A focus group and individual interviews were conducted until data saturation occurred. Results Personal and professional distress, an empowering potential of being a cost centre manager, and the need for decentralized cost centre management were indicated as barriers for nurse managers that led to a framework for a context-specific training programme. Conclusion There is a need for a context-specific training programme for cost centre managers in a hospital with cost centres. Implications for nursing management The training of cost centre managers for their dual role in cost centres could enhance cost effectiveness, quality care and staff satisfaction. [ABSTRACT FROM AUTHOR]

In a country such as South Africa with its widely diverse values and belief systems, it could be a challenge to bring about a common understanding of professionalism amongst nurses in a multicultural society. When novice nurses enter the profession, they are confronted by the core values in nursing professionalism in an environment that sometimes lacks leadership by senior nurse practitioners. It was thus decided to explore the resemblance in the concept of selfleadership and the professional values of nursing. Values influence professional practice and commitment and, therefore, principal leadership qualities and functions are to influence oneself to develop a shared service commitment, to nurture and foster the confidence in one's own capacity, and the ability to make a valuable contribution to nursing practice. The purpose of this study was to explore and describe a conceptual framework on self-leadership and the resemblance with inherent core professional values in nursing. Literature about self-leadership, professionalism, and professional values, in a global context, was explored. A conceptual framework emerged, since the researchers discovered that self-leadership qualities corresponded with professional core values required by novice nurses to be able to deliver quality nursing care. For the young nurse entering the nursing profession, the professional values are often tacit which prevent nurses from recognising their self-leadership qualities in order to act and behave accordingly. This review article could contribute to a common understanding, not previously explored, amongst nurse educators and nurse practitioners of the resemblance between selfleadership and core professional values to prepare novice nurses for professional nursing practice in a multicultural society. [ABSTRACT FROM AUTHOR]

Aims This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. Background The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. Method A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. Results The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Conclusion Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Implications for nurse managers Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. [ABSTRACT FROM AUTHOR]

jooste k. & jasper m. (2012) Journal of Nursing Management 20, 56-64 A South African perspective: current position and challenges in health care service management and education in nursing Aim The present study discusses the current context of South African nurse managers' working environment, exploring the challenges of disease demographics, service change and development, and educating a nursing workforce to meet healthcare delivery demands. Background Post-apartheid South Africa has a legacy of inequalities in access to healthcare; increasingly poor morbidity and mortality demographics; and inadequate numbers of qualified nurses to provide a service to meet the Millennium Development Goals outlined by the Government in 2010. Evaluation The present study discusses the current position and developments pertaining to nursing management relating to both healthcare challenges and educating a nursing workforce. Key issues Collaborative action by various stakeholders in the development of nursing management will ensure a nursing workforce and service environment fit-for-purpose in delivering the healthcare outcomes envisaged in the transformed South Africa in the future. Conclusion Different role players are involved in critical issues regarding the management and education of nursing in South Africa. Nurse managers are central to the success of service redesign, delivery and education. Implications for nursing management Nurse managers need to influence policy decisions regarding nursing service design and delivery, and the education required to prepare the next generation of practitioners for these new services. [ABSTRACT FROM AUTHOR]

tebid r., du plessis d., beukes s., van niekerk v. & jooste k. (2011) Journal of Nursing Management 19, 967-975 Implications for nurse managers arising from immigrant women's experience of midwifery care in a hospital Aim This paper focuses on implications for nurse managers to support midwives in delivering nursing care to immigrant mothers in some government hospitals in Gauteng, South Africa. Background Immigration and poverty in Africa has led to midwives providing nursing care to immigrant mothers in a culturally sensitive environment. This necessitates an environment in which nurse managers should support midwives in caring for these mothers as unique individuals. Method An exploratory, descriptive phenomenological design was followed. The target population included nine immigrant mothers living in the inner centre of Johannesburg who, for the first time, attended, had antenatal clinics, laboured and gave birth at a Government Hospital in the Gauteng province of South Africa. After purposive sampling, phenomenological interviews were conducted until data saturation occurred. Results The findings indicate that nurse managers should ensure that midwifery care of immigrant mothers comply with the ethical-legal context of the South African constitution. Actions should be taken in combating issues related to impaired maternal-midwife relationship, lack of cultural sensitivity and psychological distress. Conclusion The delivery of maternity care to immigrant mothers is below the standard expected in the South African context. Implications for nursing management The nurse manager should support midwives to ensure an environment to care for immigrant mothers in maternity wards. [ABSTRACT FROM AUTHOR]

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jooste k. & jasper m. (2010) Journal of Nursing Management  18, 704-714 A framework for recognition of prior learning within a Postgraduate Diploma of Nursing Management in South Africa Aims The present study focuses on the development of an initial framework to guide educators in nursing management in designing a portfolio for the recognition of prior learning for accreditation of competencies within a postgraduate diploma in South Africa. Background In South Africa, there is a unique educational need, arising from the legacy of apartheid and previous political regimes, to facilitate educational development in groups previously unable to access higher education. Awareness of the need for continuous professional development in nursing management practice and recognition of prior learning in the educational environment has presented the possibility of using one means to accomplish both aims. Evaluation Although the content of the present study is pertinent to staff development of nurse managers, it is primarily written for nurse educators in the field of nursing management. Key issues The findings identify focus areas to be addressed in a recognition of prior learning portfolio to comply with the programme specific outcomes of Nursing Service Management. Further work to refine these focus areas to criteria that specify the level of performance required to demonstrate achievement is needed. Conclusion and implications for nurse managers Managers need to facilitate continuous professional development through portfolio compilation which acknowledges the learning opportunities within the workplace and can be used as recognition of prior learning. [ABSTRACT FROM AUTHOR]

Background:  The increased complexity of the nursing care needs of patients and acuity in general wards present nursing care challenges for nurses. Self-led nurses are attentive, taking responsibility for activating the rapid response service when a patient is starting to deteriorate., Objectives:  The purpose of this article is to describe nurses' experiences practising mindfulness during self-leadership in delivering a rapid response system (RRS) in a private hospital in Gauteng., Method:  A qualitative, exploratory, descriptive and contextual design was followed. Homogenous purposive sampling was used and a total of eight focus groups were conducted. Focus groups durations were between 45 min and 60 min. The data analysis was carried out through open coding on Atlas.ti using the noticing things, collecting things and thinking about things (NCT) approach. An independent coder met with the researcher during a consensus meeting and finalised the analysis., Results:  The findings indicated an underlying theme of nurses being mindful in their self-leadership through the development of self-motivation and self-direction in the RRS. Three categories with six subcategories emerged from the data analysis, namely self-motivation in an RRS by the team, self-direction through role-modelling to peers and training., Conclusion:  Nurses practised mindfulness during self-leadership, utilising behavioural and natural reward approaches and constructive thought patterns. These findings could assist management with developing training programmes for nurses.

Background: Community service nurses placed in the Western Cape Government public health facilities render essential healthcare to underserved populations. Anecdotal evidence from operational nurse managers indicated concerns that community service nurses may lack competence in basic required nursing competencies., Objectives: To investigate operational nurse managers' perceptions of the competence of community service nurses in public health facilities in the Western Cape., Method: A quantitative survey was conducted with an all-inclusive sample of 297 operational nurse managers in the Western Cape. A self-administered questionnaire with 65 questions with a 4-point rating scale was used to rate perceived competence of community service nurses across the South African Nursing Council (SANC) competencies. Descriptive and inferential statistics were calculated per competency domain., Results: The survey (response rate: 59%) showed that the operational nurse managers perceived the community service nurses to be competent in the clinical patient care domain and mostly either developing proficiency or proficient in the SANC competencies of legal framework and ethical practice, interprofessional relationships, leadership, quality management and management competency domains., Conclusion: Community service nurses were found to be competent in the clinical patient care, possibly because of the integration of theory and practice focus of work-integrated learning in the programme. Education and practice supportive strategies for community service nurses should be developed to support the successful transition from students to community service nurses, especially around the development of research and critical thinking skills.

Background: Structural empowerment is an ever-evolving concept interpreted and applied in many different ways as it focuses on the structures in a healthcare organisation to allow competent nurses to manage empowering opportunities in a professional manner. At a public hospital in the Western Cape, nurses complained about a lack of access to structural empowerment in a hospital, including structures of power, such as clear information, to partake in important decisions., Objectives: The purpose of this study was to describe how nurse managers could support nurses in accessing structural empowerment through power resources., Method: A quantitative design was followed with a survey. The accessible population in this study was different categories of nurses of professional, enrolled and assistant nurses (N = 200), which were on duty at the time of data gathering. The sample was selected by means of probability sampling (n = 110). An existing instrument based on a five-point Likert scale was distributed that took 45 minutes to complete. Descriptive and inferential statistics were calculated, and the chi-square was used to indicate statistical significance differences among the nursing categories on the items (p 0.05)., Results: The general results indicated that the majority of nurses had challenges to access structural empowerment through power sources (information, support and resources). Significant differences were found between nurse categories for having the necessary supplies for the job (p = 0.043) and rewards for unusual job performance (p = 0.023). Those aspects on which no significant differences were found are of utmost importance, as they indicate the urgency of addressing limitations in power sources for all categories of nurses., Conclusion: Empowerment can be achieved by enabling access to structural empowerment through power sources (i.e. opportunities, information, resources and support) at different levels for all categories of nurses.

Background: Professional socialisation of student nurses needs to be integrated into the formal teaching and learning during the nursing programme. Embedded in the training programme are professional values that are used synonymously with nursing professionalism. Professionalism is the conduct, qualities, values, vision, mission and/or goals that characterise a profession, and describes behaviours that are expected within the profession's members. However, one's values are shaped by one's experiences, influence one's behaviour and interactions with others, and are manifested in many aspects of professional behaviour. New nurses to the profession are expected to display behaviours of professionalism, thus requiring nurse training schools to help students internalise these behaviours. Nurse educators therefore carry a responsibility to shape future nurses' growth towards professionalism., Objectives: This article reports on the experiences of undergraduate student nurses regarding nursing professionalism during their 4-year training programme at a Higher Education Institution in the Western Cape, South Africa., Method: A qualitative, exploratory and descriptive design was applied. Eight focus group discussions were conducted with first- to fourth-year student nurses registered for the undergraduate nursing programme. Data were transcribed verbatim and analysed using open coding. Ethical principles and trustworthiness were maintained throughout the study., Results: Six main themes indicated that undergraduate student nurses experienced issues with role modelling, language barriers, their own understanding of professional behaviour, reasons for students and practitioners' unprofessional behaviour, prejudice towards degree students and students' professional or unprofessional behaviour experienced as contributing to the image of the profession., Conclusion: Student nurses received mixed messages leading to emotional turbulence. They needed clear guidance from role models to demonstrate how to behave professionally.

Given the emerging global youth disengagement epidemic, anticipated population growth, and the threat of continued rural-urban migration among young adults, recent research has focused on community leadership practice and the factors that influence youth engagement at the local level. Studying these practices and factors can elicit interventions that can improve youth engagement and youth health. This study engaged South African rural community leaders in interviews to collect perceptions and experiences on community leadership and factors that influence youth engagement and their health behaviors. Content analysis was used to analyze the data. Emergent themes are categorized into four domains: conceptualizations of leadership, current youth behaviors, barriers to youth engagement, and youth leadership opportunities and potential solutions. Findings demonstrate a clear grasp of the concept of community leadership among community leaders, and an awareness of the complex interplay of social, economic and environmental factors on youth disengagement and the potential interventions to promote more youth participation.

Background: Mobile technology has infiltrated our day to day existence through provision of inexhaustible access to communication and information. In education, mobile devices are not only used as tools to reinforce information, motivate and accentuate engagement, but it additionally enables the delivery of course content. The adoption of authentic technological innovations using the variety of distinguishing attributes available on mobile devices could potentially promote a mobile learning enactment., Objective: The purpose of the study was to explore the experiences of undergraduate nursing students who participated in an authentic mobile learning enactment aimed at enhancing their learning experiences., Design: This study used a qualitative contextual design., Setting and Participants: Undergraduate nursing students, of a School of Nursing in a Faculty of Community and Health Sciences at a university in South Africa, were the study participants. All students (n = 101) registered for the primary care and clinical skills module were invited to submit reflections based on their experiences on an authentic mobile learning enactment using WhatsApp Messenger., Method: Students submitted electronic reflections after every two-week cycle of the enactment. The data collected was categorised into emerging themes as analysed by the researcher guided by Tesch's (1990) systematic process. An independent coder reviewed the data and, through consensus, themes identified were confirmed., Results: One hundred and one participants (n = 101; 100%) submitted online reflections on their experiences during the authentic mobile learning enactment. Seven themes were identified which included: mobile devices afforded a learning platform; mobile learning enactment enhanced engagement; learning within a group made learning easier; flexibility in time allocated to complete tasks; challenges experienced with data/airtime/Wi-Fi; impaired communication due to poor network access and use of mobile devices in practice perceived as unprofessional., Conclusion: The study provided valuable insights into students' experiences of the authentic mobile learning enactment, as well as suggesting ways to enhance the effectiveness of such an enactment., (Copyright © 2018. Published by Elsevier Ltd.)

Background:  Owing to the inadequate schooling system and the under-preparedness of students in South African high schools, Higher Education Institutions are faced with students who do not meet the minimum criteria for acceptance into a mainstream programme and need support from an extended foundation programme., Objectives:  The study described the support of students by lecturers in an extended 5-year nursing foundation programme., Method:  A qualitative, exploratory and descriptive design was applied. Purposive sampling was conducted, and eight nursing students who completed the foundation year took part in semi-structured individual interviews. Each interview took around 30 min and was digitally recorded. Data were transcribed verbatim and analysed using open coding. Ethical principles and trustworthiness were maintained throughout the study., Results:  The findings of this study indicated that experiences varied on a foundation programme. Participants expressed support in a nurturing environment in which the lecturers were open and approachable with a positive attitude. Lecturers could support students by being caring and advising in learning methods around the programme. Lecturers could focus on the method of peer support which should be encouraged beyond the programme so as to provide a sense of camaraderie amongst students., Conclusion:  Data revealed that support of lecturers in a foundation programme needs creative methods to make the learning environment nurturing for students. This provides for students from diverse backgrounds the opportunity to prepare for their studies at a university level. Insights gained from this study, which highlight the importance of supporting foundation students, could benefit all nurse educators offering foundation programmes.

Aim: This overview article aimed at outlining the image of an effective future-orientated nurse leader in the health care context through a pragmatic approach. The future nurse leaders on different levels in health care institutions is challenged in the current health care environment of culturally diverse countries, such as South Africa. This article should make all nursing leaders more aware of their important role in taking the lead in challenges faced in the current health service environment., Background: Leaders have the essentials of authority, power and influence to lead followers to their goals. The use of these essentials has changes from the past, to the present and into the future health care environment. Different changes and challenges are facing nurse leaders and they need to implement an effective leadership style in a complex health care environment., Evaluation: This overview article focuses on key elements of an effective future leader using a conceptual framework as departure, incorporating relevant literature. It analyses and evaluates the efficiency of past and present roles of authority, power and influence in leadership and summarizes a new perspective of a future nurse leader. Solutions and future actions are indicated for the future role of the nurse leader., Key Issues: The past, present and future leadership setting, role of authority, power and influence in leadership, components of the arch of leadership and solutions to effective leadership in a future dimension is all domains that is presented with the intention of motivating future nurse leaders., Conclusion: It was identified that a different kind of leader should emerge to lead in a new way, different from those leadership styles that we have known in the past. The 21st century is a new timeframe and different timeframes demand different leadership approaches.