The role and preparation of first-line nurse managers in Australia: where are we going and how do we get there?

Rationing nurses: Realities, practicalities, and nursing leadership theories

In this paper, we examine the practicalities of nurse managers' work. We expose how managers' commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We learned how nurse managers' responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers' responsibilities are shaped to conform to institutional purposes.

The challenges acute care nurse unit managers face and the strategies they use to address them: Perceptions of directors of nursing and nurse unit managers

The aim of this study was to investigate the challenges that nurse unit managers (NUMs) face while working in acute care settings, the strategies they use to deal with these challenges, and the effectiveness of these strategies from the perspectives of NUMs and their supervisors. NUMs (N = 22) and directors of nursing (N = 3) were interviewed for this study. Thematic analysis revealed 14 challenges relating primarily to NUMs interactions with others, both within and outside of their wards/units. These challenges related to the managerial, but not clinical, aspects of their roles; 16 strategies for managing these challenges were identified, the effectiveness of which seemed dependent on how well they were executed. The strategies are: seeking assistance and support; trial and error; satisficing; taking responsibility for own professional development; scheduling of time; working longer hours; delegation; adaptive staffing and rostering; being a visible presence on the ward; team development; facilitating professional development for staff; being available for staff; negotiation and collaboration; communication; working with the processes of a large organisation; and complying with the demands of others, The findings make a strong case for NUMs to be supported in undertaking comprehensive management education.

The challenges acute care nurse unit managers face and the strategies they use to address them: Perceptions of directors of nursing and nurse unit managers

The aim of this study was to investigate the challenges that nurse unit managers (NUMs) face while working in acute care settings, the strategies they use to deal with these challenges, and the effectiveness of these strategies from the perspectives of NUMs and their supervisors. NUMs (N = 22) and directors of nursing (N = 3) were interviewed for this study. Thematic analysis revealed 14 challenges relating primarily to NUMs interactions with others, both within and outside of their wards/units. These challenges related to the managerial, but not clinical, aspects of their roles; 16 strategies for managing these challenges were identified, the effectiveness of which seemed dependent on how well they were executed. The strategies are: seeking assistance and support; trial and error; satisficing; taking responsibility for own professional development; scheduling of time; working longer hours; delegation; adaptive staffing and rostering; being a visible presence on the ward; team development; facilitating professional development for staff; being available for staff; negotiation and collaboration; communication; working with the processes of a large organisation; and complying with the demands of others, The findings make a strong case for NUMs to be supported in undertaking comprehensive management education.

Preparing the air for nursing care: A grounded theory study of first line nurse managers

Abstract

The first line nurse managers’ opportunities to lead nursing care seem to be diminishing. The aim of this study was, therefore, to gain an understanding of the first line nurse managers in their experiences in the development of nursing care as part of a wider research programme. Finnish nurse managers wrote narratives at the beginning of five different leadership courses in this grounded theory study. ‘Preparing the Air for Nursing Care’ emerged as a core category. It was formed by two major categories. ‘Being Concerned about Nursing Care’ describes the nurse managers’ focus on the development of nursing care, the nursing caregivers’ health and knowledge and a concern for the whole organisation. The second major category ‘Creating the Direction and Content of Nursing Care’ describes the nurse manager working together with the staff to create individual and family-centred best practice, initiating relationships and dialogues for nursing care, and a culture of caring. A typology was created that explained the four main modalities to emerge from the data: ‘the Active Developer’, ‘the Passive Thinker’, ‘the Impulsive Creator’ and ‘the Routine Manager’.

Using a voice-centered relational method of data analysis in a feminist study exploring the working world of nursing unit managers

In this article, we discuss the application of a data analysis method used in a feminist study that explored the working world of nursing unit managers in Australia. The decision to use a voice-centered relational approach to the data was based on a desire to delve into the working world of nursing unit managers and uncover the layers within the narratives that specifically related to their perceptions of themselves, their world, and the context in which they work. Throughout this article, the focus is on how this method was applied to uncover multiple layers of meaning within the data, rather than on the researchers' and participants' roles in the coconstruction of interview data. An excerpt from an interview transcript is used to illustrate how the stories of the participants were explored using this method.

Paths to nursing leadership

AIM

The aim was to explore why nurses enter nursing leadership and apply for a management position in health care. The study is part of a research programme in nursing leadership and evidence-based care.

BACKGROUND

Nursing has not invested enough in the development of nursing leadership for the development of patient care. There is scarce research on nurses' motives and reasons for committing themselves to a career in nursing leadership.

METHOD

A strategic sample of 68 Finnish nurse leaders completed a semistructured questionnaire. Analytic induction was applied in an attempt to generate a theory.

FINDINGS

A theory, Paths to Nursing Leadership, is proposed for further research. Four different paths were found according to variations between the nurse leaders' education, primary commitment and situational factors. They are called the Path of Ideals, the Path of Chance, the Career Path and the Temporary Path.

CONCLUSION

Situational factors and role models of good but also bad nursing leadership besides motivational and educational factors have played a significant role when Finnish nurses have entered nursing leadership. The educational requirements for nurse leaders and recruitment to nursing management positions need serious attention in order to develop a competent nursing leadership.

The dynamics of curriculum design, evaluation, and revision. Quality improvement in leadership development

The nursing shortage and specifically the shortage of new nursing leaders has fueled heightened recognition of the need for leadership development. This article considers the application of the quality improvement process to leadership curriculum development for the Center for Nursing Leadership's (CNL) Journey Toward Mastery program. Both the postmodernist approach and a commitment to scholarship are used as a framework to develop, evaluate, and revise the program. Further, the importance of symmetry between philosophical perspective and curriculum design are illustrated.

Evaluation of a pilot mentoring programme for nurse managers

BACKGROUND

The Institute of Nursing Executives is a professional organization with a membership of approximately 150 Australian nurse managers and administrators. Members of rural zones were concerned by the lack of support available to new managers working in isolated areas and sought to develop a mentoring programme that would establish both professional development and support networks for these managers. A pilot programme was developed for two rural areas of New South Wales and one metropolitan site (the city of Sydney).

AIM

The evaluation reported here aimed to determine participant expectations of mentoring and outcomes of the pilot programme.

METHOD

The programme included matching and self-selection of mentor and mentee roles and attendance at a full-day Mentoring Workshop. The programme was evaluated by voluntary and anonymous pre- and postworkshop questionnaires sent to all participants, and postworkshop telephone interviews.

RESULTS

Thirty-seven participants (79% of those enrolled in workshop) responded to the preworkshop questionnaire (20 identifying as mentees; 17 as mentors). Findings reiterated the lack of professional support and access for rural/remote area nurse managers and illustrated that new nurse managers lacked confidence in coaching and stimulating staff. Expectations of both mentors and mentees were similar in valuing a confidential, on-going mentoring relationship. Postworkshop questionnaires (n = 16) and telephone interviews (n = 11) highlighted issues about personal choice and timing, expectations of a structured programme and making greater use of existing technology to support and maintain networks.

CONCLUSION

The pilot mentoring programme was highly successful in identifying strategies for the development of a tailored and sustainable programme for newly appointed nurse managers. Provision of a highly structured and facilitated programme carries high expectations of continued external support. Nurse managers also expressed a desire to choose when, how and whom they would select as mentors. Suggestions for the future included a greater use of technology to facilitate e-mail and internet-based discussion groups and mentor support.