Barriers to nurse leadership in an Indonesian hospital setting

Abstract

Background Given the prominent role of nursing within modern health care environments, it is essential that leadership is viewed as a key capability. However, little is known on how leadership evolves amongst the nurses in Indonesia and the barriers that exist to nurses gaining access to leadership roles. Limited attention is given to address the improvement of nurse leadership for the benefit of the nurses in the country. Aim To identify organizational and individual practices and how these contribute to barriers to the development of nursing leadership in the hospital setting. Methods A qualitative study employing semi‐structured face‐to‐face interviews and a thematic approach to data analysis. Results Four key themes are derived as follows: (a) hierarchical leadership and the importance of organizational structure and gender, (b) restricted perspectives, both conceptual and spatial, (c) contractual barriers, and (d) professional barriers. Conclusion Achieving the desired nurses’ leadership skills required persistence support and education. Acknowledgement on nurses as professional entity by minimizing aforementioned challenges would elevate nurses’ ability to engage further both in organization and leadership improvement. Implications for Nursing Management The findings of this study strengthen nursing leadership and management practice in hospital and beyond as they have helped to elucidate the nurses’ viewpoints on barriers they have on leadership. This research highlighted evidence for decision‐makers to bridge the gaps amongst nursing entities by, for example, encouraging regular nursing lectures for practice improvement, conducting research together/establishing research teams, or arranging interchange teaching between experienced nurses from the hospital and campus. Further, developing nursing professionals is one of the priorities for improving the Indonesian health profile, as nurses constitute the largest portion of Indonesian health workers.

Os principais desafios dos enfermeiros na liderança em enfermagem

“…5,6,7 o desenvolvimento da liderança em enfermeiros recém-qualificados,8 fatores relacionados à equipe, aos processos de liderança e ao líder 9 e os desafios e estratégias adotados para o exercício da liderança. 10 Os principais fatores mencionados como barreiras ao desenvolvimento das habilidades de liderança foram: pers- pectivas restritas, 5 questões de gênero, 5,7 barreiras contratuais e profissionais, 5,7 questões hierárquicas e de estrutura organizacional, 5,10 ritmo acelerado e mudanças repentinas no ambiente de trabalho, 6 falta de apoio por parte da instituição 7,8,10 e inexperiência profissional e jovialidade. 8,10 Os estudos também apresentaram caminhos para superar este desafio.…”

A survey of Indonesian nurses' educational experiences and self‐perceived capability to care for people with intellectual disability and/or autism spectrum disorder

“…Despite the substantial professionalization and development of the nursing workforce and education from the 1980s into the 2000s, with the advent of Bachelor of Nursing, Master of Nursing and doctoral degrees, legacies of this hierarchical system remain. Several studies have noted Indonesian nurses reported still encountering stereotypes of being the doctor's subordinate (Shields & Hartati, 2003), lack autonomy and independence in their practice due to the dominance of medical physicians in hospitals and experience barriers in ability to establish nurse leadership roles (Wardani & Ryan, 2018). Whilst the Nursing Act (No.…”

Influencing factors in the nurses’ decision-making process in Ibero-American university hospitals

“…Therefore, the health organization's responsibility to promote and provide means for nurses to act autonomously, through the establishment of roles, responsibilities and behaviors, is clearly emphasized (31)(32)(33)(34)(35)(36)(37) .…”