“…Existing hospital and regulation guidance on nursing leadership within a doctor-directed culture restricts the positive effects of shared experiences (Francis, 2013;Lovegrove & Davis, 2013). Further, senior nurses' inability to administer opioids (Elcigil, Maltepe, Esrefgil, & Mutafoglu, 2011) and execute emergency job requirements without supervision reduces job scope (Edmonson, Sumagaysay, Cueman, & Chappell, 2016), impacts on job satisfaction (Casida & Pinto-Zipp, 2008), affects professional relationships (Bianco, Dudkiewicz & Linette, 2014) and hinders productive team communications (Chadwick, 2010). One measure may be to move the EMC towards an innovation culture (Omachonu & Einspruch, 2010), thus reducing vertical barriers and introducing leadership based on knowledge, capability, efficiency and motivation, rather than be positioned by stagnated mechanistic measures aligned to doctor requirements associated with top-down management (James, 2005), rather than horizontal leadership patterns.…”