Evaluation of Elements of the Nursing Worklife Model Using Unit-Level Data

Individual and Organizational Factors Associated With Nurse Manager Success

OBJECTIVE

The aim of this study was to synthesize previous findings and provide practical guidance for maximizing nurse manager and nurse performance.

BACKGROUND

Two recent studies have linked nurse manager job design factors and individual differences to a variety of valued outcomes, but practical implications remain unclear.

METHODS

A large US sample of nurse managers was divided on the basis of nurse and patient outcomes. Various characteristics are compared across the highest and lowest performers.

RESULTS

Wider nurse manager span of control is associated with negative outcomes; the availability of support positions does not fully alleviate the consequences of wide spans. Nurse managers with fewer subordinates can effectively manage multiple units. Nurse manager experience is critical for success and cannot be fully replaced by leadership training programs.

CONCLUSIONS

Staffing and job design decisions have critical downstream implications. The present research provides guidance for effective staffing and job design.

The influence of nurse manager competency on practice environment, missed nursing care, and patient care quality: A cross-sectional study of nurse managers in U.S. hospitals

AIMS

Identify and examine drivers of nurse manager competency and high-quality practice environments.

BACKGROUND

Nurse managers are a key predictor of positive professional practice environments which are, in turn, associated with nurse, patient, and organizational outcomes. However, little work has examined the factors that contribute to nurse manager competency.

METHODS

Nurse managers completed online surveys which were matched to unit-level aggregate data of their subordinate direct care nurses' responses on the National Database of Nursing Quality Indicators. This resulted in a final sample of 541 nurse managers across 47 U.S. hospitals. Multilevel path analysis was utilized to assess a model of the antecedents and consequences of nurse manager competency.

RESULTS

Nurse manager competency and practice environments were predictive of missed nursing care and nurse-reported quality of care. Nurse manager experience was found to have twice the effect on competency as advanced education.

CONCLUSIONS

Nurse manager competency and its downstream effects are achieved through nurse manager experience and advanced education.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse manager competency yields better practice environments and nursing care. Considering the influence of experience, careful attention should be paid to the competency development process of more novice nurse managers.

A Complexity-Informed Model to Guide Nurse Manager Practice

Nurse manager practice is a broad concept that reflects the defined role responsibilities and the manner in which nurse managers perform their role. The outcome of nurse manager practice is commonly known as their job performance. The job performance of nurse managers reflects their effectiveness and is assessed by organizational, staff, and patient outcomes. There is strong evidence that nurse managers with relational leadership styles are the key drivers of positive practice environments and job satisfaction among nurses. Concluding that the solution to positive environments and satisfied nurses rests solely on the leadership style of the nurse manager seems logical; however, it ignores the role of the larger organizational context. This article applies a complexity lens to understand nurse manager practice and other organizational factors influencing job performance. The evidence developed thus far yielded the identification of dimensions of the organizational context that support nurse manager practice and nurse manager job performance. Additional research is needed to identify the essential ingredients to support nurse manager practice. Organizational success depends on developing synergy among the administrative, adaptive, and enabling leadership functions of organizations.