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

Abstract

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.

Nursing leadership to facilitate patient participation in fundamental care: An ethnographic qualitative study

“…This is consistent with nurses' perceptions about leadership in general as supporting patients' care needs. Nurses and patients have different priorities when it came to attending to patients' needs (Mudd et al, 2022). Therefore, the leadership behaviour of nurses is required to achieve prioritization of patients' needs, such as modelling expected behaviours, setting the tone for the ward, and providing resources to support the psychosocial fundamental care delivery (Conroy, 2018).…”

Establishing and leading a cross‐institutional partnership to integrate fundamentals of care into clinical practice, nursing education and research

“…In this process, nursing leaders have been introduced to the conceptual framework of FoC and the initiatives surrounding FoC to ensure their commitment to the integration. Some nurse leaders find it difficult to clearly articulate what strategies they should utilize to support fundamental care in their clinical area (Mudd et al, 2022). Despite this potential challenge, the experiences of introducing FoC to nurse leaders have shown that they have a genuine interest in FoC is and how it can be used.…”

“…In this process, nursing leaders have been introduced to the conceptual framework of FoC and the initiatives surrounding FoC to ensure their commitment to the integration. Some nurse leaders find it difficult to clearly articulate what strategies they should utilize to support fundamental care in their clinical area (Mudd et al, 2022).…”

Nurse manager intentional rounding and outcomes: Findings of a systematic review

“…7 a.m. and 7 p.m.) (Pattison et al, 2017). Therefore, the rounding seems to range from high to low intensity, with three main implications alongside the challenge in comparing its outcomes: (a) NMs should be protected during the rounding to prevent distractions and excessive workloads (Manss, 2017), (b) with intentional roundings NMs have the opportunity to show their passion supporting the staff to deliver fundamental care (Mudd et al, 2022); however, (c) a perception of intrusion in the practice might be higher in units with intensive rounding, suggesting that implications for nurses and for patients about the trust in the nurse responsible for their care should be investigated. Clinical nurses might expect to lead the entire nursing care, and with the proliferation of advanced roles, they are expected to lead the entire process of care.…”

“…NMs should be protected during the rounding to prevent distractions and excessive workloads (Manss, 2017), (b) with intentional roundings NMs have the opportunity to show their passion supporting the staff to deliver fundamental care (Mudd et al, 2022); however, (c) a perception of intrusion in the practice might be higher in units with intensive rounding, suggesting that implications for nurses and for pa- In addition, NMIR should be not seen as an isolated intervention but a part of a strategy supporting the nursing work environments and the quality of care requiring a specific competence that should be developed while preparing future NMs for their complex role.…”