Board talk: How members of executive hospital boards influence the positioning of nursing in crisis through talk

Talk by members of executive hospital boards influences the organizational positioning of nurses. Talk is a relational leadership practice. Using a qualitative-interpretive design we organized focus group meetings wherein members of executive hospital boards (7), nurses (14), physicians (7), and managers (6), from 15 Dutch hospitals, discussed the organizational positioning of nursing during COVID crisis. We found that members of executive hospital boards consider the positioning of nursing in crisis a task of nurses themselves and not as a collective, interdependent, and/or specific board responsibility. Furthermore, members of executive hospital boards talk about the nursing profession as (1) more practical than strategic, (2) ambiguous in positioning, and (3) distinctive from the medical profession. Such talk seemingly contrasts with the notion of interdependence that highlights how actors depend on each other in interaction. Interdependence is central to collaboration in hospital crises. In this paper, therefore, we depart from the members of executive hospital boards as leader and "positioner," and focus on talk-as a discursive leadership practice-to illuminate leadership and governance in hospitals in crisis, as social, interdependent processes.

Understanding Employee Voice Behavior Through the Use of Digital Voice Channel in Long-Term Care: Protocol for an Embedded Multiple-Case Study

BACKGROUND

Specific challenges in the health care sector, such as hierarchical structures, shortages of nursing staff, and high turnover of nursing staff, can be addressed by a change process of organizational culture into shared governance. Data from business organizations show that the use of digital voice channels provides employee voice. This approach makes concrete the opportunity for employees to raise their voices by answering surveys and making comments in an anonymous forum, which subsequently positively influences staff turnover and sick leave. Since there is no clear understanding of how a digital voice channel can be used in long-term care to address employee voice, a research gap has been identified.

OBJECTIVE

The purpose of ADVICE (Understanding Employee Voice Behavior; the acronym for this study) is to understand how the use of a digital voice channel performs in long-term care (residential long-term care and home care facilities). The aim of this study is to understand how the digital voice channel can support staff in making their voices heard and to see what managers need to use the voice channel to change the work environment.

METHODS

An embedded multiple-case study will be used to explore the experiences of 2 health care providers who have already implemented a digital voice channel. ADVICE is organized into two main phases: (1) a scoping review and (2) an embedded multiple-case study. For this purpose, focus group interviews with employees, discursive-dialogical interviews with managers, meeting protocols, and data from the digital voice channel will be analyzed. First, all units of analysis from every embedded unit will be separately analyzed and then comprehensively analyzed to obtain a case vignette from every embedded unit (within-analysis). In the second stage, the analyzed data from the embedded units will be compared with each other in a comparative analysis (cross-analysis).

RESULTS

The results will provide insight into how digital voice channels can be used in long-term care to address employee voice. We expect to find how the digital voice channel can empower nurses to speak up and, consequently, create a better work environment. Data collection began in August 2023, and from a current perspective, the first results are expected in summer 2024.

CONCLUSIONS

In summary, the results may help to better understand the use of a digital voice channel in the health care sector and its transformative potential for leadership. At the organizational level, research can help to improve the attractiveness of the workplace by understanding how to give employees a voice.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/48601.

Investigating the complex relationships between leadership, psychological safety, intrinsic motivation, and nurses' voice behavior in public hospitals using PLS-SEM

Background

Voice behavior among nurses in public hospitals lacks profound disclosure despite knowing its imperatives. This situation needs to be continuously studied, and the best practices discovered, disclosed, and implemented in hospitals that are serious in curbing unprofessional conduct while advancing healthcare requirements for the benefit of humanity.

Objective

This empirical research investigated the significant implications of psychological safety and intrinsic motivation in the mostly uncultivated link concerning the empowering leadership style and leader-member exchange (LMX) constructs and the practice of voice behavior among nurses in the selected Malaysian public hospitals.

Methods

Primary data of the study were from nurses employed in the selected large public hospitals within the Klang Valley, also known as the Greater Kuala Lumpur of Malaysia. A total of 366 complete and valid responses were collected with the help of head nurses via a self-administered survey in February 2020. The SmartPLS 4 for Windows software generated the standard partial least squares structural equation modeling (PLS-SEM) to estimate associations between research variables and evaluate the model's strength in explaining the proposed constructs.

Results

This research disproved the indirect effects of psychological safety on the connection explorations between empowering leadership-voice behavior (β = 0.015, t-value = 0.300, 95% CI [-0.090, 0.110]) and LMX-voice behavior (β = 0.002, t-value = 0.285, 95% CI [-0.014,0.020]). Intrinsic motivation partially mediates the link between empowering leadership-voice behavior (β = 0.214, t-value = 7.116, 95% CI [0.160, 0.279]) and LMX-voice behavior (β = 0.114, t-value = 4.669, 95% CI [0.071, 0.168]) of the nurses.

Conclusion

Patients, non-governmental organizations, volunteers, nurses, and other hospital staff are vested in how voice behavior signifies in the healthcare context. Essential factors for nurses to become more outspoken are discovered in this study, providing nurse managers and other leaders with numerous recommendations for encouraging vocal behavior and bolstering psychological safety and intrinsic motivation. More competent nurses will improve workplace culture, deliver superior healthcare services, and manage publicly financed hospitals with an overall sense of trust, but only after a substantial effort to execute reforms.

Factors influencing newly graduated registered nurses' voice behavior: An interview study

AIM

To gain insight into the factors that affect newly graduated registered nurses' voice behavior.

BACKGROUND

Employees with little work experience may experience difficulties with speaking up. Given that a lack of voice can negatively affect the delivery of safe client care and lower nurses' job satisfaction, it is important to understand which factors facilitate and hinder newly graduated nurses' voice behavior.

METHODS

A qualitative descriptive study was conducted using semi-structured interviews with 17 newly graduated registered nurses working in inpatient hospital settings.

RESULTS

In total, seven factors emerged from our data, which were grouped in four, overarching themes. Whether newly graduated nurses speak up depends on (1) their levels of self-confidence; (2) whether they feel encouraged and welcome to speak up; (3) their relationship with the voice target; and (4) the content of their voice message.

CONCLUSION

Factors that affect newly graduated nurses' voice behavior are multifaceted, but mostly center around time spent in and relationships at the workplace.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers and colleagues can build an environment that fosters newly graduated nurses' voice behavior. Specifically, induction programs, assigning mentors and offering additional training can support newly graduated nurses in developing voice behavior.

Supervisor’s Negative Mood and Healthcare Workers’ Voice Behavior: A Moderated Mediation Model

Healthcare workers’ voice is of importance in decreasing medical accidents and improving the efficacy of hospital units. To investigate the impact and the underlying mechanisms of supervisors’ negative mood on healthcare workers’ voice behavior, based on the mood contagion perspective, we designed a cross-sectional study, with 299 healthcare workers from mainland China completed the questionnaires. The results indicated supervisors’ negative mood was positively related to healthcare workers’ negative mood, which further led to less constructive voice and more defensive voice. Moreover, the healthcare worker’s emotional intelligence aspect of self-emotion appraisal moderated this relationship, but not others-emotion appraisal. We believe healthcare workers’ supervisors should pay attention to their negative mood expression and regulation. In the hope of reducing being influenced by supervisors’ negative mood, training about noticing and recognizing their own emotions are needed for healthcare workers.