Nurse managers don’t get the corner office

Aim To provide an original perspective on the power and status of first-line nurse managers by observing their working environment. Background The role of first-line nurse managers includes clinical, administrative and managerial components, with their responsibilities not always reflected in their level of organizational power. The business literature suggests that an appropriately resourced workspace is not merely functional, it also confers power and status. Method Twenty Australian rural nurse managers’ workspaces were observed, as part of a larger qualitative study that explored their role and organizational power using semi-structured interviews. The observational data consisted of detailed researcher notes that were analysed thematically. Results The nurse managers’ workspaces were suboptimal and did not provide sufficient physical space or resources for the participants’ to manage tasks effectively. These results were considered using Kanter’s theory of organizational power. Implications for nursing management The findings support those reported in the business literature that inadequate physical workspaces are counterproductive in terms of both functionality and organizational power. Suggestions are made regarding the workspace needs of first-line nurse managers, based on a closer alignment between the work environment and their role responsibilities. These findings have implications for decisions regarding organizational support of first-line nurse managers.     

Being an effective nurse consultant in the English National Health Service: what does it take? A study of consultants specializing in safeguarding

Aims This study established key attributes and perceived strengths, weaknesses, opportunities and threats (SWOT) of nurse consultants specializing in safeguarding children. Background The nurse consultant role in England spans four domains – clinical, leadership, education and research – and was intended to enable senior nurses to remain in clinical practice. Method Data identifying the time spent by the nurse consultants in the four domains was collated and a thematic content analysis of the SWOT of the role was ascertained from semi-structured interviews with nurse consultants (n = 4) and stakeholders (n = 6). Results Strengths and opportunities in clinical (consultancy), leadership and educational functions were identified but some weaknesses and threats in terms of nurse consultant’s contributions to research were also identified. The role was neither wholly strategic nor clinical. Role ambiguity meant that they were not always valued by managers, making the role potentially expendable. Conclusions Nurse consultants are pivotal within health-care organizations because they span clinical practice and leadership enabling them to support managers in strategic planning, commissioning and implementation of policy. Implications for nursing management Nurse consultants can support strategic practice development and influence quality and effectiveness service-wide. To succeed they must be understood, supported and nurtured by managers.     

Development and validation of the Nurse’s Workplace Mental Health Questionnaire

ObjectivesThis study aimed to develop and validate the Nurse’s Workplace Mental Health Questionnaire (NWMHQ).MethodsThe questionnaire was developed based on the two continua model of mental illness and health proposed by Keyes. The initial questionnaire was generated through literature review, two rounds of Delphi expert consultation, followed by a pilot survey. Finally, the reliability and validity of the questionnaire were validated through an online survey of 2,815 registered nurses selected from the public hospitals in 11 provinces from June to July 2020.ResultsThe item-content validity index (I-CVI) of the questionnaire ranged from 0.750 to 1.000 and the average scale-level content validity index (S-CVI/Ave) was 0.906. Cronbach’s α coefficient was 0.948 and test-retest reliability was 0.850. The self-rating depression scale score was negatively related to the NWMHQ score (r = −0.664, P < 0.01). The exploratory factor analysis (EFA) yielded six factors (emotional status, psychological security, positive relationship, resilience, self-efficacy, and subjective well-being), consisting of 32 items. The cumulative variance contribution rate was 65.58%. Confirmatory factor analysis (CFA) showed an acceptable fit.ConclusionThe NWMHQ developed in this study showed good reliability and validity. This questionnaire may help assess the mental health status of nurses and help nursing managers to develop appropriate targeted psychological interventions.     

Nurse Practitioners’ and Nurse Practitioner Students’ LGBT Health Perceptions

Nurse practitioner (NP) and NP student perceptions of adult lesbian, gay, bisexual, and transgender (LGBT) health needs were qualitatively explored. One overreaching theme, “We need to do better. We have a lot to do,” and four key themes were identified: (1) same basic health needs as straight people; (2) a little more risk, a little more help, a little extra care; (3) breaking down that trusting, honest provider relationship; and (4) society sucks and social media and politics play a major role. Results support the need for future research exploring NP and NP student understanding of LGBT health needs.     

Workplace managers’ view of the role of co-workers in return-to-work

Purpose: Theoretical and empirical research findings attest to the workplace being a social environment in which co-workers have a critical influence on the employment outcomes and return-to-work (RTW) success of other employees. However, co-workers do not have a formal role in RTW planning. The aim of this study was to explore how managers responsible for developing and implementing RTW procedures view the role of co-workers in this process.

Method: An exploratory qualitative pilot study was conducted in Canada. Participants (1 male; 13 females; mean experience in RTW?=?11.8 years) were workplace (n=8) or RTW managers (n=6) with direct oversight of RTW plans. The participants were recruited via invitation from a research institute and were drawn from three different provinces. Data were gathered via open-ended questions and were coded and subject to thematic analysis.

Findings: Three key themes were identified: (1) Managers view RTW as having little relevance to co-workers but expect them to cooperate with the arrangements; (2) Formal procedures are inadequate when psychosocial barriers to work resumption are present, so managers use informal strategies to engage co-workers’ emotional and social support; and (3) Managers have difficulty integrating RTW procedures with other legal obligations, such as privacy and confidentiality requirements.

Conclusion: Existing arrangements for the development and implementation of RTW are sufficient most of the time, but may be inadequate when an injured worker presents with psychosocial barriers to work resumption.

• Implications for Rehabilitation

• Standard RTW arrangements can be inadequate when a RTW plan requires active co-worker support.

• Privacy and confidentiality provisions can result in managers using informal procedures for information exchange and to engage co-workers.

• The use of risk management strategies – assessment, consultation and communication – could be used to include co-workers when workplace issues threaten the success of a RTW plan.

     

Using the lens of enablement to explore patients’ experiences of Nurse Practitioner care in the Primary Health Care setting

Background

Patient enablement is a patient-centred concept reflecting a patient’s ability to cope, understand and manage their own health. It can be used as a measure of the quality of care and has been linked with improved patient outcomes. While there have been studies into patient enablement following consultations with General Practitioners (GPs) and practice nurses, Nurse Practitioners’ (NPs) role in enabling patients remains unexplored.

Nurse Practitioners’ Experiences of Moral Distress in the Continuing Care Setting

This article describes a qualitative study designed to understand nurse practitioners’ (NPs) experiences with moral distress in the continuing care setting. The findings confirm that NPs in this setting experience moral distress. These experiences are in response to tensions that arise when factors interfere with their ability to provide “good” patient care. Five themes emerged as important factors: patients, perceptions, physicians, palliation, and policies. Moral distress is a substantial issue for NPs in the continuing care setting. Further research is required to examine NP’s experience with moral distress in other settings and identify solutions to resolve and respond to this distress.     

A National Study of Australian Nurse Practitioners’ Organizational Practice Environment

The nurse practitioner (NP) workforce in Australia plays a vital role in helping the country meet the current demand for health care. Data from Australian NPs using the Nurse Practitioner Primary Care Organizational Climate Questionnaire demonstrated that one-seventh of the overall Australian NP population completed the study. The response was overwhelmingly positive in the area of practice; 71.6% of NPs had no restriction on their practice and felt valued by their organization. The results of this study enable a benchmark for ongoing national evaluations in addition to international comparative data.     

Expect the Unexpected: United States Foreign Service Nurse Practitioners’ Worldwide Practice

Nurse practitioners (NPs) are providing primary and emergency medical care to United States government employees and family members serving at over 220 diplomatic missions globally. NPs are an integral part of the Bureau of Medical Services, a division of the US Foreign Service. Working closely with colleagues who are physician assistants, regional medical officers (physicians), psychiatrists, laboratory scientists, social workers, nurses, and locally employed medical staff, NPs perform a variety of roles to promote the health and well-being of the US diplomatic community. This is the history of NPs in the US Foreign Service, and these are their stories. Expect the unexpected!     

The Nurse Practitioners’ Role in Engaging Health Care Systems in Addressing Climate Change

A recent United Nations (UN) report concluded that the inability to curb fossil fuel emissions from burning coal, oil, and gas has resulted in a short window of time to prevent an abysmal future. The health care industry remains one of the largest contributors to climate change. NPs must not only recognize the clinical presentations resulting from climate change but must also contribute to the efforts presented by the UN report to create a health system that does not contribute to climate change. This article reviews potential ways to decrease the health care sector’s contribution to climate change.     

Does Public Health Nurse Home Visitation Make a Difference in the Health Outcomes of Pregnant Clients and Their Offspring?

Abstract Public health nurses (PHNs) at Lincoln‐Lancaster County Health Department have used the Care Pathway tool to track client progress. Conceptually similar to critical pathways used in hospital settings, the Care Pathway is used by the PHN to document milestones of progress by trimester of pregnancy. Data for this research was gathered from chart review of 55 prenatal clients. Study results demonstrate that subjects who had from five to nine home visits by a PHN during pregnancy showed a higher average hemoglobin for the mothers and a higher average birthweight for the babies than those visited four or fewer times. None of the low birthweight babies was born to mothers in the “more visits” category. Furthermore, more breastfeeding was recorded for those who had received more PHN visits. This documentation enabled us to describe better the referent population and to begin to estimate the effect of PHN home visitation on the health outcomes of clients. In essence, we addressed the questions: (1) “Does PHN home visitation make a difference in health outcomes of clients and their families?” and (2) “If so, how can effects be measured?”