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The role of the charge nurse manager: a descriptive exploratory study

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Abstract

mccallin a.m. & frankson c. (2010) Journal of Nursing Management18, 319–325 The role of the charge nurse manager: a descriptive exploratory study Aim To explore the charge nurse manager role. Background Management in nursing is increasingly challenging. Restructuring of organizations has had an impact on the scope of the charge nurse manager role that has expanded so that managers are now expected to be leaders. If role preparation is inadequate, potential for role confusion and role stress increases, undermining role effectiveness in this key senior nursing position. Method This descriptive exploratory study investigated the experiences of charge nurse managers. Twelve nurse managers from an acute care hospital in New Zealand were interviewed. Data were analysed thematically. Results Three themes, role ambiguity, business management deficit and role overload emerged. It was evident that charge nurse managers were appointed into a management role with clinical expertise but without management skills. Conclusions Findings suggest that role preparation should include postgraduate education and business management training. Role induction requires a formal organizational management trainee programme and ongoing supportive clinical supervision. Implications for nursing management New approaches to charge nurse manager role development are needed. Organizations must provide formal structural support to facilitate management development. The profession needs to promote succession planning that would reduce these longstanding problems.

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... The role as manager involves dealing with, for example, finances, business strategies, organisational operations, human resources and information technology (McCallin & Frankson 2010). Qualitative studies (Shirey et al. 2008, McCallin & Frankson 2010 conducted in hospital settings with mostly female participants have described the managerial role as overwhelming, with unrealistic expectations that tend to exceed the available resources (Shirey et al. 2008). ...
... The role as manager involves dealing with, for example, finances, business strategies, organisational operations, human resources and information technology (McCallin & Frankson 2010). Qualitative studies (Shirey et al. 2008, McCallin & Frankson 2010 conducted in hospital settings with mostly female participants have described the managerial role as overwhelming, with unrealistic expectations that tend to exceed the available resources (Shirey et al. 2008). Their role was often unclear (McCallin & Frankson 2010), involving difficulties in task reallocation (Reay et al. 2003) that resulted in feelings of work-related stress (Shirey et al. 2008). ...
... Qualitative studies (Shirey et al. 2008, McCallin & Frankson 2010 conducted in hospital settings with mostly female participants have described the managerial role as overwhelming, with unrealistic expectations that tend to exceed the available resources (Shirey et al. 2008). Their role was often unclear (McCallin & Frankson 2010), involving difficulties in task reallocation (Reay et al. 2003) that resulted in feelings of work-related stress (Shirey et al. 2008). Managerial work has been found to include conflicts concerning distribution and fragmentation of time, leading to a difficult balance between work and private life and between work assignments (Tengelin et al. 2011). ...
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Background The work situation for first‐line managers in elderly care is complex and challenging. Little is known about these managers’ work situation from a structural and psychological empowerment perspective. Aim To describe first‐line managers’ experiences of their work situation in elderly care from a structural and psychological empowerment perspective. Method Interviews from 14 female first‐line managers were analyzed using qualitative content analysis. Results The theme described the managers’ work situation as “It's not easy, but it's worth it.” In the four subthemes, the managers described their work in terms of “Enjoying a meaningful job,” “A complex and demanding responsibility that allows great authority within set boundaries,” “Supported by other persons, organizational preconditions and confidence in their own abilities,” and “Lacking organizational preconditions, but developing strategies for dealing with the situations”. Conclusion The managers described having various amounts of access to structural empowerment and experienced a feeling of meaning, competence, self‐determination and impact i.e., psychological empowerment in their work. Implications for nursing management It is vital that first‐line managers have access to organizational support. Therefore, upper management and first‐line managers need to engage in continuous dialogue to customize the support given to each first‐line manager. This article is protected by copyright. All rights reserved.
... Moreover, turnover is high for RNs employed in behavioral health settings such as SUDs when compared to turnover for nurses working in other specialties (NSI, Nursing Solutions Inc, 2016). Turnover has been linked in numerous studies to both job and role satisfaction (Brunetto, Farr-Wharton, & Shacklock, 2011;Cranford, 2013;Ho, Chang, Shih, & Liang, 2009;O'Brien-Pallas, Murphy, Shamian, Li, & Hayes, 2010 Numerous nursing studies have found that role satisfaction can be negatively influenced by role blurring and role ambiguity (Cranford, 2013;Hercelinskyj, Cruickshank, Brown, & Phillips, 2014;McCallin & Frankson, 2010). Role blurring and role ambiguity can especially result when settings, such as those for SUD treatment, employ clinicians from varying disciplines who work closely together (Kerwin, Walker-Smith & Kirby, 2006;Maddock, 2015;McNamara et al., 2011). ...
... While little literature exists on SUD nurses and their perceptions of their role, nurses in related specialties, such as in mental health, reported challenges to their role including role ambiguity, or the lack of clarity, that led to role stress (Hercelinskyj et al., 2014). The challenges reported in other nursing specialties were: feelings of frustration (McCallin & Frankson, 2010), decreased retention, and an increased job dissatisfaction (Cranford, 2013). Role overload was encountered when nurses viewed that the demands of their job outweighed resources causing them to feel overwhelmed and anxious (Chen, Chen, Tsai, & Lo, 2007;McCallin & Frankson, 2010). ...
... The challenges reported in other nursing specialties were: feelings of frustration (McCallin & Frankson, 2010), decreased retention, and an increased job dissatisfaction (Cranford, 2013). Role overload was encountered when nurses viewed that the demands of their job outweighed resources causing them to feel overwhelmed and anxious (Chen, Chen, Tsai, & Lo, 2007;McCallin & Frankson, 2010). ...
Article
Substance Use Disorders (SUDs) are a national public health crisis. However, there is minimal existing research literature on the role of the nurse working in SUD treatment. The purpose of this study was to describe the meaning of the professional role of the registered nurse working in the SUD setting. The study utilized a Heideggerian Phenomenological approach with a modified Colaizzi method for analysis and interpretation. The nine study participants, two males and seven females, aged 27–60 had worked in SUD treatment for 1–37 years. Three major themes, with sub-themes, emerged: Defining the Role for Self; Learning the Role; and Navigating with Ease in an Unchangeable Culture. Findings demonstrated that nurses in SUD treatment value their role and the care of patients with SUDs. Patient recovery or relapse influenced job satisfaction. Significantly, the findings highlighted an outdated role with rigid boundaries and no real contemporary identity. Findings can be used to address the need for a contemporary SUD nursing identity and to support ongoing involvement of nurses in health policy related to SUDs.
... Often nurse managers serve as intermediaries between clinical nurses and physicians to discuss issues regarding collaboration and patient care. Balancing between those two pursuits--being a leader and being a quality manager at the same time is seen as a real challenge (Carlin and Duffy 2013;Eggenberger 2012;McCallin and Frankson 2010;Rankin et al. 2016;Sorensen et al. 2011) and how best to juggle these functions has not always clear for nurse managers (Eggenberger 2012;McCallin and Frankson 2010). ...
... Often nurse managers serve as intermediaries between clinical nurses and physicians to discuss issues regarding collaboration and patient care. Balancing between those two pursuits--being a leader and being a quality manager at the same time is seen as a real challenge (Carlin and Duffy 2013;Eggenberger 2012;McCallin and Frankson 2010;Rankin et al. 2016;Sorensen et al. 2011) and how best to juggle these functions has not always clear for nurse managers (Eggenberger 2012;McCallin and Frankson 2010). ...
... Role ambiguity can be an explanatory factor for experiencing difficulties in carrying out the job of nurse manager. Feelings of overwork, powerlessness and frustration can also be the result of perceiving high expectations from others and an overload of tasks (McCallin and Frankson 2010). In a Belgian study, one out of every six nursing unit managers demonstrated high to very high levels of emotional exhaustion; however, two out of three showed high to very high work engagement. ...
Chapter
Interprofessional collaboration is crucial in hospitals because healthcare teams face challenges, such as complexity of clinical practice, high variation in clinical demand, ever-changing teams, and heavy workload. Moreover, communication between professionals does not always flow as it should. Ineffective or absent interprofessional collaboration has a negative impact on patient outcomes, such as medication errors, failure to rescue, increased hospital-acquired infection rates, and extended lengths of stay. Ineffective collaboration between healthcare workers was linked to two out of every three sentinel events (severe adverse events) reported to the Joint Commission’s databases. Developing effective teams and redesigned systems is vital to achieving safer, timelier, more patient-centered, effective, efficient, and equitable patient care. We can look at the Interprofessional Education Collaborative or IPEC competency framework for the competencies teams need to master to achieve role clarity, clear communication, and excellent teamwork and create a climate of mutual respect and shared values. The TeamSTEPSS educational intervention package can be used for improving team performance. In order to ensure the best possible patient outcomes, a smooth flow of collaboration and communication in the triangle between clinical nurses, nurse managers, and physicians can overcome turbulence and uncertainty in healthcare settings.
... As in other countries, there have been significant changes in health care in Turkey over the past decade (Akdağ, 2012;Cashin et al., 2017;McCallin & Frankson, 2010). Consequently, the Turkish health care system has undergone a rapid process of restructuring, affecting nursing services (Akdağ, 2012). ...
... They have been required to plan the necessary organisational changes within the scope of cost-effective policies and manage the human resources involved in this change. In this context, nurse managers needed to renew and improve their knowledge and skills in professional matters such as strategic planning, outcome management, financial management, risk management, quality management and human resources management (Akdağ, 2012;American Nurses Association, 2016;McCallin & Frankson, 2010). Some studies have indicated that nurse managers' business management and leadership skills were inadequate despite their expanding roles (Mancuso, 2016;McCallin & Frankson, 2010). ...
... In this context, nurse managers needed to renew and improve their knowledge and skills in professional matters such as strategic planning, outcome management, financial management, risk management, quality management and human resources management (Akdağ, 2012;American Nurses Association, 2016;McCallin & Frankson, 2010). Some studies have indicated that nurse managers' business management and leadership skills were inadequate despite their expanding roles (Mancuso, 2016;McCallin & Frankson, 2010). ...
Article
Objective This study aimed to establish the current management standards needed by nurse managers in Turkey and to share the process of establishing standards. Background Relevant and utilizable nursing management standards are needed for effective and efficient nursing administration to achieve better outcomes in health care. Methods A three‐round e‐Delphi method was used in this study. First, the experts were asked an open‐ended question. In the second and third rounds, data analysis measurements included item‐by‐item percent agreement, standard deviation, average, median, and interquartile range. Results At the end of the third round, 49 standards were obtained under five main standards for nurse managers: management‐organization, leadership, human resources management, quality management, and professionalism. Conclusion The results of this study, which represent a consensus on nursing management standards drawn from the views of experts across regions and institutions in Turkey, provide a baseline to design, manage and evaluate nursing services. Implications for Nursing Management Nursing management standards, which are fundamental for designing, leading, and evaluating nursing services, give a framework for nurse managers to provide effective and efficient administrative practices.
... Moreover, turnover is high for RNs employed in behavioral health settings such as SUDs when compared to turnover for nurses working in other specialties (NSI, Nursing Solutions Inc, 2016). Turnover has been linked in numerous studies to both job and role satisfaction (Brunetto, Farr-Wharton, & Shacklock, 2011;Cranford, 2013;Ho, Chang, Shih, & Liang, 2009;O'Brien-Pallas, Murphy, Shamian, Li, & Hayes, 2010 Numerous nursing studies have found that role satisfaction can be negatively influenced by role blurring and role ambiguity (Cranford, 2013;Hercelinskyj, Cruickshank, Brown, & Phillips, 2014;McCallin & Frankson, 2010). Role blurring and role ambiguity can especially result when settings, such as those for SUD treatment, employ clinicians from varying disciplines who work closely together (Kerwin, Walker-Smith & Kirby, 2006;Maddock, 2015;McNamara et al., 2011). ...
... While little literature exists on SUD nurses and their perceptions of their role, nurses in related specialties, such as in mental health, reported challenges to their role including role ambiguity, or the lack of clarity, that led to role stress (Hercelinskyj et al., 2014). The challenges reported in other nursing specialties were: feelings of frustration (McCallin & Frankson, 2010), decreased retention, and an increased job dissatisfaction (Cranford, 2013). Role overload was encountered when nurses viewed that the demands of their job outweighed resources causing them to feel overwhelmed and anxious (Chen, Chen, Tsai, & Lo, 2007;McCallin & Frankson, 2010). ...
... The challenges reported in other nursing specialties were: feelings of frustration (McCallin & Frankson, 2010), decreased retention, and an increased job dissatisfaction (Cranford, 2013). Role overload was encountered when nurses viewed that the demands of their job outweighed resources causing them to feel overwhelmed and anxious (Chen, Chen, Tsai, & Lo, 2007;McCallin & Frankson, 2010). ...
Article
As the demand for Psychiatric Mental Health Nurse Practitioners (PMHNPs) continues to grow, innovative teaching strategies that can enhance competency learning with skill transfer into the clinical setting is essential. Educational programs must adequately prepare the student for the complexity of the clinical environment. Simulation is an educational approach that replicates aspects of the real world in a safe environment so that learners can engage in an interactive manner. High-fidelity simulation (HFS) has been identified as an effective teaching strategy and mechanism to transfer knowledge and skills learned in the classroom to the clinical setting. HFS uses a human patient simulator to immerse the learner in a contextual learning environment by engaging in a realistic clinical scenario to develop cognitive, affective and psychomotor skills through deliberate practice. This article describes the theoretical foundation, development process, case scenarios, and implementation of HFS, an innovative teaching pedagogy, in a Psychopharmacology didactic course for PMHNP.
... The nurse manager's role has been studied from different perspectives and in different health care settings (Furtado, Batista, & Silva, 2011;McCallin & Frankson, 2010;Miller & Buerhaus, 2013;Pegram, Grainger, & Sigsworth, 2014). Generally, role seems to be complex (Shirey, McDaniel, Ebright, Fisher, & Doebbeling, 2010), and the content of the role is unclear (McCallin & Frankson, 2010). ...
... The nurse manager's role has been studied from different perspectives and in different health care settings (Furtado, Batista, & Silva, 2011;McCallin & Frankson, 2010;Miller & Buerhaus, 2013;Pegram, Grainger, & Sigsworth, 2014). Generally, role seems to be complex (Shirey, McDaniel, Ebright, Fisher, & Doebbeling, 2010), and the content of the role is unclear (McCallin & Frankson, 2010). Operating departments often cover many different surgical specialties ( Zhu et al., 2016). ...
... Around 40% of health care staff are educated to tertiary level (European Commission, 2013). It seems that a baccalaureate (bachelor's) degree is not enough to master nurse manager's role ( Shirey et al., 2010) and at least some management training is needed (McCallin & Frankson, 2010;Ramseur, Fuchs, Edwards, & Humphreys, 2018) starting already in nursing school (Brown, Crookes, & Dewing, 2016). The diversity of titles and the ...
Article
Aim To describe the nurse manager's role in perioperative settings. Background Role is complex and its content is unclear. There is a challenge to back up role with existing decision‐making support tools. Research in this area is scarce. We need to better understand what this role is to support nurse manager's work with information systems. Evaluation Integrative literature review was performed in May 2018. Cinahl, Cochrane, Pubmed, Web of Science and a manual search were used. Review followed a framework especially designed for integrative reviews. Quality of the literature was analysed with an assessment tool. Nine studies published between 2001 and 2016 were included in the final review. Key issue Nurse manager's role requires education and experience, and skills that are followed up by tasks. A bachelor's degree with perioperative specialisation is the minimum educational requirement for nurse manager. Conclusion The nurse manager's role in a perioperative setting is evolving. Research lacks a clear description of the role. It seems that the required education is at odds with the more demanding tasks. Information technology could provide useful support for task management. Implications for Nursing Management Findings can be used to better answer current and future demands of nurse manager's work. This article is protected by copyright. All rights reserved.
... In contrast, one-fifth of CNSs work as full-time nurse administrators such as head nurses, nursing vice-directors, or nursing directors. [11] The role of nursing administrators, and especially head nurses, is overall administrative responsibility, which involves ensuring optimal quality nursing care in their units [12,13]. To improve the quality of care, head nurses set goals, monitor important outcomes, and evaluate initiatives. ...
... The head nurse manages ward policy, nursing staff, and finances to achieve ward goals so that the staff can engage in effective nursing practice. However, head nurses placed in a highly specialized ward may experience difficulties in setting outcomes and goals [13]. This is because treatments are complex and care has a therapeutic aspect that influences the outcome. ...
Article
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Objectives This study evaluated the impact of the presence of a certified nurse specialist in critical care (CNS) as ICU head nurse in an open ICU on clinical outcomes. Methods The presence of a CNS as ICU head nurse was implemented in practice in April 2017. To evaluate the impact on patient outcomes before and after the implementation, patients were divided into two groups: before (April 2014 to March 2017; 1988 patients) and after (April 2017 to March 2019; 1664 patients). Patients’ demographic data were collected from the ICU database. Results Multivariable logistic regression analysis revealed that the presence of a CNS as ICU head nurse was associated with lower ICU mortality (odds ratio (OR): 0.52, 95% CI: 0.36–0.73, p < .001) and fewer patients receiving mechanical ventilation in the ICU (OR: 0.20, 95% CI: 0.15–0.26, p < .001). Conclusion CNSs are defined as one type of advanced practice nurses. Having a CNS as a head nurse in the ICU may have helped improve patient outcomes by leveraging these practical skills in nursing management.
... In Australia, NUMs are registered nurses who are accountable for leading clinical care and managing the business aspects of a ward or unit within health care organisations (ANMF, 2013). The term NUM has been used interchangeably in the literature with the terms nurse managers in the United States (IOM, 2011), ward managers in England (Locke, Leach, Kitsell, & Griffith, 2011), senior charge nurse in Scotland (Rankin, McGuire, Matthews, Russell, & Ray, 2016) and charge nurse managers in New Zealand (McCallin & Frankson, 2010). Nurse unit managers' accountabilities include quality patient care, staff satisfaction and retention, implementation of evidence-based practice, meeting budgetary requirements and execution of organisational change (ANMF, 2013; Gunawan & Aungsuroch, 2017;IOM, 2011). ...
... Internationally, role stress and challenges faced by NUMs are reported in the United States (Jones, McLaughlin, Gebbens, & Terhorst, 2015;Loveridge, 2017;McCright, Pabico, & Roux, 2018;Nelson, 2017;Shirey, McDaniel, Ebright, Fisher, & Doebbeling, 2010;Simpson et al., 2017;Steege, Pinekenstein, Arsenault Knudsen, & Rainbow, 2017) and Canada (Brown, Fraser, Wong, Muise, & Cummings, 2013;Udod et al., 2017;Wong & Laschinger, 2015). This is further supported by studies from New Zealand (McCallin & Frankson, 2010), the UK (Locke et al., 2011;Rankin et al., 2016;Timmons, 2017) and wider Europe (Adriaenssens, Hamelink, & Van Bogaert, 2017;Tewes & Fischer, 2017). Challenges include inadequate preparation and support to undertake the leadership role, role ambiguity, increased span of control and increased administrative load reducing opportunities for NUMs to be clinical leaders (Gunawan et al., 2018). ...
Article
Aim: To evaluate the impacts of introducing administrative support for nurse unit managers (NUMs). Background: Increased administrative load for NUMs is causing role stress and reducing opportunities for clinical leadership (State-wide Review, Queensland, Australia). In response, a health organisation implemented a clerical 'NUM Support Officer' (NSO) position. Methods: Qualitative descriptive evaluation, convenience sample (37 NUMs and NSOs), focus groups (13) provided data that was thematically analysed (guided by Braun and Clarke's framework). Results: Six impacts were identified: 1) improved NUM wellbeing; 2) more time to undertake clinical leadership; 3) greater efficiencies in finance, payroll and HR processes; 4) improved capacity for strategic leadership; 5) increased staff satisfaction and improved unit culture; and 6) improved succession planning. Conclusion: Findings reveal significant gains and benefits from the introduction of administrative support for the NUM role for the NUMs and the units they manage. Implications for nursing management: NUM role stress can negatively impact organisational climate, performance outcomes, and staff satisfaction and retention. Health organisations need to implement strategies to reduce the administrative burden for NUMs. The introduction of administrative support frees up time for NUMs to engage in clinical leadership, positively impacting organisational climate, performance outcomes, and staff satisfaction and retention. This article is protected by copyright. All rights reserved.
... E' un ruolo che trova difficoltà nella sua definizione, confermato dalla diversità della realtà pratica agita rispetto alla job description (McCallin & Frankson, 2010). Questo conduce alla mancanza delle caratteristiche che definiscono "il corretto candidato" (Kallas 2014). ...
... Inoltre è un ruolo in continuo cambiamento che richiede l'acquisizione sempre maggiore di competenze e "non è da sorprenderci se le competenze tradizionali del coordinatore possano essere fuori moda nell'attuale organizzazione dei servizi sanitari dove ci si aspetta che i manager siano dei leader (McCallin & Frankson, 2010). ...
... In our study, nurse managers reported their roles expanded or changed completely in response to COVID-19. Nurse manager roles are known to be ill-specified, leading to a lack of role clarity (McCallin & Frankson, 2010). These findings align with seminal research on nurse manager roles, which can change through "diffusion" or direct extension (Murphy, 1970, p. 381). ...
... Nurse managers are asked to recognize the pressure on clinical nurses and provide support (Labrague & Santos, 2020;Mo et al., 2020). However, nurse managers also need support themselves (McCallin & Frankson, 2010 There is an opportunity for organizations to reach out to nurse managers to inform responses to future pandemics. The participants in this study created strategies to maintain patient care quality and these strategies would be useful to capture for organizational development. ...
Article
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Aim The purpose of this study was to understand the experiences of nurse managers during the COVID-19 pandemic. Background There is a growing body of knowledge about the experiences of clinical nurses during COVID-19. However, there is less evidence about the experiences of nurse managers during the pandemic. Methods Eight nurse managers, from acute care and outpatient settings, completed semi-structured interviews about how their roles had changed during the pandemic, how they felt about these changes, and what had gone well or been difficult. Each participant was interviewed once, for 20-60 minutes. We used thematic analysis methods to analyse the interview transcripts. Findings Nurse managers had to coordinate care in a context of uncertainty and guidance that changed frequently. Participants found that their roles and responsibilities either expanded to include more duties, or they were asked to take on a completely new role, with no orientation or training. Nurse managers were expected to provide support to their staff and patients, but did not necessarily receive support themselves. Participants were expected to plan simultaneously for care during the pandemic and for a return to normal working conditions. These factors contributed to challenging and difficult participant experiences of managing during COVID-19. Conclusion Nurse managers’ experiences during COVID-19 are influenced by changes to their roles and the support they received. Nurse managers continue to support high quality care despite working a difficult context. Implications for nursing management Where possible, nurse managers can be supported to extend their roles, or receive additional education and support if they are required to take on new responsibilities. Nurse managers require support in order to be a resource for their staff.
... The final step is to "institute the change," in which the connections between new behaviors and corporate success are articulated and made permanent. Employee knowledge and attitudes toward the policy are the key components of successful change [12,13]. Hsiao et al. (2011) reported that efficient procedures as well as wellprepared hospital staff play an important role in the implementation policies [14]. ...
... The hospital developed strategies to obtain official AFH certification, including appointing a nurse manager as the CEO, forming a steering committee, and obtaining interdepartmental and interdisciplinary cooperation. Studies have indicated that appointing one person to be solely in charge of monitoring the progression of policy objectives is a factor in the successful establishment of HPHs, and nurse managers are a preferred choice for such positions [13,14]. ...
Article
Full-text available
The ageing population is a powerful and transformative demographic force. The World Health Organization (WHO) has encouraged the development of an age-friendly hospital (AFH) network. However, no specific implementation strategies or best practices of AFH standards have been produced. This study sought to apply Kotter's change model to the elements included in a successful AFH certification process and to evaluate the changes in employees' knowledge of ageing and their attitudes toward the elderly. This was an observational study that utilized a pre- and posttest design, before and after an age-friendly hospital certification process was implemented. Participants were 163 hospital employees in Taiwan, who completed both pre- and postquestionnaires. The self-administered online questionnaire consisted of three sections: The Facts on Ageing Quiz, the Geriatric Attitudes Scale, and a demographic questionnaire. Following introduction of the intervention, the change process began, and later Kotter's model was brought in as a descriptive framework. The results showed that Kotter's eight-step framework is a good choice for thinking about how to change practice and make healthcare more age-friendly. Employee knowledge of ageing and their attitudes toward the elderly improved after this certification process. Appointing a chief executive officer, forming a steering committee, obtaining interdepartmental and interdisciplinary cooperation, and "soliciting support" for new policies from all employees, were identified as key factors influencing the success of age-friendly hospital (AFH) certification. This is the first study to apply Kotter's eight-step framework of organizational change to an AFH certification process.
... Another aspect worth noting is that in perioperative care in Scandinavia, registered nurses (RNs) with long professional experience are recruited to have managerial responsibility and they are not prepared for what the assignment entails (Solbakken et al., 2020). This was also shown internationally, as was the fact that there was a lack of education in leadership, although OTNs were expected to meet the requirements and responsibilities of being a leader (Beitz, 2019;McCallin & Frankson, 2010;Pilat & Merriam, 2019). During the last year, perioperative care development has increased in Sweden (Blomberg et al., 2018a(Blomberg et al., , 2018b, patient flow has increased and OTNs claims that they are not given the opportunity to provide the patient with the care they need. ...
... Within perioperative practice, it is usual for OTNs with long professional experience to be recruited to assignments with managerial responsibility. These assignments demand that OTNs must be able to strategically plan and organize allocated resources to guarantee patient safety (McCallin & Frankson, 2010). Pilat and Merriam (2019) highlighted that expectations, essential knowledge and skills, graduate education prepared, sought support and mentoring from colleagues and role mastery is not possible. ...
Article
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Aim The aim of this study was to investigate operating theatre nurses (OTNs) with managerial responsibility, and their self-rated clinical competence and need for competence development in perioperative nursing. Design A cross-sectional study was applied using a modified version of Professional Nurse Self-Assessment Scale of Clinical Core Competence I. Method Data were collected from 303 OTNs in Sweden, 80 of whom indicated that they had managerial responsibility. Statistics analysis was used to identify the relationships between background variables to compare OTNs with and without managerial responsibility and their need for competence development. Results OTNs with an academic degree and managerial responsibility self-rated their clinical competence higher compared with OTNs without an academic degree. It also turned out that OTNs with RN education and 1-year advanced nursing in theatre care, and master's 60 credits had a lower need for competence development in cooperation and consultation, professional development and critical thinking.
... The CNS as head nurse also sets appropriate unit goals and outcomes while managing and monitoring the unit to improve the quality of care. [16,17] As a head nurse, the CNS is able to set more detailed goals and outcomes in managing the organization and make better use of human, physical, and financial resources, thereby attempting to improve care. When the CNS assumes the role of head nurse, they are able to set more detailed and realistic goals and outcomes by utilizing the perspective of an APN. ...
Article
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Certified Nurse Specialists (CNS) are advanced practice nurses that often play a role in management. This study aims to investigate whether cooperation between CNSs in the position of Intensive Care Unit (ICU) head nurse and intensivists change the length of stay for ICU patients. A single centered retrospective cohort study design was followed. A multivariable regression analysis was performed to determine whether there is a difference in patients’ length of ICU stay for two years before and after CNS as ICU head nurse and an intensivist started collaborating. The patients’ diagnosis, age, gender, scheduled/emergency admission, surgical history, length of ICU stay, usage of ventilator, and details of ICU treatment were collected from the institution’s electronic medical records. During the study period (April 2015 to March 2019), 3,135 patients were admitted to ICU, with 1,471 in the before collaboration group and 1,664 in the after-collaboration group. Collaboration between the CNS as head nurse and intensivists was significantly associated with shorter length of ICU stay (coefficient -0.03 [95% CI, -0.05–0.01], p < 0.001, t-statistic -3.29). Our main finding illustrates that in low-intensity ICUs, collaboration between CNSs as head nurses and intensivists may reduce patients’ length of ICU stay.
... A semi-structured, open-ended interview approach(Patton, 2005) was used to encourage participants to describe their perceptions of the role of nurses in LTCFs. Interview guides were structured around central topics emerging from the literature on supervisory support, including staff roles description; challenges associated with the roles; relationships between staff; quality of care and health outcomes; resident-centred care; retention and job satisfaction; perceived factors influencing effective supervision; enablers and barriers to supervision; and decision-making processes(McCallin & Frankson, 2010;McGilton, Boscart, Brown, & Bowers, 2014;McGilton et al., 2009). Questions in the interview guide included "Could you tell me a little bit about your job and what is it that you do?", "Please take me through a typical day for you.", ...
Article
Aim: The charge nurse in long-term care facilities (LTCFs) performs a multiplicity of tasks that range from oversight of the entire facility to directly assisting residents in activities of daily living. In order to refine resident-centred care strategies and to increase the quality of care provided in LTCFs, this study aims at gaining a more nuanced understanding of the different dimensions of the charge nurse role as a central figure in these institutions. Methods: Data were generated through semi-structured interviews. A purposive sample of ten Registered Nurses in a charge nurse role, diverse in experience, age, gender and background, was recruited from five LTCFs in Ontario, Canada. The study used a combination of conventional and direct qualitative content analyses. Findings: All tasks performed by the charge nurses were categorised in four dimensions: clinical, supervisory, team support and managerial. Administration was a cross-cutting sub-dimension which has gained presence over the years. Depending on the shift worked and the organisational structure of the facility, each dimension gained or lost weight as part of the overall role. Conclusion: These findings suggest that the charge nurse role is in a state of flux and lacking standardisation within and across facilities. LTCFs would benefit from increasing recognition of the role according to the wide range of tasks performed and responsibilities assumed, and by recruiting their charge nurses accordingly. Implications for practice: The proposed conceptual framework could be used to map and assess charge nurses' workloads and responsibilities, in order to enhance staff satisfaction and resident-centred care in LTCFs.
... Recent studies have argued for a greater focus on management competencies in health care and suggest that insufficient attention has been given to the development of management skills in health care (Ackerly et al., 2011;Enterkin et al., 2013;Berkenbosch et al., 2013;Yoder-Wise, 2014). However, strategies to develop these skills have been described as inadequate, contradictory and less than successful (McCallin and Frankson, 2010;Ackerly et al., 2011;Townsend et al., 2012). Whilst the application of competency modelling to develop physician and medical practitioner expertise is well established, management and leadership competencies exceed the normal role of the physician or medical practitioner and are often not present and deficient (Pillay, 2008;Dickinson et al., 2013;Kuhlmann and von Knorring, 2014;Pihlainen et al., 2016). ...
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Purpose Hospital organisations are currently experiencing significant challenges that have encouraged a move towards a value-based approach to health care. However, such a transition requires understanding the underlying competencies required to enable such a focus. This paper aims to undertake a systematic review of the available literature on managerial competencies in hospitals and considers these in a value-based health-care context. Design/methodology/approach A systematic literature review was conducted to identify research studies that describe the characteristics of management competence in hospital environments. Findings Categories and sub-categories of management competence in hospitals were identified and considered in a value-based health-care context. Research limitations/implications The systematic literature review identifies a need for further research regarding managerial competencies of managers of hospitals. Competencies for managing in a value-based health-care model also require deeper investigation. Practical implications The categories of management competence provide guidance to organisations transitioning towards value-based health care in terms of identifying and developing management competencies. Hospitals should consider the development of a competency model that includes broader categories of competencies than purely clinical or professional competencies. Originality/value This study builds upon and advances previous reviews of management competence in hospitals, and the competency categories presented can be used as a basis to identify management competency requirements in hospitals.
... Role ambiguity for NMs goes back almost 30 years, when major changes started to arise in health care sectors (Ernst, 1995;Lufkin, Herrick, Newman, Hass, & Berninger, 1992). More recent research including this current study indicates that NMs still experience confusion, self-doubt and uncertainty about what is expected of them, not only in Australia (Gaskin, Ockerby, Smith, Russell, & O'Connell, 2012;NSW Health, 2010) but also internationally (McCallin & Frankson, 2010;Stanley, 2006). Surprisingly, little research investigates the role of NMs as supporters of nurse well-being in any modern health care system. ...
Article
Abstract Aim: To explore how nurse managers perceive and experience their role in supporting the well‐being of intensive care nurses. Background: While it is known that nurse manager behaviours affect nurse well‐being, literature indicates that intensive care nurses may not receive the support they require. Understanding how nurse managers see their role in supporting nurse well‐being is crucial to offer recommendations for improvement. Methods: Qualitative multiple case study design. Twelve semi‐structured, in‐depth interviews were conducted with nurse managers from Australian intensive care unit settings. Data were analysed using thematic analysis. Results: Nurse manages felt unsure about what their supportive role involved, lacked training on how to support nurse well‐being and called for organisational backup to carry out their role effectively. The study also provided insight into the strategies that enabled nurse managers to support nurse well‐being. Conclusion: There is currently no consensus on the role of the nurse manager in supporting nurse well‐being resulting in inconsistencies and wide practice variations. Furthermore, nurse managers need support and training if they are required to support nurse well‐being. Implications for Nursing Management: A clear definition of the nurse manager supportive role describing the purpose and core functions involved in this role must be developed to support nurse well‐being.
... Although the need for leadership education is acknowledged by nurse managers, finding the time to attend postgraduate and continuing professional development opportunities is often challenging owing to competing demands of the workplace. Several alternative strategies have proven successful, including on-site organizational management training and mentorship (McCallin and Frankson 2010). Many established leadership models are available through nursing organizations, including the American Organization of Nurse Executives (AONE; Stefl 2008) and the Registered Nurses' Association of Ontario (RNAO 2013). ...
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Leadership is a critical component of health system performance. This paper describes a tailored leadership development program for nurse managers in an academic health network in Montreal, Canada, developed in collaboration with a university school of continuing studies. This program is aimed toward strengthening individual leadership competencies and developing a resilient nursing leadership community of practice. In total, 26 nurse managers across the health network participated in the program. Senior nurse directors participated by facilitating group discussions with the nurse managers. Program content was developed through a participative process and in direct response to senior leadership participation through online surveys, interviews and focus groups. An experiential learning approach was used to analyze incidents, explore problems and develop projects specific to the learners' context. The present paper describes the development of this program, outlines plans for evaluation and discusses the lessons learned throughout this process.
... From their study, McCallin and Frankson [60] concluded that the work of the NUM is complex, multifaceted, and challenging. Therefore, support for them is important. ...
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Background: Middle managers have not received enough attention within the healthcare field, and little is known how stressful factors in their work environment coupled with a lack of adequate sleep are related to musculoskeletal pain. The aim of this study was to examine the correlation between stressful factors in the work environment, lack of adequate sleep, and pain/discomfort in three body areas. Methods: Questionnaire was sent electronically to all female nursing unit managers (NUM) in Iceland through the outcome-survey system. The response rate was 80.9%. Results: NUM who had high pain/discomfort in the neck area also had very high pain/discomfort in the shoulder area and pain in the lower back. The results also revealed positive a medium-strong correlation between mental and physical exhaustion at the end of the workday and musculoskeletal pain. Stress in daily work, mental strain at work, and being under time-pressures had hardly any correlation with pain/discomfort in the three body parts. Adequate sleep had a significant negative correlation with all stressful factors in the work environment and all three body parts under review. Conclusion: The results will hopefully lead to a better consideration of stressful factors in the work environment, sleep, and musculoskeletal pain in middle managers.
... The proper knowledge of leadership and its importance and characteristics already in the early stages of a dentist career or during dental education, were found to be important to increase early interest in leadership in order to gain a new generation of younger leaders (Victoroff, Schneider & Perry, 2008, Kalendrian et al., 2010Taichman et al., 2012;Skoulas & Kalendrian, 2012;Morison & McMullan, 2013). Also, several authors who have studied other health care professions, for example physicians and nurses, have stated that leadership education would be important during graduate studies or soon after graduation (Koh & Jakobson, 2010;McCallin & Frankson, 2010;Busari, 2012;Snell, Briscoe & Dickson, 2012;Careau et al., 2014;Bekas, 2014;Brown & Dewing, 2016;Maddalena, 2016;Hargett et al., 2017;Schmidt-Huber, Netzel & Kiesewetter, 2017) as well as among those professionals who have recently started to work in a leader position (Steinhilber & Estrada, 2014;Clausen, Cummings & Dionne, 2017). Llewellyn (2001) described that a new area of expertise, medical management, could be developed. ...
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Purpose The purpose of this paper was to study the career paths of leaders with a career background as a dentist from basic degree to chief or executive leadership positions and individual factors that influenced their decisions. Design/methodology/approach Semi-structured interview and a questionnaire were used to study 13 leaders using the structure of Edgar Schein’s career anchor interview and career orientation inventory questionnaire. Theory-driven content analysis was used to analyze the data according to themes which included career paths, factors associated with job and career changes and thoughts about future careers. Findings Three different career path types were identified: Progressives (Type A), By chance (Type B), and Enthusiasts (Type C). The main motives were: the Progressives’ goal orientation to proceed to higher leadership positions, the By chance group’s job and even career changing by taking a chance on an interesting possibility that comes their way and the Enthusiasts’ willingness to make a difference and search for possibilities to change things. The most important career anchor was “pure challenge” among the Progressives and By chance groups and “general managerial competence” among the Enthusiasts. Originality/value Studies on personal factors associating with career paths in health care are scarce and similarly leaders with a dentist background are less studied, even though leadership could be an excellent career choice for a dentist. Different individuals can have varied motives and career paths toward executive positions. Because of the multi-professional functions in health care, organizations could benefit from having leaders with different expertise backgrounds.
... (Bergman et al, 2014) (Strelioff, 2007) Theme 3: Role factor Role preparation Three themes: Role ambiguity, business management deficit, and role overload. It is evident that charge nurse managers were not prepared for the management role (McCallin & Frankson, 2010) Work complexity The complex issues related to actual nurse manager work (specific responsibilities related to the role) and issues surrounding nurse manager work related to stress (interpersonal conflict, changing regulatory requirements, multiple ongoing hospital initiatives occurring simultaneously, and system inefficiencies) (Shirey et al, 2010) Job demand Challenge-related job demands (eg, workload, time pressure, and responsibility) and hindrance-related job demands (eg, role ambiguity, organizational politics, red tape, and job insecurity) were negatively related to managerial work and engagement (Simmons, 2013) development. Competence evaluation is the specific and formal evaluation of FLNMs to determine the degree to which they are performing their job (Manoharan, Muralidharan, & Deshmukh, 2009). ...
Article
Aims: To determine the factors contributing to managerial competence of first-line nurse managers. Background: Understanding factors affecting managerial competence of nurse managers remains important to increase the performance of organizations; however, there is sparse research examining factors that influence managerial competence of first-line nurse managers. Design: Systematic review. Data sources: The search strategy was conducted from April to July 2017 that included 6 electronic databases: Science Direct, PROQUEST Dissertations and Theses, MEDLINE, CINAHL, EMBASE, and Google Scholar for the years 2000 to 2017 with full text in English. Quantitative and qualitative research papers that examined relationships among managerial competence and antecedent factors were included. Review methods: Quality assessment, data extractions, and analysis were completed on all included studies. Content analysis was used to categorize factors into themes. Results: Eighteen influencing factors were examined and categorized into 3 themes—organizational factors, characteristics and personality traits of individual managers, and role factors. Conclusion: Findings suggest that managerial competence of first-line nurse managers is multifactorial. Further research is needed to develop strategies to develop managerial competence of first-line nurse managers.
... 20,21 However, efforts to develop competent health-care managers and leaders have proven insufficient without a clear focus and direction. 20,22,23 Such deficiency is more prominent in the under-resourced and less developed countries such as Iran. ...
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Background Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system including hospitals. The purpose of this study is to synthesize the evidence related competency to management and leadership in healthcare organizations including hospitals through the Best Fit Method. Methods A systematic literature review was performed to identify studies focusing on confirming and/or assessing the competency requirements of health service managers in particular hospital managers. The following electronic databases were searched from January 2000 and December 2018: ISI/Web of Sciences, PubMed, Scopus, Emerald, and the Scientific Information Database. Applying the Best Fit Framework Synthesis Method, we mapped all of the competency and associating behavioral items against the validated MCAP management competency framework which includes 6 core competencies, 18 subthemes and 83 associating behavioural items. Results Eleven studies were identified for inclusion in the review. The mapping of the competencies and relevant items identified in these studies with the validated MCAP management competency framework and associating items confirm that the MCAP framework has vastly represented findings of all recent studies. Although the MCAP framework incorporated behavioral items associating with the competency of Professionalism into the six core competencies, the study found the necessity of treating Professionalism as an independent competency to be included in the global management competency framework for health service managers, in particular hospital managers. As a result, the proposed Global Management Competency Framework includes the following 7 competencies: evidence-informed decision making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism. Conclusions This review and the mapping of the competencies identified in previous studies with the validated MCAP framework resulted in the recommendation of Global Management Competency Framework for health service managers. It provides useful guidance to the formulation of training and development direction for the health service management workforce. However, since management competencies are context sensitive, in order to developing a more targeted approach or target curriculum for the development managers from different sectors, management levels, validation is recommended.
... 20,21 However, efforts to develop competent health-care managers and leaders have proven insufficient without a clear focus and direction. 20,22,23 Such deficiency is more prominent in the under-resourced and less developed countries such as Iran. ...
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Objective: Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their management competence, understanding of management competency requirements is important. The purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method. Methods: A systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework. Results: Twelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism. Conclusion: This review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context.
... Planning of unit activities should conform to the general mission of the hospital and NMs should be encouraged to adhere to the plans, using basically as guides which will help structure management of the unit. Nonetheless, this finding is inconsistent with a study in New Zealand by McCallin and Frankson (2010) who contended that most NMs use 'shortcut' without any form of effective planning. The inconsistency in the results may be attributed to the methodology, McCallin and Frankson (2010) examined the general roles of NMs. ...
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Introduction Nurse managers (NMs) have a multifaceted role in translating organizational strategic vision, values, and objectives into action at the unit level. NMs do not only provide administrative and clinical leadership but have 24-h responsibility for all patient care services in the unit. Even though there is a paucity of literature on management competencies, NMs need to effectively and efficiently discharge their management roles. Using the Katz model as the organizing framework, this study examined important management competencies significant for healthcare delivery. Methods A quantitative exploratory design was used to collect data from 522 nurses in 19 hospitals in the Greater Accra region. Data were analyzed using descriptive statistics. Results The findings revealed that NMs possessed all the management competencies of the Katz model. NMs exhibited moderate level of management competencies (mean = 3.47, SD = 0.97); technical skill was the highest scored (mean = 3.56, SD = 0.96), followed by conceptual skill (mean = 3.50, SD = 0.98) and human relationship skill (mean = 3.34, SD = 0.99). Conclusion NMs have been identified as critical stakeholders in addressing healthcare challenges therefore, it is imperative to equip them with the relevant skills to enable them to manage these challenges in order to enhance and enable effective, efficient, and responsive healthcare systems. The study identified technical, human, and conceptual skills to be essential for nursing management in Ghana. This study is timely as the Ghana Health Service aims at strengthening the leadership and governance capacity of the health workforce.
... Managing a medical facility is no longer just about highly professional medical knowledge. The managerial skills of top health care managers are increasingly being discussed, as well as their insufficient level compared to the business sector (Ackerly et al., 2011;McCallin & Frankson, 2010;Townsend et al., 2012;Warren & Carnall, 2011). Authors Pihlainen, Kivinen and Lammintakanen (Pihlainen et al., 2016), Enterkin et al. (Enterkin et al., 2013) and Yoder-Wise (Yoder-Wise, 2014) point out, that not only to the lack of basic managerial knowledge and skills, but especially to the lack of an innovative approach in management in the form of various modern tools and techniques offered by current management theory. ...
... A head nurse manages the nursing unit, and a charge nurse is a registered nurse who oversees a unit during their shift [21]. The charge nurse's duties include direct nursing and administrative work, and the scope of the job is often unclear [22]. ...
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The mental health of nurses participating in patient care is under threat amid the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify the mental health status (depression, anxiety, and stress) and its influencing factors on nurses who provided patient care at a specialized hospital for COVID-19 in South Korea. Of the 180 nurses who participated in this study, 30.6% had moderate or higher levels of depression, 41% had moderate or higher anxiety levels, and 19.4% had moderate or higher stress levels. In this study, stigma influenced nurses’ mental health, such that the higher the stigma, the higher the nurses’ depression, anxiety, and stress. Depression was higher in female nurses than in male nurses, and stress was higher in charge nurses than nurses in other job positions. Therefore, a management program should be designed to improve the mental health of nurses during the current pandemic. In particular, a solution to reduce stigma is required, and the mental health of female nurses and nurses in leadership roles requires special attention.
... Our study further revealed that targeted professional development programs on subjects such as project management, change management and business case development can enhance the capacity of NMUM to deliver effectively on their multifaceted responsibilities. Consistent with our findings, previous studies have identified confusion among NMUMs concerning the boundaries and expectations of their role, worsened by inadequate professional development opportunities relating to leadership and management in Australia [6,20,21], New Zealand [22], Ireland [23] and South Africa [24]. ...
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Background Nurse and Midwifery Unit Managers (NMUMs) play pivotal roles in quality patient care, nurse and midwife satisfaction and retention. NMUMs are expected to be both leaders and managers simultaneously, which may create role tension. This study aimed to explore the understanding and experience of NMUMs regarding their role; to explore what barriers and facilitators NMUMs identified to achieving the goals of their clinical area; and to explore NMUMs’ career plans. Methods Set in Victoria, Australia, this study was guided by naturalistic inquiry using a qualitative descriptive approach. Thematic analysis was used to inductively develop core themes, which facilitated the motivations, experience and meanings underlying the data to be elaborated. Results In all, 39 interviews were conducted with NMUMs across four hospitals. Two overarching themes were identified from the data; system challenges and influences on people and each theme had three sub-themes. In relation to system challenges, participants spoke about the structural challenges that they encountered such as financial stressors and physical infrastructure that made their work difficult. Participants felt they were unprepared for the NMUM role and had limited support in the preparation for the role. Participants also related their frustration of not being included in important decision-making processes within the hospital. Regarding their career plans, most did not envisage a career beyond that of a NMUM. Conclusions This study of contemporary NMUMs uncovered a continued lack of investment in the orientation, professional development and support of this critical leadership and management role. There is an urgent need for targeted interventions to support and develop capabilities of NMUMs to meet the current and evolving demands of their role.
... There is some evidence, however, that managers in the NHS lack knowledge of initiatives to manage work-related stress 142,143 . Nurse managers may also feel they do not have the skills for this role, and this can undermine their effectiveness 144 . ...
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Organizations providing health services are often criticized because of inadequate and unsuitable management processes or procedures. Today’s challenge is focused on effective management and leadership skills in the area of health care. The aim of the research is to describe, analyze, and evaluate the current state of diversity management in details in the context of human resources management in the selected healthcare facilities. The source of the information was a questionnaire survey. The sample consists of 181 managers from various health care and health service organizations. The method of analysis of variance (ANOVA) was used for data processing. The results were processed in SPSS and Excel programs. Pearson’s coefficient was used to evaluate the cross-correlation of the variables. The level of significance was 5% on both sides. Basic awareness of diversity management in the healthcare facilities is low. Some tools of diversity management are used, but only in isolation, non-conceptually, and unsystematically. The acknowledgment of diversity concept is poor and chaotic. The basic models of this concept defining its goals, activities, programs, responsibilities, and measurements are not known. One of the strong areas of the diversity management in the healthcare facilities is the diversity of working teams. On other hand, the weak side is the diversity as part of the organization culture and diversity as a part of human resource management. The summarizing index Attitudes towards Diversity received a higher average value than the Diversity Management Implementation index. Significant variables influencing the level of aggregate indices were identified: Ownership, size of the organization in terms of number of employees, patients’ satisfaction, and employees’ satisfaction.
Article
Aim: To explore the current evidence on business acumen of nurse leaders. Background: Health systems across the world are under immense pressure to stay solvent, maintaining services within a defined budget as we recover from the COVID-19 pandemic. Effective nurse leaders not only need to have strong leadership and management skills, but also strong business acumen to navigate the complexity of the system. Evaluation: A scoping review of research was undertaken, using PRISMA scoping extension checklist, with 571 studies found across multiple databases, 17 meeting final review eligibility. Key issues: Findings were noted surrounding three themes: the value of business acumen in nursing, the gaining of business acumen in healthcare as a nursing leader, and the utilising business acumen as a nurse leader in the healthcare industry. Conclusion: While nursing leadership and management were well researched, limited studies covered the specific focus of business acumen in healthcare for nurses or broader clinicians. Implications for nursing management: While evidence points towards business acumen being important for healthcare leaders in balancing care and cost, inadequate research limits the recognition of these professional capabilities of nurse leaders. Further understanding could inform future policy and curriculum, as well as empower our next generation of clinicians.
Article
Background Operating rooms have stressful and complex working environments. Working in a stressful environment and exposure to various risk factors could affect human health both physiologically and psychologically and causes fatigue. The purpose of this study was to examine fatigue levels and factors affecting fatigue in operating room nurses. Methods This research was a descriptive, cross-sectional study. The study sample comprised 99 nurses working in operating rooms of hospitals in a city in Aegean Region of Turkey. Data were gathered with a descriptive characteristics form and the Checklist Individual Strength between December 2019 and February 2020. Data analysis was performed by using numbers, percentages, mean, standard deviation, Student's t-test, one-way ANOVA, Kruskal-Wallis, Mann-Whitney-U and Pearson correlation tests. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist for cross-sectional studies was used for reporting study data. Results The mean age of the nurses was 30.68±8.78 years, the mean duration of operating room experience was 5.37±4.78 years and the mean working time was 48.65±5.93 hours/week. The lowest and the highest fatigue scores of the nurses were 34 and 128 respectively with a mean of 77.53±18.76. A significant difference was found between fatigue levels according to presence of a chronic disease, type of hospital, activity levels, job titles and types of work schedules (p<0.05). Conclusions The level of general fatigue of the operating room nurses was not high. However, nurses having a chronic disease and a sedentary lifestyle and being always on the daytime shift had higher fatigue levels. Body mass index, weekly working hours, age and duration of operating room experience had a correlation with fatigue levels.
Article
The aim of this research was to describe nurse managers' leadership and management competencies (NMLMC) from the perspective of nursing personnel. Nurse managers are responsible for the management of the largest professional group in social and health care. The assessment of NMLMC is needed because of their powerful influence on organizational effectiveness. An electronic survey was conducted among the nursing personnel (n = 166) of 1 Finnish hospital in spring 2016. Nursing personnel assessed their manager using a NMLMC scale consisting of general and special competences. The data were statistically analyzed. Leadership and management competencies were assessed as being quite good by the nursing personnel. The best-assessed area of general competence was professional competence and credibility and the weakest was service initiation and innovation. The best-assessed area of special competence was substance knowledge and the weakest was research and development. The nursing personnel's assessment of their nurse manger's competencies was associated with the personnel's education level, working experience, and with their knowledge of the manager's education. Conclusion was made that nursing personnel highly value professional competence as part of nursing leadership and management. To achieve more appreciation, nurse managers have to demonstrate their education and competence. They must also work in more open and versatile ways with their nursing personnel.
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This study explored first-line managers’ leadership behavior profiles regarding their goals for utilizing the garden at residential care facilities for older people. Semi-structured interviews were conducted with a convenience sample of first-line managers (n = 12) in Sweden. Data were analyzed using deductive content analysis theoretically guided by the Three-dimensional Leadership Model. The results showed that the main leadership behavior profiles were related to the dimensions structure, relation and change. The managers emphasized workplace regulations and goals. They allowed staff to make decisions and encouraged them to see problems and opportunities.
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The need for highly engaged frontline nurse managers is becoming more evident to affect staff engagement, patient care, safety outcomes, and advancing nursing practice. At Ann & Robert H. Lurie Children's Hospital of Chicago, we created an effective framework and process to assess engagement and leadership development data across 7 units. This provided the evidence to design a relevant solution to support our frontline nurse leadership engagement and affect our frontline staff nurses' levels of engagement. To develop the framework and process, the Associate Chief Nursing Officer (ACNO) and the Director of Leadership and Organizational Development partnered to assess the engagement data, and outlined a process that led to the development of the Leadership Engagement Academy (LEA) for frontline nurse managers. Through this framework and process, there were key areas of engagement to have an effect at both the leadership and staff level across 7 units, in alignment with the American Nurses Credentialing Center (ANCC) Nursing Excellence standards.
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Objective: The aim of this study was to identify clinical nursing research priorities among nurse managers (NMs). Background: Determining research priorities is the 1st step toward building a solid evidence base for clinical practice. NMs are well poised to identify research priorities, and yet, a literature review revealed a dearth of research priorities as determined by clinical NMs. Methods: Using a Delphi survey, 38 NMs were queried at a large, urban hospital regarding critical priorities for nursing research. Results: Critical priorities for clinical nursing research included nursing workforce/nursing workflow and communication (categorized as critical by 68% and 53% of NMs, respectively). Other important priorities focused on falls/patient safety/hospital-acquired infections, patient/family satisfaction, emergency preparedness, patient outcomes, and collaboration/interdisciplinary research. Conclusions: Because NMs are positioned to direct clinical research agendas, the results provide a critical guide for policy development surrounding nursing research. Directing research toward these identified topics will help build a solid evidence base for nurses and ultimately improve patient outcomes.
Article
Given the wide professional discussion on the dominating professional focus of healthcare managers at the expense of management knowledge, the main goal of this paper is to verify the extent, to which management education of healthcare workers affects the level of their management skills. Methodology The Descriptive statistics methods have been used to answer research questions regarding the differences in the perception of the managerial skills and their disposition importance between managers with a completed management education and without it. Emphasis was placed on people management skills and communication skills. The research sample consisted of 253 healthcare managers. Results Managers with a completed specialized management study are characterized by higher values of entrepreneurial competences and communication skills. They also have exceptional skills in the area of initiator of change. Another significant difference is the higher adaptation of roles and low critique of their subordinates. They are oriented at workers and relationships with them. Conclusion Our results show that management education of healthcare managers significantly contributes to the implementation of newer approaches to people management and the use of the necessary management skills, which are a source of higher efficiency in the context of the present world of work and its challenges.
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Nurse managers play a vital role within nursing services administration. In order for the nurse manager to provide the level of service defined by their job description, a practical span of control is necessary. The University of Texas medical Branch (UTMB) utilized a comprehensive approach to accurately assess acute care nurse manager's span of control within the organization. Findings indicated that approximately 56% of UTMB nurse managers have an acceptable span of control, whereas 44% had an excessive span of control. Recommendations include the need to evaluate clerical support staff, provide leadership education that includes elements of social/emotional intelligence, and implement best practice initiatives.
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Aim(s) To understand how nurse managers facilitate learning in clinical workplaces. Background Meeting staff learning needs in the complex workplaces of contemporary health care is paramount to the delivery of safe patient care. Hospitals employ a range of strategies to address these needs. However, nurse managers’ contribution to staff learning at the unit level is under-explored in contemporary literature. Method(s) A Gadamerian philosophical hermeneutic framework guided data collection and analysis. Thirteen nurse managers from two Australian hospitals each participated in two interviews and a period of observation. Findings Nurse managers’ learning facilitation practices were enacted with staff individually, within teams, and through artefacts, and were shaped by their identities, perspectives on staff learning, knowledge of staff performance, and motivations. Power was revealed as a uniquely enacted driver of their learning facilitation practices. Conclusion(s) This paper illuminates an aspect of nurse managers’ practice that has been poorly acknowledged in contemporary nursing literature. Nurse managers’ learning facilitation practices were found to be complex, fluid, and embedded in their every-day work routines. Implications for Nursing Management Given current concerns about safety and quality in healthcare, this research opens up possibilities for definition and enrichment of nurse managers’ practice as facilitators of learning.
Article
BACKGROUND Structural empowerment (SE) is an effective method of advancing work environments and has previously been widely discussed in Western countries. Due to the lack of culturally and academically accepted scales in Iran for measuring SE, localization of a foreign scale in this field is necessary. OBJECTIVES This study aimed at investigating the validity and reliability of the Persian Version of the Conditions of Work Effectiveness Questionnaire-II (CWEQ-II-PV) among Iranian nurses. METHODS The present cross-sectional methodological research was conducted during 2017–2018. Participants were 230 nurses working in four teaching hospitals affiliated to Kashan University of Medical Sciences in Kashan, Iran, who were selected using quota sampling. A standard forward–backward translation procedure according to Wild et al. (2005) was used to translate the English Version of the CWEQ-II to Persian. The psychometric evaluation processes were achieved by face, content, and construct validity (confirmatory factor analysis [CFA]). Reliability was examined using test–retest and Cronbach's alpha for internal consistency reliability. RESULTS The CWEQ-II-PV showed good content validity (the mean content validity scores for relevancy, clarity, and simplicity were 94%, 96%, and 94%, respectively). In the CFA, the original six-factor version with 19 items was confirmed. The original model was presented and incorporated in the CFA, indicating an acceptable fit for the model (root mean square error of approximation = 0.06, comparative fit index = 0.92, goodness of fit index (GFI) = 0.94, and adjusted GFI = 0.91). Cronbach's alpha coefficient for the total scale was 0.84 and for each component ranged from 0.71 to 0.87, indicating good internal consistency, and the test–retest Spearman and intraclass correlation coefficients were 0.93 and 0.87, respectively, showing good test–retest reliability. CONCLUSIONS Evidence was found to support the reliability and validity of the CWEQ-II-PV scale that measures the quality of the work environment for nurses from a SE perspective.
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Background: Nurse managers are leaders in mining primary healthcare. Their leadership roles include inspiring and empowering operational managers and nursing personnel, by leading with competence developing them to become followers with insight and direction. However, these leadership roles are not clearly defined, and are negatively influenced by the traditional mining leadership style. Objectives: The aim of this study was to explore and describe the nurse managers’ experiences of their leadership roles in a specific mining primary healthcare service on the West Rand, to develop recommendations to enhance these roles. Method: A qualitative, exploratory, descriptive and contextual research design was used in this study, following a phenomenological approach as a research method. A non-probability purposive sampling method was used. Nurse managers described experiences of their leadership roles during individual phenomenological interviews. Data saturation was reached on participant number 7. To analyse data, four stages of Giorgi’s descriptive phenomenological data analysis was used. An independent coder coded the data and a consensus meeting was held. The study was guided by the theoretical framework of Winkler’s role theory. Results: The following subthemes emanated from data analysis: (1) leadership role ambiguity, (2) leadership roles experienced and (3) challenges experienced in leadership roles. Conclusion: This study revealed that the leadership roles for nurse managers in a specific mining primary healthcare service are not clearly defined. Hence enhancements and expansions of these leadership roles remained stagnant. A clearly defined policy on leadership roles for nurse managers should be developed. Keywords: nurse managers; experiences; leadership roles; mining; primary healthcare.
Article
Aims: This study described the development and psychometric testing of the competency inventory for nurse managers across all levels in Taiwan. Background: The competency-based approach to develop nursing leadership and management competencies for the healthcare context is still insufficiently explored in terms of professional development in nursing administration. Methods: This study used mixed methods, including qualitative study for generating the preliminary inventory and a cross-sectional survey of 573 nurse managers for psychometric properties of the inventory. Results: Exploratory factor analysis revealed four domains with 23 items that explained 58.21% of the overall variance. The overall Cronbach's alpha coefficient was 0.93. Confirmatory factor analysis showed a well-fitting goodness-of-fit statistics. The construct validity was adequate, with an average variance extracted of 0.68 and composite reliability of 0.90. Conclusions: Across different levels, nurse managers have 23 essential competencies. The competency inventory demonstrates adequate psychometric properties with good construct validity and internal consistency, thereby reliable and valid for guiding the competency development of nurse managers. Implications for nursing management: The essential competencies of the inventory can serve as a criterion-referenced measurement for competence proficiency in professional development of nursing administration and contribute to performance improvement of nurse managers in practice.
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The job satisfaction of nurses is reflected in almost all organizational outputs of medical facilities. First-line nurse managers (FLNMs), who are directly related to subordinate nurses, have a great influence on this satisfaction. The aim of our paper is to examine the connection between communication skills and the transformation style of FLNMs management with the job satisfaction of nurses and to verify the influence of three moderators on the strength of this relationship. The chosen moderators—the practice of managing FLNMs, the degree of control (span of control) and psychosocial work—follow from theoretical studies. The moderating effect of the variable management practice is also significant from the point of view of Slovak legislation. The sample consisted of 132 FLNMs from five university hospitals in Slovakia. Data collection took place in the form of a questionnaire. All data were processed using the SPSS 24 software package. A series of regression analyzes were used to identify the proposed hypotheses. ANOVA analysis was used to analyze multiple dependencies. We worked at a 5% level of significance. The findings point to the strong direct effects of communication skills and the transformational leadership style of FLNMs on nurses’ job satisfaction. Moderation effects are mild, but significant in the case of management and span of control practices. The lower values of both variables reinforce the positive relationships among the two predictors and the job satisfaction of nurses. The third moderator, psychosocial work factors, also have a significant moderating effect, which is negative, and the higher value of this moderator mitigates both positive direct effects.
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Modern dünya, yaşantıları, davranışları ve yönetim biçimlerini etkileyen birçok değişiklikle tanımlandığı için örgüt kültürüyle ilgili çalışma, vurgulanması gereken ihtiyaçlardan biridir. Etkili model liderliği değerlerin, tavırların ve davranışların şekillenmesiyle ve gelişimiyle örgütsel amaçların gerçekleştirilmesine yardımcı olur. Bu çalışma, hastane çalışanlarının örgüt kültürü türleri ve hastanelerdeki yöneticilerin liderlik tarzlarıyla ilgili algılarını ve bu iki alan arasındaki ilişkiyi tanımlamayı amaçlamıştır. Çalışmada, Gazze Şeridi ’ndeki 5 hastaneyi – 3 kamu hastanesi ve 2 vakıf hastane – kapsamaktadır. Haziran ve Aralık 2018 tarihleri arasındaki dönemde 400 katılımcıyı içeren tanımlayıcı bir kesitsel tasarım kullanılmıştır. Hedef nüfus, doktorlar, hemşireler, yardımcı sağlık hizmetleri ve yöneticiler gibi hastanelerdeki tüm çalışan kategorilerini kapsamıştır. Katılımcıların örneklem boyutları, hastanelerin türlerine ve kapasitelerine göre farklılık göstermiştir. Katılımcıların %78,3’ünün lisans derecesine veya daha yüksek derecelere sahipken %21,3’ünün diploma veya altı derecesi bulunmaktadır. En yüksek katılım oranı %37,2 ile hemşirelere aitken, bunu %28,8 ile doktorlar, %23,7 ile yöneticiler ve %15 ile yardımcı sağlık hizmetleri takip etmiştir. Gazze Şeridi hastanelerinde örgüt kültürünün en belirgin türleri, kabile ve hiyerarşiye dayalı kültürlerdir. Tüm örgüt kültürü türlerinde vakıf hastanelerinin kamu hastanelerine göre daha yüksek ortalaması bulunmaktadır. Araştırma, örgüt kültürünün ölçekleriyle ilgili algıların, sırasıyla 3,36; 3,27 ve 3,24 ortalamalarla kabile kültürü, hiyerarşi kültürü ve adhokrasi kültürü için en yüksek olduğunu ortaya çıkarmıştır. İncelenen hastanelerdeki yönetici tarzlarının, dönüşümcü liderlik ve etkileşimci liderlik tarzları olduğu görülmüştür. Dönüşümcü liderlik tarzı, en yüksek ortalamaya (x̄=3,68, Ss = 0,57) sahipken, onu etkileşimci tarzı (x̄=3,50, Ss= 0,47) takip etmiştir. İdeal etki (davranışsal), en çok algılanan liderlik davranışıydı (x̄=3,79, Ss = 0,69). Çalışmanın sonuçları, dönüşümcü liderlik ve etkileşimci liderlik tarzları ve örgüt kültürü türleri arasında değer olumlu ilişki göstermiştir. Çoklu regresyon analizi, liderlik tarzının liderlik sonuçları ve örgüt kültürü türleri üzerinde etkisi olduğunu ortaya koymaktadır. Bu çalışma, konuyla ilgili mevcut araştırmaya katkıda bulunma ve Gazze Şeridi’ndeki hastane sektörünün belirli yönlerini anlamakla ilgili boşlukları kapatma konusunda başarılı olmuştur. Aslında, bu etkinin gücü, sağlık kuruluşlarının karşı karşıya olduğu sorunların ve güçlüklerin ayrılmaz bir parçası olduğunu kanıtlayabilir niteliktedir. Anahtar Kelimeler: Filistin, Gazze Şeridi, Hastane, Liderlik, Örgüt Kültürü
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Introduction: Due to the time constraints in the nursing system, it seems necessary to assess the time management competency of clinical nurses. Time management has sociocultural nature. Existing time management tools have not considered social aspects of time management. The purpose of this study was to design a questionnaire for assessing the social component of time management competency in clinical nurses population. Methods: This research was carried out with a explanatory sequential mixed methods design. First, qualitative study and using the grounded theory method, the concept of social components of time management competency of clinical nurses was explained. Based on quotations, the items of the initial questionnaire was generated and then the face and content validity was determined by using the quantitative and qualitative methods. The construct validity was determined with the exploratory factor analysis. The reliability was approved with the measurement of internal consistency using Cronbach's alpha coefficient and the stability assessed using a test-retest (Interclass correlation coefficient) method.. Results: Of the first 41 items, 36 items entered into the exploratory factor analysis after calculating the impact score of items with values higher than 1.5, content validity ratio higher than 0.53, content validity index higher than 0.79, and item analysis. In construct validity step, 29 items was grouped into 6 factors. The internal consistency of the questionnaire was 0.858 and the stability (ICC) of the questionnaire was 0.906. These 6 factors explained 46.714 % of the variance of the Questionnaire Conclusion: The questionnaire, according to its designation, can be used to assess the social components of time management competency of clinical nurses.
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Managers should spent quality time to the basics of managing people, which if not done effectively, will result in the widespread failure that will be damaging to both employers and employees. Managers should not tell people to do their jobs, but rather let employees come up with their own methods to make them feel good inside. Employees need a boss who will set them up for success at every step and will help them earn what they need. Managers should practice the art of real empowerment that particularly include guidance, direction, and support. They should also get into the habit of managing everyday, learn to talk like a performance coach, make accountability a real process, tell people what to do and how to do it, and solve small problems before they turn into big problems. Managers should also help their employees in clarifying their goals, guidelines, and specifications, and also help them monitor, measure, and document their success every step of the way.
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Although nurse managers play a pivotal role in creating work environments for staff nurses, performance expectations for nurse managers practicing in acute care hospitals may be unrealistic. The authors discuss nurse manager interview data showing that these expectations are increasing nurse manager perceptions of stress, making coping more difficult, and potentially harming nurse manager and work environment well-being.
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Burnout among nurses is a serious condition that threatens their own health and that of their patients. In current health care settings, nurses are particularly at risk for burnout given the increased patient acuity and the worsening nursing shortage. This study examined the influence of effort-reward imbalance, a situational variable, and core self-evaluation, a dispositional variable, on nurse managers' burnout levels over a 1-year period. A predictive longitudinal survey design was used to examine the relationships described in the model. One hundred and thirty-four nurse managers responded to a mail survey at two points in time. As hypothesized, both personal and situational factors influenced nurse manager burnout over a 1-year time frame. Although burnout levels at Time 1 accounted for significant variance in emotional exhaustion levels 1 year later (beta = 0.355), nurses' effort-reward imbalance (beta = 0.371) and core self-evaluations (beta = -0.166) explained significant additional amounts of variance in burnout 1 year later. Both personal and situational factors contribute to nurse manager burnout over time. Implications for nursing management Managers must consider personal and contextual factors when creating work environments that prevent burnout and foster positive health among nurses at work.
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This study examines how nurse managers' leadership behaviour relates to job satisfaction and a creative work climate. The nursing shortage is a challenge for managers all over the world. Leadership is a core element of management and it is important to elucidate leadership behaviour in order to increase knowledge about attracting and retaining talented staff. We studied 770 subordinates at a large university hospital. Three questionnaires for assessing perceived leadership behaviour, creative work climate and job satisfaction were used. Subordinates with a manager perceived as 'super' have the highest rates on job satisfaction. The correlation between leadership and creative work climate is stronger than between leadership and job satisfaction. Between job satisfaction and work climate the correlation is strong. The study shows that the relationship between a creative work climate and job satisfaction is strong. A managers' ability to lead has a major affect on work climate. Nurse managers must work on developing their leadership behaviour towards being an all-round leader that cares about people, is concerned about productivity and can handle changes. Support of ideas and initiatives are important in order to enable subordinates to perceive their work as challenging.
Article
The aim of the study was to describe and compare the characteristics of the nurse manager's work in different hospital environments and at different times. Business values and pressures for cost efficiency have become a reality in health care. The data comprised the diaries of 155 nurse managers working in one Finnish health district's hospitals in the 1990s and 2000s. In addition, focus group interviews were used as a data source. The data were subjected to qualitative and quantitative content analysis. The nurse manager's work comprises responsibility activities, accountability activities, and traditional bedside nursing. They also described the recognition of the underlying premises of their work and outcome orientation. Their descriptions of work varied between university and rural hospitals, between psychiatric and somatic nursing and between different wards. The work changed in the 2000s as the nurse manager's role changed from nurse to nurse leader. It appears that nurse managers have succeeded in integrating different leadership models into their daily work pattern. A new leadership model was devised based on an emerging nursing framework. Nurse leaders should assess who can assume leadership positions in health care and on what grounds.
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