Abstract
This article outlines the process and status of implementing self-directed nursing leadership teams at the San Diego Veterans Affairs Medical Center. Perspectives from a staff nurse and nurse practitioner, clinical specialists, nurse managers, and the director of the nursing service contribute to an overview of this endeavor. Difficulties of decentralizing management functions within a centralized system are discussed, as well as considerations and strategies prior to initiating change. Integration of self-directed leadership and total quality management principles are explored.
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