Looking ahead to our next generation of nurse leaders: Generation X Nurse Managers

Training Opportunities for Managers in Home Health, Hospice, and Community-Based Care Settings

OBJECTIVE

The aim of this study was to identify areas for developing management skills-focused continuing education for managers working in home health, hospice, and community-based settings.

BACKGROUND

Healthcare managers play a vital role in organizations, yet they have a range of management training.

METHODS

Researchers conducted a cross-sectional survey of managers at a large Visiting Nurse Association. Descriptive and bivariate analyses were performed to examine confidence in management skills by respondent characteristic. Factor and cluster analyses were used to examine differences by role.

RESULTS

For all 33 management tasks, managers with 6+ years of experience reported greater confidence than managers with 0 to 5 years of experience. Tasks with the lowest confidence were budgeting, interpreting annual reports, strategic planning, measuring organizational performance, and project planning. Managers were clustered into 5 "profiles."

CONCLUSION

Management training is not 1-size-fits-all. Healthcare organizations should consider investing in training specific to the identified low-confidence areas and manager roles to better support and develop a robust management workforce.

A modified Delphi study on establishing a curriculum content structure for the leadership and management competency cultivation for future nurse managers in China

Background

It is critical to train future nursing managers in advance for the prospective development of healthcare organizations, but a widely recognized curriculum content structure for leadership and management competency development for nurturing future nurse managers was lacking in China.

Objective

To establish a curriculum content structure for the leadership and management competency cultivation for future nurse managers in Chinese healthcare setting.

Methods

A modified Delphi study was conducted. 22 experts who have in-depth knowledge of nursing leadership and management from 4 main geographical regions in China were included. The initial curriculum content structure was constructed based on a previous qualitative study and two team meetings. Subsequently, a two-round Delphi survey was conducted with 22 panelists in the first round and 19 in the second round. Scores of importance and textual comments were collected and used to judge the achievement of consensus.

Results

After the two-round Delphi process, consensus was reached, as each item was rated ≥4 by 84.21-100% of the experts and each one had a coefficient of variance (CV) ≤ 0.174. The finalized curriculum content contains 9 modules and 27 items.

Conclusions

This study formed a curriculum content structure for leadership and management competency training for nurses preparing for managerial roles, which contribute to the establishment of a nursing management talent pipeline to meet the needs of healthcare institutions for contemporary nurse managers.

A Survey of Interim Nurse Managers to Understand the Role and the Impact on Nurse and Patient Outcomes

OBJECTIVE

The aim of this study was to describe the current state of the interim manager (IM) role and the impact of the role on job performance.

BACKGROUND

Interim managers provide leadership during organizational change, yet little is known about the role and its impact on outcomes.

METHODS

An electronic survey was completed by 179 IMs working in acute care hospitals. Instruments included the Nurse Manager Practice Environment Scale, Decision Involvement Scale, Subjective Stress Scale, Maslach Burnout Inventory, and Brief Resilience Scale.

RESULTS

The average tenure for IMs was 10 months. Despite moderately high levels of stress and exhaustion, IMs were resilient, positively viewed their work environment, and perceived their job performance as positively impacting nurse and patient outcomes. Interim managers were generally satisfied in their roles and likely to pursue nursing leadership as a career.

CONCLUSION

Interim managers desire permanent leadership opportunities providing a pool for replacing exiting nurse managers. Support is needed to be successful.

Nurses' generational stereotypes and self-stereotypes: a cognitive study

PURPOSE

The present research offers insights into the generational stereotypical beliefs that different generations of nurses hold about the own and the other generations and the implications on the work floor.

DESIGN/METHODOLOGY/APPROACH

This cross-sectional, exploratory study employs a cognitive mapping approach known as the repertory grid. The sample consisted of 15 Generation Y, 15 Generation X and 15 Baby Boomer nurses.

FINDINGS

Beliefs of nurses about their own and the other generations direct social categorization and generational stereotypes of the in-group and out groups. These stereotypes mold nurses' beliefs and attitudes towards their coworkers and are enacted leading to self-fulfilling prophecies. Especially Generation Y and Baby Boomer nurses are negatively stereotyped and have their ways to deal with these negative stereotypes.

PRACTICAL IMPLICATIONS

Nurses and their managers who hold generational stereotypes may unknowingly create cliques within an organization and adopt behaviors and expectations based on generational (self-) stereotypes. The author offers noteworthy insights for fostering intergenerational synergies amongst nurses, which are important since the level of interdependent relations amongst nurses required to provide care.

ORIGINALITY/VALUE

The present study moves away from the research about the typical characteristics of nurses across the generational workforce. Instead, mental models about how different generations of nurses construe their coworkers belonging to different generations including their own generation are drawn. Employing the repertory grid technique (RGT), an established method for uncovering people's personal and collective belief systems, the present study shows how generational stereotyping and self-stereotyping among nurses belonging to varying generational cohorts occurs and debates its implications.

Current turnover intention among nurse managers, directors, and executives

BACKGROUND

Nursing leadership turnover can adversely affect nurse retention and thus quality of care. Little research has examined the way nurses at differing levels of leadership experience their workplace and voluntarily decide to leave.

PURPOSE

Our study sought to explore and compare intent to leave and turnover experiences of acute care nurse managers, directors, and executives.

METHODS

Data were collected via an online survey. Participants included nurse managers, directors, and executives from 47 states (n = 1880) working in acute care settings.

FINDINGS

Over 50% of respondents intend to leave their current positions within the next 5 years with reasons for leaving differing by type of nurse leader. Retirement was a factor for slightly over 30% of those nurse leaders overall and almost 50% of nurse executives.

DISCUSSION

Nurse managers, directors, and executives experience turnover and intent to leave differently. Most frequently, voluntary factors for leaving a position include job dissatisfaction and a desire for promotion and advancement.

Measuring work engagement in a multigenerational nursing workforce

AIM

To examine the level of work engagement among Veteran-aged, Baby Boomer, Generation X, (Gen X) and Millennial registered nurses.

BACKGROUND

Workforce engagement plays a critical role in health care organisations. Organisations with a highly engaged nursing workforce outperform those organisations that have disengaged or non-engaged employees.

METHOD

Quantitative non-experimental causal comparative study measured multigenerational nurses' level of work engagement.

RESULTS

Veteran-aged nurses were the most engaged, followed by Baby Boomer, Gen X and Millennial. The sample scored highest on dedication and lowest on vigour. Veterans and Baby Boomer nurses were statistically different than Gen X and Millennial nurses in their level of engagement. There were no statistical differences between Veteran and Baby Boomers and between Gen X and Millennials in their level of engagement.

CONCLUSIONS

Gen X and Millennial RNs scored lowest on level of engagement and are statistically similar in their level of disengagement.

IMPLICATION FOR NURSING MANAGEMENT

Nurse managers must prioritize engagement strategies as a core function of their leadership role. It is essential that leaders cultivate an employee engagement culture across a multigenerational workforce. Nurse leaders should take full advantage of the experience of the retiring generations to mentor and transfer critical knowledge to the Gen X and Millennial nurses.

Common components of nurse manager development programmes: A literature review

AIMS

To critically appraise contemporary literature and synthesize common components of nurse manager development programmes.

BACKGROUND

Although the need for nurse manager development programmes has been well documented, minimal recent research exists which identifies and evaluates the common components in these programmes. Furthermore, nurse managers continue to be poorly prepared and supported in role transition, contributing to poor organisational and role performance and decreased retention.

METHOD

A structured literature review saw 14 original research publications appraised for quality, analysed and included in the review.

RESULTS

The common components identified in nurse manager development programmes include curriculum, method of delivery, support, and funding components. Various subthemes were also identified.

CONCLUSION

The components identified within existing nurse manager development programmes are varied. Although there are common components within nurse manager development programmes, these individual components have not been evaluated for effectiveness. There is a clear need for further development of nurse manager development programmes and evaluation of the specific components within.

IMPLICATIONS FOR NURSING MANAGEMENT

An understanding of the common components in NM development programmes is useful for designing and implementing robust evidence-based programmes. Inclusion of these components may facilitate a smoother role transition, enhance performance and improve recruitment and retention of nurse managers.

Factors that influence nurse manager job satisfaction: An integrated literature review

AIMS AND OBJECTIVES

To understand factors that influence nurse manager job satisfaction.

BACKGROUND

Nurse managers influence patient care, staff retention and health care initiatives, yet poor retention and recruiting outcomes threaten the supply of managers. Research regarding staff nurse job satisfaction and retention is substantial, but far less is known about these same areas for nurse managers.

EVALUATIONS

Electronic databases were systematically searched to find studies regarding nurse manager job satisfaction. Articles were selected using professional guidelines and set criteria. Fourteen peer-reviewed publications were included in this review. Major themes were extracted and synthesized.

KEY ISSUES

Findings from this review indicate that nurse manager job satisfaction is influenced by workloads, organisational support, nurse manager-supervisor relationships and the quality of their training and competency.

CONCLUSIONS

This review found overwhelming workloads, inadequate resources, poor supervisor relationships and insufficient training to be commonplace for nurse managers. To improve satisfaction and retention, institutions must cultivate practice environments that promote healthy workloads, strong interorganisational relationships, professional growth and success of their nurse managers.

IMPLICATIONS FOR NURSING MANAGEMENT

Findings from this study reveal areas for improvement that health care institutions and senior nursing leadership can use to transform practice environments, increase nurse managers' job satisfaction and entice them to stay.

Preparing Nurse Managers for Authentic Leadership: A Pilot Leadership Development Program

OBJECTIVE

This study examined the impact of a pilot leadership development program on nurse managers' (NMs') use of authentic leadership behaviors.

BACKGROUND

Nurse managers often receive little or no formal training. Literature suggests formal leadership development programs can enhance their leadership competency. A leadership development program was designed and pilot tested to determine effectiveness in enhancing authentic leadership competency.

METHODS

A cross-sectional study used a convenience sample of 16 NMs who participated in the pilot program.

RESULTS

Measurable increases in authentic leadership behaviors were demonstrated in both the self-assessments (mean scores increased in 3 of 4 subscales) and RN direct report assessments (mean scores increased in all 4 subscales), with statistical significance achieved in 1 self-awareness behavior.

CONCLUSIONS

The pilot program demonstrated merit as a tool to enhance NMs' authentic leadership behaviors. Managers perceived greater self-awareness, and direct reports perceived positive change in managers' use of authentic leadership behaviors.

Creating a Culture of Promoting From Within

Although it is common to promote direct care nurses to management positions in nursing, it is important to have a well-defined process. Excelling in clinical skills at the bedside does not always translate into management and leadership abilities. Having a way to internally identify and develop frontline leaders for future management positions is important in succession planning, creating organizational culture, decreasing costs, and increasing employee engagement.

Exploring the role of advanced nurse practitioners in leadership

There have been several changes to healthcare services in the UK over recent years, with rising NHS costs and increasing demands on healthcare professionals to deliver high-quality care. Simultaneously, public inquiries have identified suboptimal leadership throughout the NHS, which has been linked to a lack of clear leadership across the healthcare professions. In nursing, the role of the advanced nurse practitioner is regarded as a solution to this leadership challenge. This article examines the background to the development of the advanced nurse practitioner role. It also explores the various factors that may affect nurse leadership and the role of the advanced nurse practitioner, including professional identity, gender, nursing's strategic influence, clinical outcomes, and recruitment and retention. The article concludes that while advanced nurse practitioners can positively influence clinical outcomes and cost efficiency, they must also be adequately prepared to undertake a leadership role.

Stress and ways of coping among nurse managers: An integrative review

AIMS AND OBJECTIVES

To appraise and synthesise empirical studies examining sources of occupational stress and ways of coping utilised by nurse managers when dealing with stress.

BACKGROUND

The Nurse Manager's role is challenging yet draining and stressful and has adverse consequences on an individual's overall health and well-being, patients' outcomes and organisational productivity. Considerable research has been carried out; however, an updated and broader perspective on this critical organisational issue has not been performed.

DESIGN

An integrative review.

METHODS

Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO and MEDLINE) were searched to identify relevant articles. Search terms and MeSH terms included: "charge nurse," "coping," "coping strategy," "coping style," "psychological adaptation," "psychological stress," "stressors," "nurse manager" and "unit manager." Twenty-two articles were included in this review. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines.

RESULTS

Four themes were identified: moderate stress levels, common sources of stress, ways of coping and the impact of nurses' characteristics on stress.

CONCLUSIONS

Nurse managers experienced moderate levels of stress mainly from heavy workloads, lack of resources and financial responsibilities. Enhancing social support and promoting job control were seen as important in reducing work stress and its related consequences. Additional studies using a more rigorous method and a larger sample size preferably in multicultural settings would shed more light on this topic.

RELEVANCE TO CLINICAL PRACTICE

Hospital and nurse administrators play an important role in promoting supportive structures for daily professional practice for nurse managers through staffing, organisational resources, support services, leadership and stress management training.

Outcomes of interventions for nurse leaders' well-being at work: A quantitative systematic review

AIMS

The aim of this study was to gather, assess and synthesize current research knowledge on interventions that aimed to improve nurse leaders' well-being at work.

BACKGROUND

The research evidence on interventions for nurse leaders' well-being at work has been sporadic and there are a lack of evidence-based recommendations for effective interventions that inform practice, future studies and education.

DESIGN

A quantitative systematic review, in accordance with the Cochrane Collaboration procedures and the reporting guidance in the PRISMA statement.

METHODS

CINAHL, Cochrane, EBSCO, PubMed, PsycInfo and Scopus databases were searched from 2009 - December 2016. The final data consisted of five studies, which were assessed with the Cochrane Risk of Bias Tool. The data were summarized narratively.

RESULTS

The interventions were mainly concerned with stress management and were targeted at individuals. Four of the five interventions examined produced statistically significant outcomes on well-being at work.

CONCLUSIONS

Stress management interventions that included mental exercises were the most successful. Interventions primarily reduced the stress experienced by participants, but the evidence on the stability of these outcomes was poor because of the short follow-up periods. The certainty of evidence was low, indicating that the use of these interventions among nurse leaders might be beneficial. Further studies are needed to provide more reliable recommendations for their use. As the performance of nurse leaders influences organizations, through interpersonal relationships, it is important to pay more attention in the future to the development of organization- and person-directed interventions and their combinations. A structural empowerment approach should also be considered.

Wired to the Workplace: The Relationship Between Electronic Connectedness to Work and Nurse Manager Satisfaction

OBJECTIVE

The aim of this study is to describe the beliefs and behaviors of nurse leaders regarding electronic connectedness with their workplace and workplace support.

BACKGROUND

Electronic communication enables leaders' continuous availability to the workplace. This may blur home-work boundaries and contribute to burnout.

METHODS

This mixed-methods study surveyed nurses in 6 acute care hospitals in north Texas. A qualitative phase employed focus groups composed of nurses from participating hospitals to validate and enrich data collected in the quantitative phase.

RESULTS

Data showed that leader support directly influenced work-related electronic communication by influencing expectations regarding connectedness. Furthermore, leaders who frequently thought of leaving employment reported significantly lower levels of supervisor support and stronger beliefs that work interfered with home life than other respondents did. Focus group data supported survey findings.

CONCLUSIONS

Electronic availability of nurse leaders did not directly affect satisfaction, but supervisor support and perception that work interferes with home life strongly and directly affected satisfaction.

Nurse managers' insights regarding their role highlight the need for practice changes

AIM

The purpose of this study was to understand the insights of nurse managers regarding the nurse manager role.

BACKGROUND

Nurse managers are vital to the success of healthcare organizations. Vacancy rates of nurse manager positions are on the rise. Recruiting and retaining qualified individuals for these positions requires an understanding of the perceptions of nurse managers regarding the role and the issues embedded in the role.

METHODS

A descriptive, qualitative investigation was conducted. Data were analyzed using content analysis.

FINDINGS

Although desired, role orientation, mentorship, and a strong foundational knowledge, were often lacking. Personal attributes viewed as important for success in the role included seeking opportunities and intentional self-growth. Lessons learned while in the role included the art of managing role demands and that comfort comes with time.

CONCLUSION

Concerns regarding the preparation for, introduction to, and support in the nurse manager role highlight the need for practice changes.