RESUMO
This article examines some of the fundamental challenges facing the district nurse in delivery of the managerial aspects of her role in contemporary practice. It discusses the personal attributes that are essential for this role to ensure safe, effective and compassionate leadership and management. The communication skills and ethos underpinning collaborative multidiscilplinary team work and person-centred care are discussed. Issues that compromise positive and productive team working are identified, and strategies dealing with conflict and also change management are debated. These factors are interrelated with the everyday demands of caseload management, the development of educational needs to meet the demands of increased complexity in care needs, and the place of technology in modern health care. It is evidenced that sustained organisational support for this role is more important than ever, due to increasing demand and decreasing capacity. Potential solutions to these challenges are offered to assist the contemporary district nurse.