Dear Dr Gould,

Thank you for your interesting comments on leadership in nursing in the latest issue of DCCN. I agree with you that so many nurses are leaders without realizing this and with no idea about leadership theory. However, I believe leadership is essential in nursing and that we as researchers and educators in nursing should do more to describe and appreciate nurses' professional leadership. Some years ago, we studied intensive care unit nurses' role managing open visitation, and here the leadership role was evident and fundamental in intensive care unit nurses' interactions with the patients' relatives. Please find our paper attached.

Thank you for sharing your thoughts and promoting the concept of leadership in nursing.

Kind regards,

Anne Sophie Agard, PhD

Clinical Nurse Specialist

Department of Anaesthesiology and Intensive Care Head and Heart Centre, Aarhus University Hospital Aarhus, Denmark

RESPONSE

Dear Dr Agard,

Thank you for your kind thoughts. I agree, nurses exhibit leadership in every aspect of their work. We need to do more work to describe and celebrate nursing leadership in clinical practice. Your letter has stimulated many ideas and thoughts about this subject. I hope we can continue this discussion and invite others to join us!

Your work in this area is impressive. Your recent study and article entitled, "Flexible Family Visitation in the ICU: Nurses' Decision Making," highlights how nurses must think like leaders in every encounter with friends and families. Your attention to understanding the values embedded in decision making and comments about clinical leadership speak to many of the strengths of our intensive care unit staff. I hope that many nurses have the opportunity to read this work and to continue this discussion. I am pleased to recommend this article to our readers!

Agard AS, Lomborg. Flexible family visitation in the Intensive care unit: nurses' decision making. J Clin Nurs 2011;20(7-8):1106-1114.

Kathleen Ahern Gould, PhD, RN

Editor in Chief, Dimensions of Critical Care Nursing

Adjunct Faculty, William F. Connell

School of Nursing Boston

College Chestnut Hill, Massachusetts