Nurse Executives Research Articles

Deborah Zimmermann, DNP, RN, NEA-BC, FAAN

Deborah Zimmermann, DNP, RN, NEA-BC, FAAN, is chair of the American Organization for Nursing Leadership (AONL) Foundation.

Air Force Executive Nurse Leadership Impact: Brigadier General Diann Hale O’Connor, Air Force Nurse Corps Chief From 1982 to 1985

In the 1980s, nurses became more recognized as interprofessional healthcare partners who actively participated in the advancement of patient care and the nursing profession. There is a significant gap in the nursing literature about the significant contributions of executive military nurse leaders. The purpose of the interview with Brigadier General (Brig Gen) Hale O'Connor was to explore the personal stories, experiences, leadership strategies, lessons learned, and impact of her leadership on the future development of nursing as a profession. The oral history method provided a framework for the interview and the analysis. In compliance with the Oral History Association guidelines, the primary investigator obtained Institutional Review Board permission, participant informed consent, and an audiotaped interview. A graduate research assistant transcribed the 3-hour audiotaped interview verbatim. The participant reviewed the transcription, provided clarification, and validated accuracy. Three independent coders extracted prevalent themes and subthemes during analysis. Researchers compared findings and reached a consensus when resolving minor discrepancies. Two broad thematic qualities, commitment to duty and fairness, emerged from the data with their respective subthemes. Subthemes of trust, patriotism, loyalty, and assiduousness supported the main theme of commitment to duty. Pillars of alignment, equality, and advocacy supported the broad theme of fairness. Although the team did not use the Reina Trust Model as a framework, the trust-building behaviors emerged from the transcribed interview during the analysis. Surprisingly, many of the leadership strategies utilized by Brig Gen Hale O'Connor fit well into the Reina Trust Model, published 25 years following O'Connor's tenure as Chief, Air Force Nurse Corps. In addition, several of Brig Gen Hale O'Connor's leadership accomplishments are still relevant today, solidifying the observation that the foresight of Brig Gen Hale O'Connor was fundamental to the advancement of nursing during her tenure and for those who followed.

Leading Through Chaos: Perspectives From Nurse Executives.

The COVID-19 crisis created unique and interesting challenges for health care systems and changed how health care professionals delivered care. Evidence suggests that leadership skills remain of utmost importance during crises as it is the leader who often determines the response of the follower. A descriptive qualitative approach was used to ascertain the essence of nurse executive leadership and innovation during the COVID-19 crisis. Nurse executives were recruited via personal invitations to participate in the study. Participants were asked about their current challenges of COVID-19 on health care delivery, their leadership style, and what innovative processes their teams deployed. Using a thematic analysis approach, 3 themes emerged and resonated from the interviews: the importance of communication; the need for leadership presence; and mental toughness. With any health care crisis, leadership is essential to guide followers. As demonstrated by these findings, communication, leadership presence, and mental toughness are 3 key components to promoting and providing quality care in an austere, complex, and changing health care environment. Further understanding of the roles of these key concepts may add insight into nurse leaders and leadership development.

The Relationship Between Charge Nurses and Clinical Nurses' Perceptions of Patient Safety Culture and Leadership Practices

Background: A patient safety culture needs to be developed for quality and safe care in health care institutions. Executive nurses having transformational leadership behavior have an important effect on establishing a patient safety culture in hospitals. Objectives: The aim of this study is to reveal transformational leadership practices of unit charge nurses from their own perspective and the perspective of staff nurses they work with, to determine the patient safety culture perceptions of unit charge nurses and staff nurses, and to examine the relationship between transformational leadership practices and patient safety culture. Methods: This descriptive, relationship-seeking and cross-sectional study was conducted between March and June 2014 in four hospitals in Konya province. The sample of the study consisted of 70 unit charge nurses and 357 staff nurses working with these unit charge nurses. Participation rate in the study is 84.5%. Data were collected by using the Demographic Data Form, Leadership Practices Inventory and Patient Safety Culture Hospital Questionnaire. Means, t test, percentages, standard deviation and Spearman's tests were used in the analysis of the data. Results: According to the evaluations of the unit charge nurses and staff nurses; it was found that the unit charge nurses' averages scores for prodding others into action, encouraging others and questioning the process sub-dimension and total leadership practice were significantly higher than those of the staff nurses. Patient Safety Culture perceptions of unit charge nurses are higher than service nurses. According to the findings obtained from the study, there is a positive relationship between nurses' transformational leadership practices and patient safety culture. Conclusion: In the study, it has been shown that there is a positive relationship between nurses' transformational leadership practices and patient safety culture. In order to create a positive patient safety culture in the units of charge nurses, it is necessary to develop the unit charge nurses' transformational leadership practices.

The State of the Perioperative Nursing Specialty Workforce:: A Concern for Executive Nurse Leaders

Executive nurse leaders with operational responsibilities over perioperative departments are faced with challenges in recruitment, retention, and educational preparedness in perioperative nurses. Establishing academic partnerships with hospital facilities and incorporating perioperative nursing education in undergraduate curricula is a successful approach to addressing recruitment and retention challenges. This article provides an overview based on the literature of the current state of the perioperative nursing workforce and offers recommendations for executive nurse leaders from health care facilities and academic institution to establish programs to address perioperative nurse workforce shortages. Executive nurse leaders with operational responsibilities over perioperative departments are faced with challenges in recruitment, retention, and educational preparedness in perioperative nurses. Establishing academic partnerships with hospital facilities and incorporating perioperative nursing education in undergraduate curricula is a successful approach to addressing recruitment and retention challenges. This article provides an overview based on the literature of the current state of the perioperative nursing workforce and offers recommendations for executive nurse leaders from health care facilities and academic institution to establish programs to address perioperative nurse workforce shortages. Rebecca Vortman, DNP, RN, CNOR, is clinical assistant professor in the Department of Population Health Nursing Science at the College of Nursing, University of Illinois Chicago, in Springfield, Illinois. She can be reached at [email protected] . Sara McPherson, PhD, RN, is clinical assistant professor in the Department of Biobehavioral Nursing Science at the College of Nursing, University of Illinois Chicago.

Rasch Analysis of Lebanese Nurses' Responses to the Copenhagen Burnout Inventory Alternative to the Maslach Burnout Inventory.

IntroductionLebanon struggled with political and economic crises before it was affected by the COVID-19 pandemic. Executive nurses and hospital administrations need reliable open-source measures to monitor burnout and prioritize nurses for intervention as Lebanon struggles with the multiple crises compounded by rising numbers of COVID-19 cases and deaths.ObjectivesThe study aimed to determine whether the Copenhagen Burnout Inventory scales are suitable for settings experiencing multiple crises. Its objectives were to investigate the CBI scales' measurement properties, identify burnout levels in a sample of nurses experiencing compound stressors, assess whether the scales' three-dimensional burnout model is plausible, and establish norms for using the scales in work settings subject to compound external stressors.MethodsThe study is a psychometric analysis of the anonymous survey data of 142 registered nurses working in acute hospitals in Lebanon. We fitted the data to unidimensional and multidimensional Rasch rating scale models. Item fit, person separation and reliability, targeting, differential item functioning, and scale norms were estimated.ResultsNurses in the sample had a high level of burnout. The Copenhagen Burnout Inventory scales have excellent reliability. The personal burnout and work-related scales were highly correlated and moderately correlated with the client-related burnout scale. Possible differential functioning in the work-related burnout scale requires further investigation.ConclusionMore extensive and diverse studies in workplaces subjected to compound stressors are required to confirm the study results. Meanwhile, executive nurses and hospital administrations can use the norms reported to prioritize nurses for burnout prevention and intervention programs. In Lebanon, our reported CBI scale values can be used as baseline standards for studies tracking how the COVID-19 pandemic is impacting the nursing workforce.

Yönetici Hemşirelerde İş Stresi, Yönetici Olarak Çalışma Memnuniyeti ve Kurumdan Ayrılma Niyeti

Aim: This study was carried out to examine the job stress, job satisfaction and intention to leave the institution of the manager nurses. Method: This descriptive study was carried out with the participation of 100 manager nurses working in six different hospitals in a city center between June and July 2019. Data were collected using the Personal Information Form and the Perceived Job Stress Level Scale. “SPSS 20.0” statistical package program was used in the analysis of the data. Number, Percentage, Man Whitney-U, Kruskal Wallis, Cronbach Alpha Coefficient analysis methods were used in the evaluation of the data. Results: The mean job stress level score of the manager nurses participating in the study was found to be 2.40±0.51. It was determined that 48% of the manager nurses were satisfied with working as executive nurses and 72% of them did not consider leaving the institution. It was determined that the job stress levels of the manager nurses differed according to their satisfaction with working as a manager nurse and their intention to leave the institution (p<.005). Conclusion: It was found that the job stress levels of manager nurses were the most favorable stress level in terms of “D” group health and productivity, and those who had the intention of leaving the institution and who were not satisfied with working as manager nurses had higher job stress.

Bir İhmal Hatası: Karşılanmayan Hemşirelik Bakımı

Missed nursing care is being explored with an increasing interest in the literature in recent years. Studies have focused on the frequency, reasons, associated factors, predicting factors and consequences of missed nursing care. The results of research conducted in many regions of the world show that the necessary nursing care is missed for various reasons. While this fact shows that missed nursing care is a global problem, it also attracts researchers around the world to focus on this issue. However, there are only two research articles investigating missed nursing care in Turkey, so further research and evidence are needed on this subject. Therefore, in this review, it was aimed to raise awareness of nurses and executive nurses on this issue and to contribute to the national literature.

Advocating for LGBTQ+ older adults: a review of the role of executive nurses.

Over the past four decades, the number of people aged over 60 years has increased worldwide, and within this population there has been a proportional increase in people with diverse sexual orientations and gender identities. Executive nurses have an important leadership role in challenging heterocisnormative care practices in healthcare environments that affect the well-being of older adults who are lesbian, gay, bisexual, transgender, queer or questioning and others (LGBTQ+). This article reports on the findings of a secondary analysis of data extracted from an earlier scoping review to provide recommendations for executive nurses on how to advocate for LGBTQ+ older adults and create safe and inclusive healthcare environments for them.

Balancing Resiliency and New Accountabilities: Insights from Chief Nurse Executives amid the COVID-19 Pandemic

This article outlines how chief nurse executives (CNEs) in an urban regional hospital network are navigating the balancing act of organizational (internal) and system-level (regional and/or provincial) accountabilities amid the coronavirus disease 2019 (COVID-19) pandemic. Key to their leadership efforts is finding the right balance in making critical decisions and building trust to ensure staff resiliency and safety amid managing their own resilience while enacting both internal and external accountabilities. These accountabilities include having presence and influence at the regional planning, executive planning and incident command decision-making tables. Insights from their experiences and lessons learned will be shared alongside recent calls to action for nursing leadership that can serve as a playbook for CNEs dealing with future waves of COVID-19 and unplanned events.

The Relationship Between the Implicit Rationing of Nursing Care and Emotionally Intelligent Leadership Style.

The study examined relationships between nurses' perceptions of implicit rationing of nursing care and leadership style in the nursing work environment. Nurses' perceptions of higher amounts of implicit rationing of nursing care relate to perceptions of lower quality of care and poorer patient outcomes. This study was the 1st to examine leadership style and implicit rationing of nursing care. Using a cross-sectional survey study design, 35 039 RNs were randomly sampled during September 2017 to March 2018. Findings support an association between nurses' perceptions of an emotionally intelligent leadership style and lower amounts of implicit rationing of nursing care. Implicit rationing of nursing care in the nursing work environment is significantly associated with emotionally intelligent leadership style. Nurse executives, and nursing faculty in administrative-focused graduate programs, can provide development and education in emotionally intelligent leadership skills.

Empowering Nurse Executives to Advocate for Surgical Smoke–Free Operating Rooms

Evacuating surgical smoke in the operating room protects patients and perioperative teams from the hazards associated with inhaling surgical smoke. States have passed bills mandating health care facilities and ambulatory surgery centers adopt policies to evacuate surgical smoke. We use a 5-step process for identifying options to reduce exposure to the harmful toxins found in surgical smoke and recommend executive nurse leaders collaborate with states and professional organizations to pursue smoke evacuation legislation. This strategy empowers executive nurse leaders and perioperative teams to work with professional organizations and state legislators to reduce exposure to the harmful health hazards associated from surgical smoke.

Creating safe and healing environments: Innovative curriculum to support team members during patient and family escalations in a quaternary care pediatric hospital

Workplace violence in healthcare settings is at a crisis point. Healthcare organization have almost as many serious injuries from violence then all other industries combined (OSHA, 2013; Phillips, 2016). The costs of workplace violence have reached a crescendo provoking a response from several leading healthcare organizations including the Center for Disease Control, Occupational Safety and Health Administration, American Organization of Nurse Executives, American Nurse Association, and the Joint Commission who have all prioritized workplace violence initiatives.To address the issues of workplace violence our hospital embarked on a systematic change to improve the physical and psychological safety of faculty and team members. A multidisciplinary curriculum team developed the Creating Safe and Healing Environment course that introduces concepts to honor the unique demand on team members as they manage the intricacies of caring for others in a hospital setting. The team revisited the complex nature of the relationships and partnerships that are formed in healthcare between the team member, patients and families.The focus of this paper is to discuss the complex issue of workplace violence and review the development of curriculum that focuses the complexities of caring for pediatric patients, introduce the concepts of healing environments and teaches the skills and knowledge needed to co-create safe and healing environments for both care providers and their patients. This paper will also highlight the how a curriculum of this type is informed by the expertise of nursing theories including revisiting Nightengale ideals and incorporating Jean Watson's “Philosophy and Science of Human Caring”.

Faktor Determinan yang berhubungan dengan Kepuasan Kerja Perawat Pelaksana di Rsud Dr. Rasidin Padang

Job satisfaction of nurses need serious attention because nurses care provider with the largest and longest time to patients. The achievement of hospitals BOR is low (26.20%) that be caused the result of achievement of the performance of nurses are not optimal yet, this is caused to the dissatisfaction of nurses to hospitals management. The aim of this research is to find determinant factors that related to job satisfaction of nurses executive in RSUD dr. Rasidin Padang. This research is know deskriptive correlation with cross sectional to 72 executive nurses in RSUD dr. Rasidin. Instrument of the research is questionnaire. Univariate data analysis used frequency distribution, bivariate with chi square test, and multivariate used logistic regression test. The result of the research is 51.4% executive nurses state dissatisfaction in working. Chi-square test is obtained there is significant correlation between the incentive, promotion opportunity, and supervision with job satisfaction. There is not correlation between the leadership, and work environment condition with job satisfaction. The result of multivariate analysis is obtained variable incentive that is dominant factors related to job satisfaction of nurses. It is expected the stakeholders of hospital management to consider the burned and risk of work based on objective performance assesment, the setting of level system performance-based on achievement career. Running the monitoring system to nursing care is given by executive nurses, and immediately to do accreditation of hospital to improve the quality of hospital services.

Do We Know How to Sacrifice?

Do We Know How to Sacrifice?

Kriz ve Pandemide Hemşirelik Hizmetleri Önerileri

Coronavirus Disease-2019 (‘Coronavirus Disease-2019’, COVID-19) has been spreading with high acceleration in Asia, Europe and America continent, especially hospitals have become the most active points in the treatment and spread of the disease. Nurses, which have a vital role in the provision of health services and influencing public health, are at the forefront in the fight against the epidemic and perform their roles in health care as practitioners, managers, educators, researchers and professionals. The fight against the pandemic action plans in coordination with the Ministry of Health and other Ministries in Turkey are carried out. The nursing services applied during the pandemic in hospitals saglanare carried out by considering the recommendations in the circulars of the Ministry of Health. Effective and high-quality nursing services should be targeted by ensuring that nurses and executive nurses working in emergency departments, clinics and intensive care units at the stage of examination, diagnosis and treatment of patients with COVID-19 diagnosis or suspicion are provided with the most up-to-date and evidence-based informations. It is important for nurses to take into account the COVID-19 status and the amount of resources, by sharing their experience, practice and recommendations. In this process, the introduction of good practices that will benefit patients and saving lives is of great importance. Here, we present a review and suggestions to ensure that the system can be supported as nursing services by protecting patients and nursing teams in hospitals during the crisis such as COVID-19 pandemic, taking into account the status of COVID-19 and its resources rationally and dynamically and ensuring the sustainability of nursing services.

How to Win Friends and Influence People—as a Nursing Leader

Nursing leaders are responsible for guiding quality, patient-centered care that is safe, timely, efficient, and equitable. The American Organization for Nursing Leadership (AONL) Nurse Executive Competencies have outlined the skills necessary to carry out this important work. Many of these competencies involve the use of "soft skills" to effectively lead, such as effective communication, enthusiasm, emotional intelligence, and interpersonal skills. This paper provides practical guidance for how to cultivate these soft skills using Dale Carnegie's classic book <i>How to Win Friends and Influence People</i> as a guide.

Use of the ADKAR® and CLARC ® Change Models to Navigate Staffing Model Changes During the COVID-19 Pandemic

In early 2020, hospitals faced unprecedented patient volumes resulting from the COVID-19 outbreak. Nurse executives at a faith-based, not-for-profit health care system quickly responded to ensure safe staffing, conservation of personal protective equipment, and implementation of infection prevention strategies. A significant challenge was safe staffing for the expected patient surge. To address this, a team of nurse executives utilized the ADKAR change model to guide a transition from primary to team nursing. The processes varied between hospitals, but core principles and implementation strategies were the same. This article discusses the quick, but methodical, journey one health care system experienced.

Emergency Nursing Review Questions: September 2020

Benjamin E. Marett, Member, Palmetto Chapter, is the Chief Nursing Executive with Emergency Care Consultants of the Carolinas, Inc, Rock Hill, SC. Matt Pearson, Member, Kentucky Chapter 090, is a staff RN, Norton Healthcare, and on faculty at University of Louisville School of Nursing, Louisville, KY. Sarah Webb is an advanced practice RN in pediatric surgery/trauma at Johns Hopkins All Children’s Hospital, Baltimore, MD.

Chief Nurse Executive Readiness for the Here and Now.

The significant role of the chief nurse executive in leading healthcare innovation has been widely discussed in the literature, including the importance of monitoring market disruptors and determining how to best respond. Critical to implementing and sustaining innovation is attention to leadership competencies, organizational enablers, and cultural transformation throughout the entire nursing enterprise. Chief nurse executives are challenged to examine personal and organizational readiness.