Abstract
Over the past 2 decades, the size and complexity of organizations have tended to increase. 1 There has been consolidation of hospitals and associated services into larger entities. In some parts of the world, a continuum-of-care approach has been developed in which primary, secondary, and tertiary services work as an integrated system. 2 Alongside these structural changes, the extended hierarchy of positions with direct linear reporting relationships has been replaced by matrix structures and advisory roles. 1 These changes often require nurse leaders to be able to function in a more dynamic environment in which influence rather than direct managerial competencies is seen as an essential requirement of the nurse executive.
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