Nurses In Management Positions Research Articles

Nurse Managers' Professional Quality of Life During the COVID-19 Pandemic.

Health systems cannot effectively support nurse managers without understanding psychosocial effects of the COVID-19 pandemic. The objective of this study was to describe the professional quality of life of frontline nursing management during the COVID-19 pandemic. A cross-sectional online survey of 54 nurses in management positions at a large Midwest academic medical center during 2022 was conducted. Participants completed an electronic survey including demographics, Professional Quality of Life Measure Version 5, and items assessing past consideration of and future intent to leave their position, organization, or profession. Most participants had previously considered changing roles (80%) or leaving the organization during the pandemic (76%). Fewer respondents reported that changing role (24%) or organization (20%) was likely during the upcoming 6-12 months. Most participants scored in moderate ranges of Compassion Satisfaction, Burnout, and Secondary Traumatic Stress scales (85%, 89%, and 74%, respectively). Higher Compassion Satisfaction was associated with extreme unlikelihood of leaving for an internal non-management role. Higher Burnout scores were associated with more time working and past consideration or future likelihood of leaving for an external non-nursing position. Secondary Traumatic Stress scores were higher for nurse managers and house operation managers than assistant nurse managers and associated with past consideration of moving to an internal non-management role or external non-nursing position and future likelihood of moving to an external non-nursing position. Nurse management occupies a demanding position between frontline staff needs and administrative requirements, profoundly impacted by COVID-19. Health care researchers, administration, and policymakers must learn how to support, retain, and sustain nursing management in a post-pandemic world.

El rol de la enfermería en el ámbito de la salud pública

ObjectiveIdentify the role of public health nurses and differentiate it from that of community care nurses in the context of Catalonia, through the experiences and perspectives of professionals in the field of public health. MethodDescriptive phenomenological qualitative study. Fourteen interviews were conducted with key informants, from the field of public health and community care, selected by i purposive sampling. Content analysis using thematic methodology, creation of categories from the triangulation of results. ResultsThe professional competencies and functions performed by nursing in the field of public health are analysed. Most of the specific functions were the ones related to “care” and the “global vision” of health. The indeterminacy of functions and roles, related to gender inequality, leads to a low recognition of the profession and a lack of appropriateness of the professional category, reflected in a low presence of nurses in management positions in public health. Although some competencies are shared with the family and community nurse, there are also differences. ConclusionsThis study sheds light on the role of public health nursing, often overlooked. It is urgent to define public health nurses role and functions, in order to avoid inequalities and increase their recognition.

Developing a leadership programme for junior nurses.

Lifelong learning is an expectation of all nurses and nursing associates. However, after preceptorship there is limited guidance on how junior nurses can progress in their careers. Formal training programmes were limited by pressures associated with the coronavirus disease 2019 (COVID-19) pandemic, as well as long-term financial and resource restrictions across the NHS. Nurses' expectations of professional development and well-being have also been affected by their experiences during the pandemic. This article explores how nurses in management positions can create professional development opportunities for nurses, particularly in leadership. The author identifies how leaders can support their staff to broaden their skills and knowledge despite pressures on staffing and resources.

Aspects of Prevention of Urinary Tract Infections Associated with Urinary Bladder Catheterisation and Their Implementation in Nursing Practice.

In the case of the prevention of catheter-associated urinary tract infections (CAUTI) related to healthcare provision, high-quality and comprehensively provided nursing care is essential. Implementation of preventive strategies is based on recommended procedures, and the introduction of whole sets of measures has been shown to be effective. The objective of this research is to find out whether the providers of acute bed care have implemented the steps of CAUTI prevention, and specifically which measures leading to improved quality of care in the area of urinary infections are already in place. To determine this, we carried out quantitative research. Data were collected using a questionnaire-based investigation; we used two non-standardised and one standardised questionnaire, and the respondents were general nurses in management positions (n = 186). The results revealed that result-related CAUTI indicators are monitored by only one-third of the respondents, and records of catheterisation indication are not kept by 17.3% of general nurses. The results of the research showed deficiencies in the monitoring of CAUTI outcome and process indicators, and a weakness of the implemented preventive measures is the maintenance of catheterisation documentation. Periodic CAUTI prevention training is not implemented as recommended. It is positive that there are well-working teams of HAI prevention experts in hospitals.

Technical-assistance arrangements in coping with the COVID-19 pandemic from the managers' perspective.

to describe the technical-assistance arrangements developed within the scope of work management in the COVID-19 pandemic care network, from the managers' perspective. a qualitative research study, of the incorporated single case type, conducted with 23 managers of a Health Care Network. The analysis was applied in two thematic coding cycles, with the aid of the ATLAS.ti software. the arrangements were analyzed in categories related to health care; management; incorporation of technologies; implementation of a field hospital; and retrospective analysis of the experiences as a whole. There was emphasis on the implementation of care flows, virtual health bulletins, Telemonitoring, chatbots, use of applications, and implementation of field hospitals and of basic urgency services within the scope of the Basic Health Units. Hyperjudicialization in the system was identified; as well as weaknesses in information management, intersectoriality and technical-political leadership at the national level; the role of nurses in management positions and for coping with the pandemic. despite the health services' unpreparedness to face the pandemic, the actors' resilience promoted dynamism and technical-assistance arrangements in the context of management and humanized care. The study has a potential to contribute to the qualification of the public policy management and development practices.

Arranjos tecnoassistenciais no enfrentamento da pandemia da COVID-19 na perspectiva de gestores

Objective: to describe the technical-assistance arrangements developed within the scope of work management in the COVID-19 pandemic care network, from the managers’ perspective.Method: a qualitative research study, of the incorporated single case type, conducted with 23 managers of a Health Care Network. The analysis was applied in two thematic coding cycles, with the aid of the ATLAS.ti software. Results: the arrangements were analyzed in categories related to health care; management; incorporation of technologies; implementation of a field hospital; and retrospective analysis of the experiences as a whole. There was emphasis on the implementation of care flows, virtual health bulletins, Telemonitoring, chatbots, use of applications, and implementation of field hospitals and of basic urgency services within the scope of the Basic Health Units. Hyperjudicialization in the system was identified; as well as weaknesses in information management, intersectoriality and technical-political leadership at the national level; the role of nurses in management positions and for coping with the pandemic.Conclusion: despite the health services’ unpreparedness to face the pandemic, the actors’ resilience promoted dynamism and technical-assistance arrangements in the context of management and humanized care. The study has a potential to contribute to the qualification of the public policy management and development practices.

Gaining consensus on key terms in community health activities: A national survey using the Delphi method

Objectives The purpose of this study was to define the terminology used in community health activities by systematically establishing agreement among public health nurses and related professionals, to aid them in effectively cooperating with other professionals.Methods We extracted the major terms described in "Guidelines for Public Health Nurses' Activities in the Region," which was issued by the Director of Health Bureau, Ministry of Health, Labor and Welfare; and conducted 2 iterations on the proposed definition of the terms using the Delphi method. The survey targeted 800 stakeholders from the following 4 professions: public health nurses in managerial positions in local governments, clerical staff in local governments, public health nursing professors at educational institutions, and social welfare council staff. Respondents indicated their degree of agreement with the definition of the terms using a 4-point Likert scale. We tallied the answers indicating "I agree" or "Mostly agree." A 70% term agreement was considered "conformed." A free text box for each proposed definition was also available so that respondents could share their opinions and offer alternatives.Results The first survey received 231 responses. The conformity of their definitions ranged from 83.9%-96.9% (mean=91.5%). Although all definitions exceeded the consensus level, we examined their adequacy with reference to the definitions and opinions from the free text. Various opinions were obtained from those engaged in each occupation. The second round included 117 consenting stakeholders from the first survey, yielding 90 responses. Their degree of conformity ranged from 86.7%-98.9% (mean=94.6%). Therefore, we determined the definitions had reached a robust agreement. We revised the definitions of some terms with reference to the opinions from the free texts and finalized the definitions. Finally, we defined 23 terms-such as region, community diagnosis, and policy.Conclusion All terms had a conformity of more than 85%, thus bringing into alignment those community health terms that had varying interpretations among related occupations earlier. By including the opinions of those from the related occupations who collaborate with public health nurses, the definitions of these terms could be established and shared. These definitions can be used in public health nursing practice, education, service, and research-among those in involved these related occupations.

Bullying in nursing: How has it changed over 4 decades?

This study sought to explore how bullying in the nursing profession in Australia has changed over four decades, and why it continues to persist. Bullying in nursing is recognized as a pervasive problem. While much attention has been given to demonstrating the existence and impact of bullying in the nursing profession, little is understood about the evolution of this phenomenon and factors that contribute to its persistence. This study employed an historical methodology using the testimony method of data collection. Testimonies were collected online and via interview from seventy registered nurses across Australia. Data were analysed using a three-dimensional analysis to produce a chronological historiography. This study found that the antecedents, manifestations, responses to and impacts of bullying in the nursing profession changed according to context and over time. The findings shed light on the role of nurse managers in the prevention and appropriate management of bullying in the workplace. Prevention and intervention approaches must be developed to combat the complex and changing factors that allow bullying to persist. This study shows the role that management plays in tackling the problem of bullying in nursing. It can no longer be acceptable for culture to be used as an excuse for unacceptable behaviour, nor for power to be abused to protect perpetrators of workplace bullying. The findings discussed in this paper reveal that inexperienced nurse managers are often ill-equipped to identify and manage bullying. Nurses in management positions must recognize and acknowledge this deficit if the problem of bullying is to be effectively tackled.

Experiences of internationally educated nurses holding management positions in the United States: Descriptive phenomenological study.

The purpose of this study was to explore the experiences of internationally educated nurses in management positions in United States health care organisations to understand the obstacles and support these individuals' experience when pursuing and working in managerial roles. Although internationally educated nurses are an integral part of the US health care industry, few work in managerial roles. Little is known about the experiences of internationally educated nurses who do obtain management positions. In this qualitative, phenomenological study, seven internationally educated nurses who were managers in Chicago, Illinois, responded to open-ended interview questions. Supervisors contributed to the participants' acceptance of management positions. The participants experienced challenges such as cultural differences, language, and communication. Despite these challenges, the participants had positive working relationships with staff and supervisors. Further, the participants had opportunities for education and professional growth. Internationally educated nurses benefit from participating in organisational committees. They face challenges related to work responsibilities, cultural differences and communication but can succeed in management roles through developing strategies to overcome the challenges and through receiving support from staff, colleagues and supervisors. More internationally educated nurses may obtain managerial positions if supervisors provide encouragement and support.

The importance of a culture of openness.

Revamping the counselling service at Birmingham Children's Hospital, as well as offering wa 24/7 telephone service and face-to-face counselling, led to reduced work-related stress - as stated in Nursing Management. Sara Brown, deputy chief officer for workforce at the hospital, says a culture of openness is essential for tackling the demands of nursing. She says nurses in management positions are responsible for supporting the daily demands of service delivery.

MEASURING HEAD NURSES’ COACHING PRACTICE: MODIFYING AND TESTING THE INSTRUMENT FOR ASSESSING MANAGERIAL COACHING SKILLS

Managerial coaching has been reported as a successful leadership development approach that has potential benefit for nurses. It also was recognized as a powerful tool to promote personal and professional development in the nursing profession. Therefore, there is an increasing needs for reliable and valid assessment tools to measure the coaching skills of nurses in managerial positions. This study reviewed and revised an existing instrument created by (Park, McLean, and Yang, 2007) which measured coaching skills of managers in business and industrial organization. In order to adapt the original instrument to the nursing profession, this study firstly identified the five primary dimensions of the managerial coaching skills of head nurses through both qualitative and quantitative approaches. Review experts and a pilot study were then performed to ensure the reliability and validity, and validated the revised instrument of managerial coaching skills. The results of this study indicate the revised managerial caching skill instrument demonstrates good reliability and validity for measuring the managerial coaching skill of head nurses in a hospital setting. Hospitals can administer and use the revised instrument as an assessment tool to evaluate their nurse managers’ coaching skills, and identify the areas for improvement. This allow the head nurses to more effectively manage and support the staffs’ development. 

Vislumbrando “O Artífice” no cotidiano de trabalho das enfermeiras na gerência hospitalar

This study aimed at understanding the daily work of nurses in managerial practice in medium-sized hospitals, based on working process proposed by the architect Richard Sennet. This is a qualitative descriptive study was conducted through a case study whose scenario consisted of four medium size hospitals in a city located in the northern region of Minas Gerais. Data collection was conducted through semi-structured interviews with twelve nurses in management positions in strategic and intermediate levels of a hospital organization. Study participants were 12 nurse managers that met the established inclusion criteria. Data were submitted to content analysis, and the study uncovered four empirical categories operationalized in three stages: pre-analysis, material exploration and treatment of results and interpretation. The analysis showed the following empirical categories, “the nurse in the search for quality of care,” “leadership as essential skill of the nurse manager” and “the formation of the nurse for the exercise of the managerial function. The results showed that nurse managers have interest and concern for the quality of care, vision of leadership as a key component in working relationships and communication. In addition, they stressed the importance of academic training for the performance of management functions and everyday practices in this function. We conclude that nurse managers understands their importance in the hospital, seeing themselves as professionals and experts of labor and administrative relationships, proposing strategies to achieve a planned care with a higher quality.

Gender segregation as a benefit - a qualitative study from Pakistan.

To explore the possibility of exploiting gender segregation as a benefit for registered female nurses. Nursing is a highly gendered profession in Pakistan with 95% of nurses comprising females who suffer from low professional status, negative identity and unfavourable work environments. A qualitative research design was used to interview 12 nurses in management positions through purposive sampling. Face-to-face in-depth interviews were conducted to explore the views of female nurses on the benefits, if any, of gender segregation in the nursing profession. Content analysis identified three major categories of benefits of gender segregation for female nurses including: (1) demand for female nurses compared with demand for males, (2) resilience of female nurses in the face of difficult work environments and (3) comfort and safety of female co-workers in a male-dominated setting. Realising the benefits of gender segregation could mobilise nurse teamwork and union efforts in order to improve nurse identity, professional status and work environments. The present study highlights the nurse manager role in advancing knowledge of gender segregation benefits, team-building for gender solidarity, control of nurse supply, union mobilization and raising community awareness for women's health development.

Associations of menopausal symptoms with job-related stress factors in nurses in Japan

ObjectiveThe main objective was to ascertain the typical menopausal symptoms and job-related stress factors in Japanese nurses during the menopausal transition, and the associations of menopausal symptoms with job-related stress. A supplementary objective was to determine whether there were any differences in menopausal symptoms and job-related stress factors among nurses in managerial positions. MethodsOne thousand seven hundred female registered nurses aged 45–60 years who were working in hospitals in Japan were asked to complete a self-administered survey that included Greene's Climacteric Scale and the Brief Job Stress Questionnaire. ResultsThe proportions of nurses who reported feelings of tiredness, irritability and difficulty in concentration were higher than the proportions with other menopausal symptoms. The proportions of nurses reporting feeling unhappy or depressed and having crying spells were higher among nurses in managerial positions than among other nurses. Stresses related to ‘quantitative overload’ on the Brief Job Stress Questionnaire among nurses in managerial positions were significantly greater than among nurses not in managerial positions, while stresses related to ‘physical overload’, ‘job control’, ‘skill discretion’, ‘workplace environment’ and ‘job satisfaction’ among nurses not in managerial positions were significantly greater than they were among nurses in managerial positions. Psychological symptoms were significantly correlated with poor job-related interpersonal relationships. ConclusionsHealth care practitioners should be aware that menopausal symptoms are associated with job-related stress during the menopausal transition. Information on the differences in these associations between nurses in managerial positions and other nurses is important as it will allow their health care to be managed on a more individual basis.

Impact of a quality improvement intervention on nurses' management of same-day primary care flow.

To evaluate the impact of an interdisciplinary intervention designed to improve the capacity of nurses to manage walk-in patient demand for primary health care. Implementation of a programme to expand nursing practice is a complex process that requires the application of context-appropriate measures and adaptation when results do not meet expectations. A longitudinal, uncontrolled intervention study with a 3-year follow-up, from 2009 to 2012, was carried out in Catalonia (northeast Spain). The intervention included three training periods focused on clinical and instrumentation topics. The capacity of nurses to manage walk-in patient demand was assessed by determining the number of cases resolved and of return visits for the same complaint within 72hours. In total, 2751 patient care demands were evaluated. Resolved cases increased (χ(2) =54.624, df=1, P<0.001) and the number of return visits decreased (χ(2) =54.585, df=1, P<0.001) significantly from baseline to the end of the study period. Nurses' capacity to manage walk-in patient demand improved after an interdisciplinary intervention using a mutually agreed upon, locally adapted approach. To improve outcomes, nurses in management positions should systematically consider the need for skills training, specific academic courses, leadership development and, as appropriate, legislative initiatives.

Motivations, contradictions and ambiguities in the leadership of nurses in management positions in a university hospital

To analyze the contradictions and ambiguities which permeate nurses' motivation for exercising leadership in management positions, in a university hospital. This study has a qualitative approach and is exploratory and descriptive, and used a total of 33 semi-structured interviews which were submitted to thematic analysis. The information converged on five categories: Motivation to take on a management position; The view of nursing managers on the exercising of leadership; The emblematic aspect of working with people; Leadership in nursing--mediatory and conciliatory; Time: a dilemma between managing and caring. Leading people can be both a great encouragement, and an impeding aspect, bearing in mind the nuances of teamwork and the complexity of the context in which this process is constructed. In addition to this, conciliatory and mediatory attitudes are shown to be fundamental for a healthy and productive organizational atmosphere; however, the lack of time was indicated as a dilemma between managing and caring.

Relational Experiences of Power and Gender for Nurse-Managers of Private Hospitals

Influenced by increased technology and globalization, Brazilian hospitals are undergoing significant changes. The managerial models focused on the male model are being slowly and gradually replaced, with an expressive participation of female nurses in management positions. Thus, we aimed to uncover some aspects of the relational experiences of power and gender of nine female nurse-managers working in four large and medium-sized private hospitals in Belo Horizonte, MG, Brazil, through a qualitative case study. The results show that management discourses value a managerial style focused on the organizations' humanized aspects, where authoritative styles have no space. In this scenario, the work of female nurse-managers strengthens teamwork, which improves their image and contributes to forming their identity.

Challenges in community health nursing of old migrant patients in Norway – an exploratory study

Old people of non-western minority backgrounds are an invisible group in Norway in several ways: in the national debate about the ageing population, in geriatric health care services, and in the general picture of ethnic minorities. There is a lack of knowledge about health and care amongst old migrants. This study aimed at exploring nurse managers' perceptions of the content of community health nursing care of older people from non-western countries of origin, and the challenges associated with caring for this group of patients. The study took place in a medium-sized Norwegian community, a mostly urban area with surrounding rural areas. The community health nursing system was organized in six districts with nurses in management positions, covering nursing homes, special housing and home-based care. Data were collected by a questionnaire with structured and open-ended questions answered by 18 nurse managers. The data provided scarce information, but indicated a lack of systematic cultural care assessments. Community health nursing of old non-western migrant patients was described as deficient and a demanding burden. The challenges were captured in four themes: language barriers, family involvement in care, deficiencies in cultural competency and the need for development. Increased competency, action and local responsibility were identified as propositions to manage the challenges. The lack of awareness and knowledge concerning cultural issues found in this study highlights the need for further development and research on this topic.

University and industry partnerships: lessons from collaborative research.

Collaborative research between educational institutions and health agencies is being increasingly used as a method of achieving joint outcomes and bringing together theory and practice. This paper reports on the experiences of collaboration that arose out of just such a project carried out in a residential aged care setting. The research team included university academics, two nurses in management positions in the aged care facility and a senior research assistant. In this paper, we explore some of the unexpected issues that emerged during implementation of the research project. The major challenges to successful collaboration arose not from within the collaborative research team, but from the responses of the broader staff who generally had little, if any, experience of research. Despite efforts to inform and involve staff, deep suspicions about the 'real' motives of the project proved difficult to shift. Trust and commitment are vital dimensions of successful collaborative research, yet gaining these from some staff proved elusive. Collaborative relationships between educational and practice settings need to be viewed as long-term endeavours driven by a common unifying goal to enhance client care. This has implications for costs and timelines which might be difficult to manage.

Occupational stressors and coping as determinants of burnout in female hospice nurses.

Stressors, coping and demographic variables were examined as predictors of burnout in a sample of hospice nurses. The study aimed to investigate the level of burnout among hospice nurses; to ascertain which aspects of nursing work were positively or negatively related to burnout; to examine the relative contributions made by these different variables and to suggest individual and organizational interventions to reduce levels of burnout. Eighty-nine female nurses from nine hospices completed a battery of questionnaires comprising the Maslach Burnout Inventory, Nursing Stress Scale, Ways of Coping Scale and a demographic information form. In general, the level of burnout (characterized by high emotional exhaustion, high depersonalization of patients and low personal accomplishment) was found to be low. In multiple regression analyses, 'death and dying', "conflict with staff', 'accepting responsibility' and higher nursing grade contributed to emotional exhaustion. 'Conflict with staff', 'inadequate preparation', 'escape' and reduced 'planful problem-solving' contributed to depersonalization. 'Inadequate preparation', 'escape', reduced 'positive reappraisal' and fewer professional qualifications contributed to lower levels of personal accomplishment. Overall, stressors made the greatest contribution to burnout and demographic factors contributed the least. The importance of not labelling individuals as good and bad 'copers' was discussed, as the effectiveness of a strategy may depend on the situation. It was concluded that the investigation of problem-focused and emotion-focused coping in relation to burnout, was oversimplifying the coping-burnout relationship. Suggestions for stress management included staff training in counselling skills, monitoring staff conflict, implementing stress inoculation training to teach appropriate use of coping skills and finally, monitoring particularly vulnerable groups of hospice staff such as unqualified nursing assistants and qualified nurses in management positions. It was concluded that despite the difficult nature of hospice work, the hospice is a positive environment in which to work.