Nurse manager communication and outcomes for nursing: An integrative review

Exploring the role of communication in effective nurse leadership and patient care

Nurses have to be aware of their personal responsibility to demonstrate effective leadership and thereby contribute to safe and effective patient care. One of the primary skills that nurses can use to become effective leaders is communication. This article explores how communication is a vital tool in enabling nurse leaders to motivate their team members and advocate for patients. The author details some of the essential communication skills that nurses require if they are to promote person-centred care and explores the often-neglected areas of non-verbal and written communication. By possessing a full range of communication skills, nurses can empower themselves to lead clinical teams and advocate for patients.

Nurse leaders' interpersonal communication competence: A mixed-method systematic review

AIM(S)

To identify and synthesize evidence available on nurse leaders' interpersonal communication competence.

DESIGN

Systematic mixed-methods review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist.

METHODS

The data were collected following predefined inclusion criteria. Two authors independently performed the study selection using Covidence software. Three authors assessed the quality using Joanna Briggs' Institute's critical appraisal tool and the mixed-methods appraisal tool. The data-based convergent synthesis design and narrative synthesis were used.

DATA SOURCES

CINAHL, PubMed, Scopus, Business Source Elite, Academic Search Premier, Communication & Mass Media Complete, PsycInfo, Web of Sciences, Medic and Finna.fi were searched and the screening of citations in relevant articles. The final searches were performed on 17 October 2022.

RESULTS

A total of 26 studies-15 quantitative, 9 qualitative and 1 of both mixed-method and multi-method-met the inclusion criteria. The nurse leaders' interpersonal communication competences described in the extant literature were categorized into three themes: message competence, relational competence and task competence. There were considerable differences in the levels of competence, as some competences were considered basic communication skills, while others required more advanced level competences. Furthermore, three competence levels were identified: novice, competent and expert.

CONCLUSIONS

This study unravels a unique hierarchical description of communication skills across competence categories, supported by the assumption that communication skills are structured hierarchically. The studies reviewed herein had a narrow perception of nurse leaders' interpersonal communication competence and indicated a transmissional understanding of communication.

IMPACT

This is the first mixed-methods systematic review that describes and synthesizes the evidence on nurse leaders' communication competencies hierarchically and across competence levels. The study suggests that further research should focus on a broader and more analytical understanding of the cognitive and affective aspects of interpersonal communication competence.

PROSPERO ID

CRD42023385058.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Nursing experience and leadership skills among staff nurses and intern nursing students in Saudi Arabia: a mixed methods study

BACKGROUND

Nurse leaders have a crucial impact in healthcare settings. Hospitals require qualified nurses with leadership skills to provide healthy work environments and enhance the outcomes related to staff nurses and patients. This study aimed to investigate the effect of nursing experience on leadership skills among staff nurses and intern nursing students.

METHODS

A mixed methods design was applied (quantitative survey design for quantitative part and open-ended questions for qualitative part). Convenience sampling of staff nurses and intern nursing students in Saudi Arabia was applied. There were148 participants who completed the survey of the quantitative part, and 50 of them completed the qualitative part. Participants completed the Leadership Practice Inventory Questionnaire. SPSS v26 was used to analyze quantitative part, and thematic analysis was used to analyze qualitative part.

RESULTS

This study found a significance difference among participating groups regarding to the years of experience (F = 5.05, p = 0.00). Three themes were found for the qualitative part which were strategies to enhance leadership skills, factors affecting leadership skills, and obstacles facing participants related to leadership skills. The qualitative data also revealed that participants found that clinical supervision and education ways to enhance the leadership skills, while work pressure, work environment and communication were obstacles of developing their leadership skills.

CONCLUSION

Leadership skills are considered as a significant component of the function of qualified nurses and should be viewed as central to intern nursing students' learning development. Moreover, leadership skills are essential for the patient and organization outcomes. Nursing colleges and educators play an important role in enhancing to leadership skills as well as experience. Nurse leaders can create healthy care environments that have high quality and safety for patients. Management systems in healthcare organizations must motivate and support clinical leaders who can recognize both individual and clinical requirements and address current issues in their field.

Relationships between nursing leadership and organizational, staff and patient outcomes: A systematic review of reviews

AIM

To assess and describe reviews of nursing leadership styles associated with organizational, staff and patient outcomes.

DESIGN

A systematic review of reviews.

METHODS

Reviews describing a search strategy and quality assessment. The review followed the PRISMA statement. Nine databases were searched in February 2022.

RESULTS

After screening 6992 records, 12 reviews were included reporting 85 outcomes for 17 relational, nine task-oriented, five passive and five destructive leadership styles. Transformational leadership, which is one of the relational styles, was the most studied among all the styles. Of the outcomes, staff outcomes were the most reported, notably job satisfaction, and patient outcomes were less reported. Also, mediating factors between relational leadership styles and staff and patient outcomes were identified.

CONCLUSION

Extensive research shows the beneficial impacts of relational leadership; however, destructive leadership research is lacking. Relational leadership styles should be conceptually assessed. More research is needed on how nurse leadership affects patients and organizations.

Nurse managers' support of fundamental care in the hospital setting. An interpretive description of nurse managers' experiences across Australia, Denmark, and New Zealand

AIMS

To explore the role of ward-based nurse managers in supporting nurses to undertake high-quality fundamental care.

DESIGN

A qualitative study guided by the principles of interpretive description. Reported in accordance with Consolidated Criteria for Reporting Qualitative Research (COREQ).

METHODS

Nurse managers in three urban, publicly funded hospitals in Australia, Denmark and New Zealand, were invited to participate in group interviews to discuss how they support fundamental care in their clinical areas. Six group interviews were conducted between February 2017 and March 2020 involving 31 participants.

RESULTS

Six interrelated themes were identified: Difficulty expressing how to support the nurse-patient relationship; Establishing expectations for care delivery without clear strategies for how this can be achieved; Role modelling desired behaviours; Significance of being present to support care quality; The importance of engaging and supporting staff in their work; and Recognizing the challenges of prioritizing care needs.

CONCLUSION

This study indicates that nurse managers are not universally clear in explaining how they support their staff to provide fundamental care. If fundamental care is not clearly understood and communicated in the nursing team, then there are risks that fundamental care will not be prioritized, with potential negative consequences for patient care. Nurse managers may benefit from additional resources and guidance to help them to support fundamental care delivery in their clinical areas.

IMPACT

Previous research exploring fundamental care and missed care highlights the importance of the role of the nurse manager in influencing nursing care. This study demonstrates that though nurse managers have a passion for supporting their staff to deliver fundamental care, clear strategies to achieve this are not always evident. This study suggests that scholarship around leadership to promote and facilitate fundamental care is crucial to improving nursing practice and patient outcomes.

How to undertake annual appraisals and ongoing performance reviews

Annual appraisals, which are mandatory in most healthcare organisations, are crucial for enhancing staff performance and embedding a culture of continuous improvement within teams. Appraisals can be usefully complemented by ongoing performance reviews, which support nurse managers and staff to identify and address issues in a timely manner. The term 'performance management' often has negative connotations, but it can be a powerful tool for staff development and positive learning experiences. This article supports nurse managers to understand how to adequately prepare for and conduct appraisals and performance reviews. Reflective activity 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of.

Competencies of Nurse Managers as Predictors of Staff Nurses' Job Satisfaction and Turnover Intention

Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the specific domains of nurse manager competencies that associate with nurse outcomes. A cross-sectional survey was conducted on a convenience sample of 698 staff nurses to measure the perceived competence of their nurse managers and their job satisfaction and turnover intention levels. The overall perceived nurse manager competency level in our sample was 3.15 out of 5 (SD = 0.859). The findings indicated that 34.3% of nurses were dissatisfied with their current jobs, and 36.3% of nurses were considering leaving their current workplace. Regression analyses identified "Team Communication and Collaboration" (β = 0.289; p = 0.002), "Staff Advocacy and Development" (β = 0.229; p = 0.019), and "Quality Monitoring and Pursuance" (β = 0.213; p = 0.031) as significant predictors of staff nurses' job satisfaction and "Staff Advocacy and Development" (β = -0.347; p < 0.000) and "Team Communication and Collaboration" (β = -0.243; p = 0.012) as significant predictors of nurses' turnover intention. The findings of the study have implications for the future recruitment, training, and performance evaluation of nurse managers.

Staff Nurses’ Perceptions of Barriers and Facilitators of Effective Nursing Leadership in a Major Saudi Hospital

Background:

Leadership skills on the part of nursing managers are expected to improve care for patients under the care of registered nurses. To do so also requires all Saudi hospital nursing leaders to attract and retain qualified nursing staff during a time of global shortages.

Aim:

The purpose of this study is to explore and identify the staff nurse perceptions of the barriers to and facilitators of effective nurse leadership for a major Saudi hospital and make recommendations for change.

Methods:

An interpretative methodology guided by John Kotter’s change theory. Qualitative data were collected from 14 participants using semi-structured interviews in 2016 and analysed using content analysis.

Results:

Two main categories have been identified through the data analysis process. The first category was barriers to effective leadership, comprising an inadequate leadership education and skills development; a limited authority and clinical empowerment; an unawareness of the need for change; and poor communication. The second category was facilitators of effective leadership, encapsulated engaging and listening to staff and seeking their ideas; recognizing staff performance, and motivational strategies.

Conclusion:

Even though the staff nurses who participated in this study were dissatisfied with the quality of leadership shown by their nurse managers, nevertheless they proffered an abundance of data during the study which accentuated the variety of organizational obstacles encountered by their nursing managers. They also voiced opinions on the workplace factors which might serve to assist nurse managers to improve the efficacy of their guidance. These were included in the study recommendations which were forwarded to all nursing managers employed at the hospital.