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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

Published online by Cambridge University Press:  02 February 2015

Cadeyrn J Gaskin
Affiliation:
Gaskin Research, Melbourne, VIC, Australia
Cherene M Ockerby
Affiliation:
School of Nursing and Midwifery, Deakin University, Melbourne, VIC, Australia
Tammy R Smith
Affiliation:
School of Graduate Education, The University of Melbourne, Melbourne, VIC, Australia
Vibeke Russell
Affiliation:
Animal Accident and Emergency, Melbourne, VIC, Australia
Bev O'Connell
Affiliation:
School of Nursing and Midwifery, Deakin University, Melbourne, VIC, Australia

Abstract

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.

Type
Healthcare management challenges for nurse managers
Copyright
Copyright © Cambridge University Press and Australian and New Zealand Academy of Management 2012

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References

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77101.Google Scholar
Collins, K. M. T., Onwuegbuzie, A. J., & Sutton, I. L. (2006). A model incorporating the rationale and purpose for conducting mixed methods research in special education and beyond. Learning Disabilities: A Contemporary Journal, 4, 67100.Google Scholar
Conley, S. B., Branowicki, P., & Hanley, D. (2007). Nursing leadership orientation: A competency and preceptor model to facilitate new leader success. Journal of Nursing Administration, 37, 491498.Google Scholar
Duffield, C., & Franks, H. (2001). The role and preparation of first-line nurse managers in Australia: Where are we going and how do we get there? Journal of Nursing Management, 9, 8791.Google Scholar
Duffield, C., Kearin, M., Johnston, J., & Leonard, J. (2007). The impact of hospital structure and restructuring on the nursing workforce. Australian Journal of Advanced Nursing, 24(4), 4246.Google Scholar
Duffield, C., Roche, M. A., Blay, N., & Stasa, H. (2010). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20, 2333.Google Scholar
Gallo, K. (2007). The new nurse manager: A leadership development program paves the road to success. Nurse Leader, 5(4), 2832.Google Scholar
Giber, D., Lam, S. M., Goldsmith, M., & Bourke, J. (Eds.). (2009). Linkage Inc.s best practices in leadership development handbook (2nd ed.). San Francisco, A: Pfeiffer.Google Scholar
Goddard, H. A. (1953). The work of nurses in hospital wards: Report of a job analysis. London, England: Nuffield Provincial Hospitals Trust.Google Scholar
Hay Group. (2008). Nurse leadership: Being nice is not enough. London, England: Author.Google Scholar
Ingersoll, G. L. (1998). Organizational redesign: Changing educational needs of midlevel nurse administrators. Journal of Nursing Administration, 28(4), 1316.Google Scholar
Janićijević, N., & Aleksić, A. (2007). Complexity of matrix organisation and problems caused by its inadequate implementation. Economic Annals, 52, 2844.Google Scholar
Joyce, W. F. (1986). Matrix organization: A social experiment. Academy of Management Journal, 29, 536561.Google Scholar
Management training helps ward leaders to improve staff morale. (2009). Nursing Standard, 23(39), 6.Google Scholar
McCallin, A. M., & Frankson, C. (2010). The role of the charge nurse manager: A descriptive exploratory study. Journal of Nursing Management, 18, 319325.Google Scholar
McGovern, J., Lindemann, M., Vergara, M., Murphy, S., Barker, L., & Warrenfeltz, R. (2001). Maximizing the impact of executive coaching: Behavioural change, organizational outcomes, and return on investment. The Manchester Review, 6, 19.Google Scholar
Medland, J., & Stern, M. (2009). Coaching as a successful strategy for advancing new manager competency and performance. Journal for Nurses in Staff Development, 25, 141147.Google Scholar
Mintzberg, H. (1994a). Managing as blended care. Journal of Nursing Administration, 24(9), 2936.Google Scholar
Mintzberg, H. (1994b). Rounding out the manager's job. Sloan Management Review, 36(1), 1126.Google Scholar
Mintzberg, H. (2002). Managing care and cure – up and down, in and out. Health Services Management Research, 15, 193206.Google Scholar
Morse, J. M. (2000). Determining sample size. Qualitative Health Research, 10, 35.Google Scholar
NSW Department of Health. (2009). ‘Take the lead’: Strengthening the nursing/midwifery unit manager role across NSW (Report Phase One: 08 2008). Sydney, NSW: Nursing and Midwifery Office, NSW Department of Health.Google Scholar
Onwuegbuzie, A. J., & Leech, N. L. (2006). Linking research questions to mixed methods data analysis procedures. The Qualitative Report, 11, 474498.Google Scholar
Paliadelis, P., Cruickshank, M., & Sheridan, A. (2007). Caring for each other: How do nurse managers ‘manage’ their role? Journal of Nursing Management, 15, 830837.Google Scholar
Platt, J. F., & Foster, D. (2008). Revitalizing the charge nurse role through a bespoke development programme. Journal of Nursing Management, 16, 853857.Google Scholar
Queensland Government. (2008). Review of the nurse unit manager role: Final report. Brisbane, QLD: Author.Google Scholar
Redfern, S. (1981). Hospital sisters: Work attitudes, perceptions and wastage. Journal of Advanced Nursing, 5, 451466.Google Scholar
Reed, S. (2008). Ward management: Education for senior staff nurses. Paediatric Nursing, 20(3), 2731.Google Scholar
Royal College of Nursing. (2009). Breaking down barriers, driving up standards: The role of the ward sister and charge nurse. London, England: Author.Google Scholar
Sandelowski, M. (1986). The problem of rigor is qualitative research. Advances in Nursing Science, 8(3), 2737.Google Scholar
Victorian Department of Human Services. (2001). Nurse recruitment and retention committee: Final report. Melbourne, VIC: Policy and Strategic Projects Division, Author.Google Scholar
Wolf, G. A., Bradle, J., & Greenhouse, P. (2006). Investment in the future: A 3-level approach for developing the healthcare leaders of tomorrow. Journal of Nursing Administration, 36(6), 331336.Google Scholar