Aim: This study determines whether the culture within an acute care hospital empowers 'all' nurses to be leaders by exploring intersectionality and nursing leadership in the context of the social environment.Background: Nurses practice leadership in their day-to-day activities as clinical leaders alongside traditional roles of management and leadership. However, some nurses do not acknowledge nursing work as leadership activity, nor is it seen so by others where hierarchical leadership approaches remain prevalent. Social constructs of gender and race are barriers to accessing formal leadership positions for some, while dominant power structures such as class diminish the value of bedside nursing work.Unexplored is the impact of the intersection of these and other social identities on nurses being leaders.Design: An embedded case study design.Methods: Thirty-one participants participated in semi-structured interviews. Four levels of analysis including inductive and deductive approaches were applied to the data. The research complied with COREQ guidelines for reporting qualitative research. Results:This study shows nurses do not identify themselves as leaders without an associated title and the pathway to leadership varies depending on intersecting social constructions. Conclusion:The impact of the organisational structures and the experience of navigating intersecting social constructions on nurses being leaders goes unseen, privileging some while disadvantaging others.

Aims and objectives: Identify the key concepts, principles and values embedded within Indigenous Māori models of health and wellbeing; and determine how these could inform the development of a Māori-centred relational model of care.Background: Improving health equity for Māori, similar to other colonised Indigenous peoples globally, requires urgent attention. Improving the quality of health practitioners' engagement with Indigenous Māori accessing health services is one area that could support improving Māori health equity. While the Fundamentals of Care framework offers a promising relational approach, it lacks consideration of culture, whānau or family, and spirituality, important for Indigenous health and wellbeing. Design and methods:A qualitative literature review on Māori models of health and wellbeing yielded nine models to inform a Māori-centred relational model of care. We followed the PRISMA guidelines for reporting literature reviews.Results: Four overarching themes were identified that included dimensions of health and wellbeing; whanaungatanga (connectedness); whakawhanaungatanga (building relationships); and socio-political health context (colonisation, urbanisation, racism, and marginalisation). Health and wellbeing for Māori is a holistic and relational concept. Building relationships that include whānau (extended family) is a cultural imperative. Conclusions:This study highlights the importance and relevance of relational approaches to engaging Māori and their whānau accessing health services. It signals the necessary foundations for health practitioners to build trust-based relationships with Māori. Key elements for a Māori-centred model of relational care include whakawhanaungatanga (the process of building relationships) using tikanga (cultural protocols and processes) informed by cultural values of aroha (compassion and empathy), manaakitanga (kindness and hospitality), mauri (binding energy), wairua (importance of spiritual wellbeing).

Aim and objective: This paper reports on the proceedings of the second AustralasianInternational Learning Collaborative conference and summit.Background: In December 2019, over a hundred people attended the second Australasian International Learning Collaborative Conference and Summit. This was the first to be held in Aotearoa New Zealand, the land where cultural safety was developed, its origins being in nursing education. Perhaps not surprisingly, culture, cultural safety and the context of care featured highly in the presentations and workshops.Design and methods: Discussion paper. Results:A key outcome of the conference proceedings and workshops was the call for nurses and the International Learning Collaborative to work in partnership with indigenous groups to iterate the importance of the Fundamentals of Care framework and evaluate the impact of that on health equity. Other essential messages were to value establishing relationships, to continue to talk about the fundamentals of care, to research and to own them. Nurses were reminded to use their humanity to create a climate and culture in which patients and staff feel valued, safe and trusted. Conclusions: Future iterations of the Fundamentals of Care framework must incorporate indigenous worldviews, which emphasise the importance of relationships, family and spirituality on wellbeing. Such additions will provide an opportunity for the International Learning Collaborative to optimally respond and direct nursing practice. Relevance to clinical practice: International Learning Collaborative members and conference attendees learned, listened and worked on meeting the challenges of consistently implementing and applying the fundamentals of care in practice and its importance to education, research and policy. The takeaway message is, when this does not happen, nurses must speak up. K E Y W O R D S cultural issues, fundamental care, holistic care, indigenous health, inequalities in health, models of care, nurse-patient relationship, spirituality

This article presents intersectionality theory with critical realism as a philosophical framework for studying nursing leadership. In response to gaps in the current leadership literature, the aim is to develop an approach that addresses how the multiple social positions nurses hold can create an intersecting matrix of oppression that impacts on their opportunities to develop as leaders. The result is a theoretical foundation, which can inform the methodological framework of future studies. Providing evidence by which a reader can judge the merits of a chosen methodology, it sets the case for integrating intersectionality with critical realism for studying nursing leadership.