The Practice of Leadership in Healthcare Organisations: Interpretation, Authority, and Organisational Authorship

This chapter explores the emergent unfolding of practical leading—always located in places, histories, and experiences—as exercised by clinical professionals who occupy leading roles in healthcare contexts. We offer a view of leadership as a continuous interaction incorporating subjectivity, intersubjectivity, interpretation, and meaning-making based on three intertwined perspectives: 1. The interpretation of one’s organisational role 2. The exercise of authority and power 3. The development of organisational authorship, defined as a relational, embedded, and contextual activity leaving a mark on working activities and organisational roles. We draw our analysis from an ethnographic study on how head nurses act upon daily challenges and situations related to their leadership. Based on the data, we propose an overview of how role interpretation, authority, and authorship unfold. The chapter aims to highlight the value of a practice-based approach to leadership and to contribute to the understanding of its intersubjective and relational aspects. These insights could be helpful for healthcare leaders who seek to reflect on how they can actively play a leading role (and promote the leadership of others) in their organisations.