From leadership research to district action: Reflections of Nurse Leaders on Optimising Organisational Culture in Aged Care in Rural and Regional Australia: A Critical Discourse Analysis

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Background Research on organisational culture in aged care settings is formative. This study gives primacy to the voices of registered nurses (RNs) who are integral to clinical and managerial leadership in rural and regional aged care contexts in Australia. Objective To describe and analyse the reflections and understandings of RNs who are or have been employed in residential and community aged care settings in rural and regional Australia on optimising organisational culture and cultures of care. Methods This manuscript reports on a component of a larger study with 14 participants. Five RNs at the board, executive and clinical nurse consultant level employed in residential or community aged care settings in rural or regional Australia during 2017–2024 participated in semistructured interviews. The interview questions were guided by appreciative inquiry, and this facilitated a strength‐based approach to discussion on organisational culture. Data were analysed using critical discourse analysis informed by Michel Foucault, which is concerned with an examination of the nature and utilisation of power as a relational force in social systems. Findings The participants, reflecting on their experience in rural and regional contexts, viewed strong nursing leadership as integral to person‐centred cultures in aged care settings. Nursing leadership incorporates nurses working to full scope of practice in settings that support postgraduate study and research and innovation. Interwoven through these perspectives is evidence of Foucault’s concepts of governmentality and disciplinary structures informing nursing practice. Power is both a repressive and productive force that shapes professional relationships and the capacity for RNs to be agents of change. A clear separation of the operational and governance arms of aged care organisations was viewed by participants as necessary for effective management, while highlighting the need for more RNs to contribute in roles at the board and executive level. Conclusions This study underscores the opportunity for professional nursing bodies, government agencies and the aged care sector to work together to require RN representation on boards of aged care providers; to develop policies that enable RNs to work to their full scope; and to strengthen mentoring, career pathways, and financial assistance for nurses pursuing further education. RNs working in aged care also emphasised the importance of building a research‐focused culture that drives improvement and innovation, noting that staff education is essential for enabling meaningful involvement in research and project work.

Study methods

The findings reported in this manuscript are part of a larger study that also included RNs in direct care and leadership positions in facilities. This paper focuses on RNs in board, executive and clinical nurse consultant positions. This study was approved by the Charles Sturt University Human Research Ethics Committee, approval number H23884.

Limitations

A strength of this study is the diversity of the participants which, in conjunction with the breadth and depth of professional experience, added to the richness of the data collected. The utilisation of appreciative inquiry and CDA is an innovative way of explicating both the current challenges of working in aged care environments and the participants’ perspectives on creating healthy organisational cultures.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one recurring leadership practice described in the source. Map its participants, incentives and constraints to a district setting, then design a small reversible staff pilot with an accountable owner. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Record implementation fidelity, staff review time, task quality and unintended burdens against a baseline. Use a comparison team where feasible and document alternative explanations before expanding. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Deborah Magee; Marguerite Bramble; Samantha Jakimowicz; Holly Randell-Moon; Karen Francis. Reflections of Nurse Leaders on Optimising Organisational Culture in Aged Care in Rural and Regional Australia: A Critical Discourse Analysis. Journal of Nursing Management (2026-01-01). https://doi.org/10.1155/jonm/1474638

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.