Dissertations / Theses on the topic 'Nurse leadership'

ISBN 978-91-86739-28-7

ISBN 978-91-86739-28-7

The problem addressed was the low job satisfaction levels of nurses and subsequent nurses' decision to leave the organization. The quantitative correlational survey study involved determining whether a relationship exists between nurses’ perceptions of nurse managers’ leadership style and nurses’ job satisfaction. Eighty-three fulltime medical surgical intensive care nurses in two hospitals in Phoenix, Arizona, completed the Job Description Index for Jobs in General (JID/JIG) and the Multifactor Leadership Questionnaire (MLQ, Form 5X). The results suggest a significant, positive correlation between job satisfaction and perceptions of nurse managers' leadership style by nurses. Nurses with the highest satisfaction scores in three of the six subscales perceived their managers used the transformational leadership style. The mean score for nurses whose managers were rated as transactional was higher than the mean score for nurses whose managers were rated as passive-avoidant. The promotion and supervision subscales and the job in general scale showed a significant relationship with transformational leadership. Implications for healthcare administrative leaders include hiring transformational managers to increase job satisfaction in nurses and offer nurses opportunities for promotion and training.

Frontline nurse leaders are expected to lead staff while managing the work systems and processes on their units in addition to ensuring high quality and safe patient care is being delivered. It is not known if frontline nurse leaders who have been oriented with only onthe-job-training are competent and if a professional development program will improve their competencies and confidence. This project used a quantitative quasi-experimental design. The basic design elements for this project were the PCC curriculum and completion of the survey pre-and post-attendance. This project was conducted at an acute care, Magnet facility and included 20 frontline patient care coordinators. Data from the surveys were analyzed using SPSS 23. Spearman’s rho was used, a nonparametric test which determines the strength and significance of the correlation between two measures, and ANOVA, a parametric method which determines whether there is a significant mean difference in some measure between two or more groups. The initial average competency ranking of the participants was 2.91, which reflects a just below competent ranking; paired-samples ttests were conducted which resulted with the average self-rated competency level of participants increasing by 27% to 3.69 post intervention. Implications for this research is far reaching, considering the impact frontline nurses have on nurse satisfaction and engagement, in addition to improved quality of care, patient satisfaction, and patient outcomes.

Nurse managers are central figures in the delivery of safe and high quality nursing care (Cathcart et al., 2010; IOM, 2010; Rouse, 2009; Squires, et al., 2010). It is estimated that the majority of nurse managers are educationally underprepared and have little initial training or continuing development for the role (Kleinman, 2003; USDHHS, 2010). Transformational leadership skills of nurse managers have been linked to patient, staff, and organizational outcomes including, increased staff empowerment, job satisfaction, staff retention, productivity, and organizational commitment (Cummings et al., 2010; Pillay, 2010). Patient outcomes of satisfaction, adverse events, and 30-day mortality are also positively correlated with TL skills of nurse managers (Germain & Cummings, 2010; Kleinman, 2004; Kramer et al., 2010; Squires et al., 2010). Therefore, nurse managers’ transformational leadership skills development is needed to improve the quality, safety, and cost associated with health care delivery.

The purpose of this study was to determine whether the use of a simulation-based leadership development program develops new transformational leadership skills and/or improves the quality and frequency of transformational leadership skills used over time in a sample of nurse managers, thus, developing and/or improving the corresponding leader outcomes that include follower satisfaction and extra effort, and leader effectiveness, as measured by the Multifactor Leadership Questionnaire (MLQ). (Abstract shortened by ProQuest.)

Today's nurse leaders face many challenges and concerns that require a new type of leadership — authentic leadership. Nurse leaders who are authentic are behaviorally altruistic, transparent, have personal integrity, possess attributes of caring, ethical moral values, shared and balanced decision making, effective communication, and integral relationships. The purpose of this research was to explore, develop and validate an instrument measuring perceived authentic leadership, by staff nurses, that is grounded in a nursing theoretical framework that supports clinical practice and knowledge development. In addition, to validation of the instrument, hypotheses investigated in this research examined the extent in which the Authentic Nurse Leadership Questionnaire, is supported by the Authentic Nurse Leadership conceptual framework, and its relationship between authentic nurse leaders' attributes, nurse engagement, and nurse work-life. The methodology included Polit and Beck's method of multi-item scale development. A cross-over design was employed to compare the Authentic Nurse Leadership Questionnaire, this new instrument, with Authentic Leadership Questionnaire was implemented in the pilot and full study phase. Sample included: an expert panel (n =19) which included clinical nurse leaders, faculty and researchers, pilot study (n = 20) registered staff nurses and full study (n = 309) registered staff nurses who provide 50% or more direct patient care. Study results indicated: the average Content Validity Indices (CVI) for the final 29-item scale, its subscales and individual questions, all surpassing the .9 bench mark. The Cronbach's alpha coefficients ranged from .89 to .99, and the Intra Class Coefficients (ICCs) for 3 week test-retest reliability from 0.87 to .94. Findings indicated the ANLQ was reliable and valid instrument to measure authentic nursing leadership. Overall the ANLQ demonstrated better nursing values as indicated by a stronger relationship with nursing areas of work-life and nurse engagement than what ALQ did. The ANLQ concepts were statistically supported by both exploratory and confirmatory factor analyses. Nurse leaders who incorporate Authentic Nurse Leadership into their practice are uniquely positioned to influence nurse work-life environment and nurse engagement.

Leadership is essential for the survival of the healthcare organization in the midst of challenging times due to health care reform and the public's desire for transparency and improved quality outcomes. Transformational leadership is desirable for nurse leaders in a rapidly changing environment, but nurse leaders are often challenged with the inability to meet the demands of this complex environment for a variety of reasons. The increasing competition for resources, both human and fiscal, leading to wider spans of control is one of those challenges. The purpose of this quantitative, correlational research study was to explore the relationship between span of control and the leadership style of nurse leaders. The setting for the study was a multi-facility healthcare system in the Midwest. Avolio and Bass' (2004) Multifactor Leadership Questionnaire Form 5X Short (MLQ) was utilized to determine the nurse leader's leadership style along the full range of leadership continuum. The span of control or number of direct reports each nurse leader had was collected along with other demographic data.

The Pearson product moment correlation was utilized to analyze the relationship between span of control and transformational leadership, and span of control and transactional leadership. The Spearman's rho correlation coefficient was utilized to analyze the relationship between span of control and passive/avoidant behavior. The data suggest that there is no relationship between span of control and the leadership style of nurse leaders. While no relationship was found, the findings remain significant to nurse leaders as they navigate the complex territory of healthcare and make strategic decisions about organizational structures.

Healthcare management is an industry where skill sets are incremental, and Registered Nurses (RNs) must gain their clinical skills before they develop their management skills. Professional training for management-bound RNs seldom comprises more than a few disjointed days or weeklong development seminars, which is valuable but inadequate. The purpose of this original basic qualitative study, which employed Husserl and Heidegger’s approach of phenomenology, was to explore the lived experiences of staff RNs who transitioned into the Clinical Nursing Supervisor (Nurse Manager) role within a small rural community hospital in North Carolina. Semi-structured interviews using open-ended questions were utilized to collect rich, contextual data until data saturation occurred. Open and axial coding of the data, documented in a code/theme frequency table, facilitated the discovery of central themes within the data including: a lack of orientation to the new role; inconsistent expectations of the new role; the benefits of a formal program or structured orientation for the new role, and a need to focus the hospital administration on formal leadership orientation and succession planning. The evidence from this original basic qualitative study aligns with the published literature regarding the transition from a staff RN role into a nursing leadership role and supports making a proposal to the hospital’s administration for a systems-oriented Clinical Nursing Supervisor training opportunity such as a 90-day nursing leadership orientation that included formal classes on budgeting, common human resource management issues, and how to evaluate staff. This formalized training, in concert with one-on-one mentoring with experienced Clinical Nursing Supervisors, would ensure a smoother transition from the staff RN role into a Clinical Nursing Supervisor role and would produce more efficient, more satisfied nursing leadership professionals who are more inclined to stay with the organization that helped their career growth.

ABSTRACT An Ethnographic Investigation on How Chief Nursing Officers Use Transformational Leadership to Lead and Support New Nurse Graduates by Susan Pailet Purpose: The purpose of this ethnographic study was to examine how chief nursing officers (CNOs) use transformational leadership to lead and support new nurse graduates based on the Transformational Leadership Skills Inventory (TLSi) tool developed by Larick and White (2012). Methodology: The sample for this qualitative ethnographic study included 13 CNOs in 4 counties in California (Los Angeles, Orange, San Bernardino, and Riverside) working for hospitals and other healthcare settings. The data sources for this study included observations, interviews, and artifact reviews. Data were analyzed using a thematic analysis. Findings: 8 major findings emerged: (a) CNOs participate in rounds and take time to listen to new nurses, (b) CNOs create a culture of caring and compassion with new nurses, (c) CNOs use storytelling to create sustainable change, (d) CNOs meet with new nurses regularly, (e) CNOs recognize generational differences, (f) CNOs hire new nurses with critical thinking and soft skills, (g) CNOs support evidence-based decision making, and (h) CNOs encourage teamwork and collaboration through shared governance. Conclusions: Based on the findings, it can be concluded that new nurses thrive when CNOs communicate with them by rounding and listening to them; new nurses understand their responsibility to patient outcomes when CNOs create a culture of caring; new nurses are retained when CNOs adapt rapidly to change; new nurses thrive when they feel like they are able to share their opinions, thoughts, and experiences with their CNOs; CNOs are working to engage older generations with the new millennial generation of nurses; patient satisfaction increases when CNOs focus on ensuring new nurses have good customer service and critical thinking skills; new nurses make fewer medical errors when CNOs support evidence-based decision making; and new nurses thrive when CNOs encourage teamwork and collaboration through shared governance. Recommendations: Further research is recommended in other geographical areas, with other types of nursing facilities, on factors that influence new nurses to leave the profession within 2 years of graduating nursing school, using new nurses as the population to understand their perspective, on nurses who have at least 5 years of experience, and to further correlate patient satisfaction surveys to employee satisfaction surveys.