[How staff perceives head nurses' leadership: a qualitative study].

BACKGROUND: The leadership style of the head nurses plays a crucial role in ensuring a work environment that fosters high quality nursing care. Their role involves a range of activities that constantly change, and is therefore difficult to describe. In fact, we do not have a fixed set of characteristics to define the 'ideal candidate'.

AIM: To understand how staff defines the key leadership characteristics of the ideal head nurse in charge of a hospital ward.

METHOD: Between April-July 2015, 27 nurses were selected from the departments of general medicine in five hospitals. Three focus groups were conducted to identify the key leadership characteristics of an ideal head nurse.

RESULTS: The ideal leadership characteristics are expressed through actions of staff empowerment, management skills, and use of coping strategies. All these categories require that a leader should be strongly determined, resourceful, enthusiastic, and willing to be a leader. When balancing 'what you give and receive', the main difficulty of being a leader is to be sufficiently determined to avoid exhaustion, which leads to emotional disengagement and consequently the loss of the leadership role.

CONCLUSIONS: The level of determination of a head nurse, just like any source of energy, may sway. Therefore, it is important to recognize the signs of exhaustion and identify the strategy to rekindle determination. Sharing one's vision with others and job rotation could be used as strategies to recharge a leader's levels of energy, and meet the expectations linked to the leader's role. KEY WORDS: nurse manager, leadership style, determination, job rotation, vision.