Political Astuteness in Nurse Leadership: A Concept Analysis. — TEI-tagged view

Namadzavho Joyce MuswedepersName, Vhothusa Edward MatahelapersName (2026date). “Political Astuteness in Nurse Leadership: A Concept Analysis..” Journal of Nursing Managementtitle·j.

Object of study — political astutenessterm·dom in nurse leadershipterm·key

Research question — what political astutenessterm·dom means in nurse leadershipterm·key, and how it differs from adjacent terms

Contribution — a clarification of political astutenessterm·dom as a multidimensional leadership capability, set apart from political skillterm·dom, awareness and advocacy

Full text — tagged

Political Astutenessterm·dom in Nurse Leadershipterm·key: A Concept Analysisterm·key.

Abstract To conduct a concept analysisterm·key of political astutenessterm·dom in nurse leadershipterm·key, clarifying its attributesterm·mth, antecedentsterm·mth and consequencesterm·mth.

Concept analysisterm·key.

Literature published between 1990 and February 2025 was searched in EBSCOhost, Emerald, ProQuest, Sabinet, SAGE and ScienceDirect.

Walker and Avant’s (2019) eight‐step concept analysisterm·key framework was used to identify defining attributesterm·mth, antecedentsterm·mth, consequencesterm·mth and empirical referentsterm·mth. Model and contrary casesterm·mth were constructed to illustrate the presence and absence of the concept.

Analysis of 24 included sources identified defining attributesterm·mth of political astutenessterm·dom in nurse leadershipterm·key, including strategic awareness, policy acumenterm·dom, advocacy, stakeholder engagement and ethical reasoning. Antecedentsterm·mth included policy knowledge, emotional intelligence, governanceterm·key exposure and experience of political environments. Reported consequencesterm·mth in the literature included stronger strategic and ethical decision‐making, greater capacity for stakeholder alignment and increased potential to engage in policy and organisational influence.

This concept analysisterm·key suggests that political astutenessterm·dom is a relevant leadership capability in nurse leadershipterm·key, particularly in contexts requiring policy engagement, stakeholder alignment and navigation of complex organisational environments. Clarifying the concept may support more coherent scholarship, leadership development and future empirical work in this area.

This study contributes conceptual clarity to political astutenessterm·dom in nurse leadershipterm·key and offers a basis for considering how political capability may be addressed in leadership development and nursing education. The findings may also inform future work on how nurse leaders are prepared for policy engagement, organisational influence and system‐level leadership.

A PRISMA 2020 flow diagram was used to report the literature identification and selection process within this concept analysisterm·key.

This study was a concept analysisterm·key; therefore, no patient or public involvement in its design, conduct or reporting was required.

Keywords: governanceterm·key, healthcare reform, nurse leadershipterm·key, nursing education, policy advocacyterm·dom, political astutenessterm·dom, political competency, strategic decision-making 1. Introduction Political astutenessterm·dom is increasingly recognised as an important leadership capability for nurse leaders who work across policy processes, organisational politics and interprofessional relationships. In this paper, the concept denotes a broader capability than interpersonal influence alone: it combines contextual reading, strategic judgement, stakeholder alignment and ethically informed action in settings where power, resources and priorities are contested [ 1 , 2 ]. Although political astutenessterm·dom has been developed mainly in public leadership scholarship, its specific meaning for nurse leadershipterm·key remains insufficiently clarified.

The nursing literature often places political astutenessterm·dom alongside related constructs such as political skillterm·dom, political awarenessterm·dom, political acumen, political competenceterm·dom, political efficacyterm·dom and policy advocacyterm·dom. These constructs are useful but not equivalent. Political skillterm·dom foregrounds interpersonal influence and networking; political awarenessterm·dom and acumen emphasise sensitivity to power and judgement; political competenceterm·dom, efficacy and advocacy focus on preparedness, confidence and action in policy participation. Political astutenessterm·dom is broader because it includes reading the wider context, working across stakeholders and using strategy ethically across organisational and policy arenas [ 1 – 4 ].

Without this distinction, political astutenessterm·dom remains difficult to teach, develop or study in nurse leadershipterm·key. A concept analysisterm·key is therefore needed to clarify its defining attributesterm·mth, antecedentsterm·mth, consequencesterm·mth and empirical referentsterm·mth and to provide a more coherent foundation for nursing leadership scholarship, education and professional development.

2. Background Political astutenessterm·dom is most useful in this analysis as a leadership capability that helps nurse leaders interpret complex policy and organisational environments, identify interests and power relationships and act strategically while remaining accountable to professional and public values. Health leadership studies link political astutenessterm·dom with stakeholder mapping, coalition building, strategic framing, timing and the management of informal power in major change processes [ 1 , 2 , 5 , 6 ]. Nursing‐specific work similarly shows the relevance of political preparation and policy engagement for nurse leaders, while also indicating that many nurses and nurse leaders remain underprepared for sustained participation in policy and governanceterm·key [ 7 – 9 ].

To avoid conflation, this analysis treats political astutenessterm·dom as distinct from, but related to, several adjacent constructs. Political skillterm·dom refers mainly to interpersonal influence, social astuteness, networking ability and apparent sincerity [ 3 , 4 ]. Political competenceterm·dom and political efficacyterm·dom are more closely linked to knowledge, confidence and participation in policy or political processes [ 10 , 11 ]. Policy advocacyterm·dom refers to action directed at influencing policy decisions or public priorities [ 12 , 13 ]. Political astutenessterm·dom draws on these capacities but integrates them within a wider leadership capability for reading context, aligning stakeholders, timing action and exercising ethical strategic influence across organisational and system arenas [ 1 , 2 , 5 ].

Such differentiation matters because nurse leaders often see how policy and governanceterm·key decisions shape staffing, service delivery, quality and equity, yet formal clinical expertise alone does not secure influence in decision‐making spaces [ 8 , 12 , 13 ]. Political astutenessterm·dom points to the additional capability required to interpret formal and informal systems of power, work with competing interests, build credible alliances and frame nursing concerns in ways that can be heard within organisational and policy processes.

Accordingly, this concept analysisterm·key focuses on political astutenessterm·dom as a multidimensional leadership capability rather than as a synonym for political skillterm·dom, awareness or advocacy. Clarifying the concept can support more precise use in nurse leadershipterm·key scholarship and provide a cautious basis for future educational and empirical work.

3. Method This study used Walker and Avant’s [ 14 ] eight‐step concept analysisterm·key method to examine political astutenessterm·dom in nurse leadershipterm·key. Concept analysisterm·key is used in nursing scholarship to clarify the meaning of concepts, distinguish them from related terms and support theoretical development and future empirical inquiry [ 15 ]. Walker and Avant’s method was selected because it provides a structured process for identifying defining attributesterm·mth, antecedentsterm·mth, consequencesterm·mth, model and contrary casesterm·mth, and empirical referentsterm·mth of a concept within a specific disciplinary context. In this study, the analysis followed Walker and Avant’s eight steps: selecting the concept, determining the purpose of the analysis, identifying uses of the concept, determining defining attributesterm·mth, constructing a model caseterm·mth, constructing a contrary caseterm·mth, identifying antecedentsterm·mth and consequencesterm·mth and identifying empirical referentsterm·mth.

3.1. Search Strategy and Study Selection A literature search was conducted between October 2024 and February 2025 across EBSCOhost, Emerald, ProQuest, Sabinet, SAGE and ScienceDirect. The search covered literature published between 1990 and February 2025. This time frame was selected to capture early work on political skillterm·dom and related leadership constructs, the later development of political astutenessterm·dom in public sector and health leadership scholarship, and contemporary work relevant to nurse leadershipterm·key.

Search terms were developed from the focus of the analysis and combined using Boolean operators. Core terms included ‘political astutenessterm·dom’, ‘nurse leaders’, ‘political skillterm·dom’, ‘policy advocacyterm·dom’ and ‘policy influence’. A keyword‐based strategy was used across databases to ensure consistency in retrieval across platforms with differing indexing systems.

Publications were eligible for inclusion if they were published in English, available in full text and explicitly addressed political astutenessterm·dom in relation to nurse leadershipterm·key or provided conceptually relevant discussion that informed its definition, attributesterm·mth, antecedentsterm·mth, consequencesterm·mth or empirical referentsterm·mth. Publications were excluded if they lacked sufficient conceptual or methodological details to inform the analysis, or if they did not meaningfully address political astutenessterm·dom within leadership, policy or governanceterm·key contexts relevant to nursing. English language publications were included because the analysis required close interpretation of conceptual definitions, theoretical nuance and contextual meaning. Full‐text access was required to support detailed extraction and interpretation of the concept.

Two authors independently screened titles and abstracts and then reviewed potentially eligible full‐text articles. Disagreements were resolved through discussion and consensus. No automation tools were used in the screening process. A total of 2223 records were identified. After removal of 1979 duplicates, 244 records remained for screening. Following title and abstract screening, 43 reports were sought for retrieval and assessed for eligibility. Nineteen reports were excluded because they were not conceptually or methodologically relevant to political astutenessterm·dom. A total of 24 sources met the inclusion criteria and were included in the concept analysisterm·key.

To enhance transparency, the identification and selection process is presented in a PRISMA 2020 flow diagram (Figure 1 ). In this study, the flow diagram was used to report the search and screening process only; the conceptual analysisterm·mth itself remained guided by Walker and Avant’s framework.

PRISMA flowchart of included articles.

The included studies are presented in Table 1 .

Studies identified for concept analysisterm·key of political astutenessterm·dom ( n = 24).

4. Results 4.1. Step 1: Select the Concept Political astutenessterm·dom was selected because it captured a broader leadership capability than several related constructs found in the reviewed literature. Political skillterm·dom emphasises interpersonal influence and networking; political awarenessterm·dom and acumen emphasise judgement about power; political competenceterm·dom and efficacy emphasise knowledge, confidence and participation in policy processes. Political astutenessterm·dom, by contrast, was most consistently associated with reading people and context, aligning stakeholders and coalitions, timing strategic action and exercising direction across organisational and system settings [ 1 – 4 , 10 ].

The concept was therefore selected because it offers a more suitable frame for examining how nurse leaders interpret, navigate and influence complex governanceterm·key and policy environments without reducing leadership to interpersonal influence or policy participation alone.

4.2. Step 2: Determine the Purpose of the Analysis The purpose of the analysis was to clarify the meaning of political astutenessterm·dom in nurse leadershipterm·key by identifying its defining attributesterm·mth, antecedentsterm·mth, consequencesterm·mth and empirical referentsterm·mth. In doing so, the analysis sought to distinguish the concept from adjacent terms and to provide a clearer conceptual basis for future scholarship in nursing leadership. No prior concept analysisterm·key focused specifically on political astutenessterm·dom in the nursing profession was identified in the reviewed literature.

4.3. Step 3: Identify Uses of the Concept Across the reviewed literature, political astutenessterm·dom was used primarily in relation to leadership within nursing, health systems and public sector settings. In nursing and health leadership contexts, it referred to the capacity of nurse leaders to interpret political environments, recognise stakeholder interests, build alliances and influence decisions across organisational and policy arenas. These uses were identified across a range of settings, including acute and primary care services, educational institutions, professional associations, regulatory structures and broader health policy environments.

Within nursing, the concept has been used to describe how nursing leaders assess policy opportunities, frame issues strategically and engage in reform‐oriented leadership [ 7 , 9 ]. It is also reflected in interprofessional coalition building, where healthcare leaders work across professions and services to secure support for change initiatives [ 5 ]. At the organisational level, political astutenessterm·dom is associated with micropolitical work such as reading informal power relations, negotiating trade‐offs and sustaining legitimacy within constrained authority structures [ 6 , 34 ]. Nursing education literature further links political astutenessterm·dom with policy learning and political preparation among students and educators [ 19 , 21 , 31 ].

Public leadership literature was used selectively to clarify transferable elements, particularly multilevel influence, stakeholder alignment and ethical action in shared‐power contexts [ 1 , 23 , 25 ]. However, nursing and health leadership literature remained the primary anchor for interpreting the concept in this analysis.

4.4. Step 4: Define Attributesterm·mth Attributesterm·mth are the characteristics that repeatedly appear in the literature as central to a concept and that help distinguish it from related constructs [ 14 ]. In this analysis, political astutenessterm·dom in nurse leadershipterm·key was understood as a leadership capability involving the capacity to read context, interpret stakeholder interests, act strategically and exercise judgement in politically and organisationally complex settings.

Across the reviewed literature, defining attributesterm·mth were synthesised as contextual and strategic awareness, policy acumenterm·dom, stakeholder engagement, advocacy‐oriented influence, ethical reasoning and judgement under uncertainty [ 1 , 2 , 4 – 6 ]. These attributesterm·mth describe nurse leaders who can recognise the organisational and policy landscape, understand how formal and informal decisions are shaped, align relationships across stakeholders and act in ways that balance strategic feasibility with professional and public values.

Several enabling features appeared repeatedly but were treated as supporting rather than defining attributesterm·mth. These included interpersonal intelligence, negotiation and diplomacy, communication, networking ability, adaptability and problem‐solving orientation [ 2 – 4 , 34 ]. On their own, these features may indicate political skillterm·dom or general leadership capability; they become expressions of political astutenessterm·dom when integrated with contextual reading, strategic timing and ethical system‐level influence.

Collectively, the findings support political astutenessterm·dom as a multidimensional leadership capability with strategic, contextual, relational and ethical dimensions. The concept overlaps with political skillterm·dom, awareness, acumen, competence, efficacy and advocacy but is not reducible to any one of them. Its distinctive contribution lies in integrating these elements into a broader capacity to read, navigate and influence organisational and policy environments in nurse leadershipterm·key [ 1 – 3 , 5 ].

4.5. Step 5: Identify Model Caseterm·mth Following Walker and Avant [ 14 ], researchers developed a constructed model caseterm·mth as a composite scenario created by the authors to demonstrate the defining attributesterm·mth identified in Step 4 of the analysis. The vignette, represented by the hypothetical example of Dr Thembeka Mkhize, is illustrative rather than evidentiary and does not depict a real individual.

A team of highly skilled nephrology nurses faced restrictive fee‐for‐service policies that limited their scope of practice and compromised patient access to specialised renal care. As team leader, Dr Thembeka Mkhize recognised that change required more than technical expertise. She first mapped the policy landscape, distinguishing between administrators implementing legislation and policymakers with authority to amend it. She led her team in developing an evidence‐based policy brief that combined clinical data, economic arguments and patient outcomes, framing the issue as a public access and health system benefit rather than a narrow professional demand.

Dr Mkhize strategically established coalitions with professional associations, patient groups and legal advisors to amplify nurses’ voices. She led timed engagements with relevant key stakeholders and policy review cycles. Anticipating resistance, she responded through diplomatic and persistent negotiation, acknowledging funders’ concerns while presenting well‐supported counterarguments. These efforts contributed to amendments that expanded reimbursable services in nephrology care and also created momentum for wider reform affecting nurse specialists.

This scenario constitutes a model caseterm·mth because it demonstrates the defining attributesterm·mth of political astutenessterm·dom in nurse leadershipterm·key, including contextual and systems awareness, strategic framing, stakeholder alignment, advocacy, ethical judgement and skilful engagement with decision‐makers.

4.6. Step 6: Identify Contrary Caseterm·mth Contrary casesterm·mth serve as distinct examples that illustrate instances where the concept is absent or does not apply [ 14 ]. The following illustrates a contrary caseterm·mth, which has been amalgamated from qualitative examples in the literature: Ms Badosi, a senior nurse leader in a provincial health department, was tasked with implementing a policy affecting the care of a vulnerable population. Rather than reviewing the legislation, budget allocations and readiness reports that shaped the policy context, she proceeded with immediate implementation without considering alternative options or recognising major resource and capacity constraints. She cancelled planned meetings with key stakeholders; did not consult community leaders, district health councils or professional associations; and declined invitations from patient advocacy groups and interprofessional forums.

When frontline nurses and clinic managers raised concerns about transport, chronic understaffing and cold‐chain limitations, she dismissed these as resistance to change and enforced departmental circulars rigidly without adapting implementation to local realities. The rollout subsequently faltered: supply chains broke down, clinics missed reporting deadlines, staff lacked adequate preparation and resources, and service disruptions attracted negative media attention, ultimately leading to suspension of the policy. This scenario constitutes a contrary caseterm·mth because the defining attributesterm·mth of political astutenessterm·dom are absent. The nurse leader demonstrates little contextual or systems awareness, does not engage stakeholders or build alliances, fails to act strategically in relation to timing and implementation conditions and neglects the ethical and equity dimensions of leadership in a politically and organisationally complex setting.

4.7. Step 7: Identify Antecedentsterm·mth and Consequencesterm·mth 4.7.1. Antecedentsterm·mth Antecedentsterm·mth are events, conditions or capacities that precede the emergence of a concept [ 14 ]. In this analysis, political astutenessterm·dom appeared to depend on both individual capabilities and contextual opportunities. Individual antecedentsterm·mth included policy knowledge, strategic awareness, ethical reasoning, emotional intelligence and previous exposure to governanceterm·key or politically complex environments [ 1 , 2 , 35 ].

These antecedentsterm·mth span cognitive, emotional and behavioural domains. Cognitively, nurse leaders require policy literacy, analytical judgement and awareness of organisational dynamics. Emotionally, they require the ability to read relational cues and regulate their responses in politically sensitive situations. Behaviourally, prior opportunities to network, communicate strategically and participate in committees, coalitions or policy forums may strengthen the conditions through which political astutenessterm·dom develops [ 34 , 35 ].

External antecedentsterm·mth include organisational culture, leadership support, governanceterm·key structures and formal opportunities for nurses to participate in decision‐making [ 6 , 8 ]. Regulatory frameworks, policy climates and public expectations also shape whether political activity by nurse leaders is perceived as legitimate, possible and professionally valued [ 2 , 22 ].

4.7.2. Consequencesterm·mth Consequencesterm·mth are outcomes that follow the emergence of a concept [ 14 ]. In this analysis, the literature suggested possible consequencesterm·mth at individual, organisational and policy levels. Because much of the evidence is conceptual, descriptive or self‐reported, these consequencesterm·mth should be interpreted as plausible and literature‐supported rather than as established causal effects.

At the individual level, political astutenessterm·dom may support more context‐sensitive strategic and ethical judgement. Politically astute leaders are described as better able to balance professional values, organisational priorities and political realities when making decisions in contested settings [ 23 , 25 ]. Such practice may also strengthen credibility and legitimacy in policy or governanceterm·key forums.

At the organisational and health system level, political astutenessterm·dom may support policy implementation and service change by helping leaders anticipate resistance, frame proposals strategically and broker relationships across professional and organisational boundaries [ 5 , 6 ]. In nursing contexts, this could contribute to stronger nursing representation in decision‐making, improved stakeholder buy‐in and organisational climates more receptive to nursing‐led change; however, these outcomes require further empirical testing.

At the policy, societal and educational levels, political astutenessterm·dom may strengthen the visibility and influence of nursing in public debate and formal governanceterm·key processes. By understanding and negotiating competing interests, nurse leaders may be better positioned to contribute to feasible policy options and to mentor future nurses as policy actors [ 12 , 13 , 24 ].

4.8. Step 8: Define Empirical Referentsterm·mth Empirical referentsterm·mth are observable indicators that help identify a concept in practice [ 14 ]. For political astutenessterm·dom, existing measurement options remain limited. The Political Astuteness Inventoryterm·mth (PAIterm·mth), originally developed by Clark [ 36 ] and later adapted in nursing research by Primomo [ 31 ], is the most frequently cited tool linked to the term. However, the PAIterm·mth primarily reflects political awarenessterm·dom, involvement and selected advocacy behaviours, whereas this analysis conceptualises political astutenessterm·dom more broadly as a strategic, contextual, relational and ethical leadership capability.

The PAIterm·mth includes items on policy knowledge, political engagement behaviours, committee involvement and advocacy‐related attitudes. It classifies respondents across levels of political awarenessterm·dom and involvement [ 31 , 36 , 37 ]. Although the instrument has been useful in nursing education and policy preparation studies, it should not be treated as a comprehensive measure of the broader concept described in this analysis. Rather, it offers partial evidence of some cognitive and behavioural dimensions.

Other instruments measure related, but not identical, constructs. The Political Skill Inventoryterm·mth captures social astuteness, interpersonal influence, networking ability and apparent sincerity and is therefore most relevant to the relational and interpersonal dimensions of political astutenessterm·dom [ 3 ]. The Political Competenceterm·dom Scale for Nurses assesses political knowledge, efficacy, interaction and activity [ 38 ], while political efficacyterm·dom and participation measures capture confidence and engagement in political processes [ 11 ]. These tools can function only as proxy indicators for selected attributesterm·mth; none fully captures the contextual, strategic and ethical integration identified in this concept analysisterm·key.

Behavioural referents may include documented participation in policy forums, authorship of policy briefs or submissions, leadership in professional coalitions, evidence of stakeholder mapping and records of negotiated organisational or policy change. These indicators may help researchers and educators observe selected manifestations of political astutenessterm·dom, but they require careful contextual interpretation. The current literature therefore supports cautious use of existing tools and indicators, while highlighting the need for future work to develop and test conceptually aligned measures.

5. Discussion This concept analysisterm·key clarifies political astutenessterm·dom in nurse leadershipterm·key as a multidimensional leadership capability that extends beyond political awarenessterm·dom, political skillterm·dom or policy advocacyterm·dom alone. Across the reviewed literature, it referred to the ability to read context, understand stakeholder interests, exercise strategic judgement and act ethically within organisational and policy environments where power and priorities are contested. It is therefore best understood as an integrative leadership capability for complex health systems, rather than as a single interpersonal or advocacy behaviour [ 1 , 2 , 5 ].

The main contribution of the analysis is conceptual differentiation. Political skillterm·dom foregrounds interpersonal influence and networking; political competenceterm·dom and efficacy foreground knowledge, confidence and participation; policy advocacyterm·dom foregrounds action directed at policy change. Political astutenessterm·dom overlaps with these constructs but brings them together through a wider concern with context, timing, stakeholder alignment and ethically informed strategy. This distinction is important because imprecise use of the term may weaken leadership scholarship and make it difficult to design coherent educational or developmental interventions [ 1 – 4 , 10 ].

The analysis also shows practical relevance, but within cautious limits. The literature suggests that politically astute nurse leaders may be better positioned to work in contexts characterised by competing interests, formal and informal power structures and implementation uncertainty. However, the evidence base does not yet support strong causal claims about outcomes. Broader nursing literature on political and policy engagement shows that participation remains uneven and is constrained by organisational, professional and contextual barriers [ 7 , 8 , 39 – 41 ].

The empirical referentsterm·mth remain the least developed aspect of the concept. The PAIterm·mth and related instruments provide useful starting points but should be treated as partial or proxy indicators, not as comprehensive measures of political astutenessterm·dom in nurse leadershipterm·key. Future methodological work should examine whether existing tools can be adapted or whether a new instrument is needed to capture the contextual, ethical, strategic and relational integration identified in this analysis [ 3 , 31 , 36 , 38 ].

Collectively, the findings suggest that political astutenessterm·dom may help explain how nurse leaders engage with policy, negotiate organisational complexity and exercise influence when formal authority alone is insufficient. It also offers a potentially useful lens for examining how nursing perspectives become visible or marginalised in governanceterm·key processes. The value of the concept at this stage is therefore primarily theoretical and developmental, with empirical testing still required.

At the same time, the concept should be taken forward carefully. The literature does not yet provide a sufficiently consistent empirical basis for claims about measurement readiness, intervention effectiveness or direct impact. Future research should refine the boundaries of the concept, examine its expression in diverse nursing leadership settings and develop indicators that are conceptually aligned with its strategic, relational, ethical and contextual dimensions [ 41 , 42 ].

5.1. Implications for Nursing The findings suggest that political astutenessterm·dom warrants greater attention in nurse leadershipterm·key development, management preparation and professional socialisation. However, the present analysis supports this implication primarily at the level of conceptual clarification rather than intervention effectiveness. Accordingly, the implications offered here should be understood as analytically informed directions rather than prescriptive conclusions.

5.2. Implications for Nursing Education The concept analysisterm·key suggests that nursing education could more explicitly engage with the policy, governanceterm·key and stakeholder dimensions of leadership, particularly because political knowledge and policy engagement are longstanding and contemporary concerns in nurses’ professional preparation [ 12 , 13 , 43 ]. This is especially important because nursing education reform is itself shaped by policy processes, stakeholder coordination and regulatory alignment [ 44 ]. Educational approaches that expose students and emerging nurse leaders to health policy processes, systems thinking, advocacy, negotiation and stakeholder engagement may help build some of the capabilities associated with political astutenessterm·dom. However, the present study does not provide evaluative evidence on which educational strategies are most effective, and this remains an important area for future research.

5.3. Implications for Nursing Practice For nursing practice and management, the analysis suggests that political astutenessterm·dom may be particularly relevant in contexts of organisational change, interprofessional negotiation, service redesign and policy implementation. Nurse leaders frequently work in environments shaped by competing priorities, constrained resources and layered governanceterm·key arrangements, and the concept provides a useful lens for understanding how leadership is exercised under such conditions. The reviewed literature suggests that nurses’ political engagement may be constrained by limited policy preparation, organisational cultures, workload pressures and the marginalisation of the nursing voice in decision‐making spaces [ 7 , 8 , 39 – 41 ]. These constraints suggest that leadership development and organisational support structures may need to pay greater attention to the political and relational dimensions of nurse leadershipterm·key practice.

5.4. Limitations Several limitations should be considered when interpreting this concept analysisterm·key. First, although the included literature spans multiple countries, the evidence base is weighted toward high‐income Anglophone contexts, which may limit transferability across different health system, cultural and governanceterm·key environments. Second, the body of literature includes a mixture of empirical, conceptual and theoretical sources, with relatively limited intervention‐based evidence. This means that the analysis is better positioned to clarify the concept than to establish the effectiveness of particular educational or leadership strategies. Third, some empirical referentsterm·mth rely on self‐report measures and related proxy constructs, which do not fully capture the broader conceptualisation of political astutenessterm·dom advanced in this paper. Finally, the analysis focuses specifically on political astutenessterm·dom in nurse leadershipterm·key and does not attempt a broader comparison with all leadership effectiveness frameworks. Future research should therefore test the concept in diverse settings and work toward more contextually sensitive and conceptually aligned measures.

6. Conclusion This concept analysisterm·key clarifies political astutenessterm·dom as a multidimensional leadership capability relevant to nurse leadershipterm·key in organisational, interprofessional and policy contexts. The findings suggest that political astutenessterm·dom extends beyond interpersonal influence, general political awarenessterm·dom or policy advocacyterm·dom and includes contextual reading, strategic judgement, stakeholder alignment and ethically informed action in complex governanceterm·key environments.

By clarifying its defining attributesterm·mth, antecedentsterm·mth, consequencesterm·mth and empirical referentsterm·mth, this study provides a more coherent conceptual foundation for understanding political astutenessterm·dom in nurse leadershipterm·key. Its main contribution lies in conceptual clarification rather than in demonstrating intervention effectiveness, measurement readiness or causal outcomes. In this sense, the analysis helps position political astutenessterm·dom as a potentially useful concept for future nursing leadership scholarship, educational inquiry and professional development.

The study also highlights the need for further empirical and methodological work. Future research should examine how political astutenessterm·dom is expressed in diverse nursing leadership settings, refine its conceptual boundaries and develop contextually sensitive and conceptually aligned indicators. Greater conceptual and empirical attention to political astutenessterm·dom may strengthen understanding of how nurse leaders engage with policy, exercise influence and navigate the complexity of contemporary health systems.

Author Contributions Namadzavho Joyce MuswedepersName conceptualised the research, critically reviewed the manuscript, made substantial revisions, and developed the case studies. Vhothusa Edward MatahelapersName conceptualised the research, conducted the initial literature review, and conducted the concept analysisterm·key.

Funding This study did not receive any funding.

Disclosure All the authors reviewed and approved the final manuscript.

Ethics Statement Ethics approval and consent to participate were not required because this study was a concept analysisterm·key of published literature and did not involve human participants, identifiable personal data or primary data collection.

Conflicts of Interest The authors declare no conflicts of interest.

MuswedepersName, Namadzavho Joyce , MatahelapersName, Vhothusa Edward , Political Astutenessterm·dom in Nurse Leadershipterm·key: A Concept Analysisterm·key, Journal of Nursing Management, 2026, 7258276, 10 pages, 2026. 10.1155/jonm/7258276 Contributor Information Namadzavho Joyce MuswedepersName, Email: jmuswede@sanc.co.za.

Vhothusa Edward MatahelapersName, Email: matahve@unisa.ac.za.

Justin Fontenot, Email: jfontenot@wiley.com.

Data Availability Statement All data used to support this concept analysisterm·key were derived from the published literature cited in this article.

References Associated Data Data Availability Statement All data used to support this concept analysisterm·key were derived from the published literature cited in this article.