Abstract
Nurse leaders in the Nordic countries are facing increasing challenges in terms of required knowledge and skills (competencies). This is due to recent and ongoing large changes in the health systems and their environment. The purpose of this study was to answer the following questions: What knowledge and skills are needed by nurse leaders in order to meet new challenges and to be competent and effective? How do the nurse leaders perceive their competence to correspond to these challenges. Data were collected through a mail survey from 1261 nurse leaders in the municipal primary health services of Nordic countries. The highest rated competence areas were coordination and collaboration, keeping nurses in the workforce and motivating nursing staff, and the lowest rated competence areas were related to research and evidence based practices, nursing informatics, and quality control. There was some variation in this respect among the nurse leaders of the five countries. Differences between the required and self-assessed competencies indicate the areas in nursing management where development and further training are needed.