Nurse Managers Describe Their Practice Environments

Abstract

Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.

Estrutura Do Conhecimento Sobre Administração Em Enfermagem Na Pós-Graduação Brasileira

“…The nursing executives working at the North American health services considerably appreciate these themes, like in the example on patient safety. 18 This would explain the influence of the reflection on these themes in the universe of Brazilian NA, which acknowledges the hegemony of American thinking in this field.…”

The content of nurse unit managers’ work: a descriptive study using daily activity diaries

“…The main responsibilities that NUMs hold with other managers at the hospital are quality of care, patient safety and staff encouragement. A number of studies have shown that NUMs’ knowledge of clinical work, leadership style, encouragement and communication positively influence staff and quality of care and patient safety as a result. The three last attributes were indirectly assessed within the domain of staff responsibility .…”

“…Nursing leadership, especially the leadership role of first‐line managers such as nurse unit managers (NUM), has been shown to be pivotal for staff and patient outcomes . Over the past two decades, the role of NUMs has been changing from one whose primary remit is that of bedside nursing to one whose focus is in large part on leadership , with study results indicating an inconsistency between NUMs’ role according to their job description and the expectations from superiors and subordinates and how NUMs really spend their working time . Such conflicts can be a source of burdensome distress for NUMs and can have a series of damaging outcomes not only for the individuals involved but also for the organisations they work for and the patients in their care .…”

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

“…Three quantitative studies found hospital support and adequate resources to be predictive of nurse manager satisfaction and intention to stay (Hewko et al., 2015; Kath et al., 2012; Warshawsky et al., 2016). Nurse manager participants in three qualitative studies identified administrative support as foundational to a healthy work environment and job satisfaction (Huddleston & Gray, 2016; Udod et al., 2017; Warshawsky, Lake, et al., 2013). One study found that organisational support mediated the effects of job stress on nurse manager job satisfaction (Simpson et al., 2017).…”

“…Many of the nurse managers from these studies, however, lacked organisational support and were dissatisfied (Shirey et al., 2010; Udod et al., 2017; Warshawsky, Lake, et al., 2013). Participants from several studies expressed frustration over lack of institutional support and the resources needed to implement complex organisational initiatives (Moore et al., 2016; Udod et al., 2017; Warshawsky, Lake, et al., 2013). There was a shared perception among nurse manager participants that organisational constraints created obstacles to success often exacerbated by frequent policy changes and administrative bureaucracy (Udod et al., 2017; Warshawsky, Lake, et al., 2013).…”