Clinical leadership in nursing development units

There is an expectation for Nursing Development Units (NDUs) to explore and develop the clinical leadership role. This paper describes how 28 Department of Health funded NDUs in England sought to meet this objective. We describe the personal and professional characteristics of NDU clinical leaders (CLs) and their perceived responsibilities. We identify 10 elements which appear to be central to the CL role and together form a core role set of the leader which is applicable, to some extent, across clinical specialties and settings. The position of the CL in the organizational hierarchy emerges as crucial to his/her ability to act on these responsibilities and fulfil a leadership role.     

Multigenerational workforce issues and their implications for leadership in nursing

stanley d . (2010) Journal of Nursing Management 18, 846–852
Multigenerational workforce issues and their implications for leadership in nursing Aim(s) With many countries facing current or impending nursing shortages, considering the impact of the multigenerational workforce, their needs and behaviours may impact on efforts to recruit and retain nurses. Background As the nursing workforce changes, with ageing nurses, an increased demand for nursing care and an ageing population, greater emphasis is placed on an understanding of the workforce’s needs and the differences highlighted by various generational groups. Evaluation Offered is a literature review and definitions of the four different generational groups evident in the current nursing workforce. These are offered as an insight into the different needs and attitudes that multigenerational groups bring to the nursing workforce. Key Issue(s) Making the most of the multigenerational workforce and offering recommendations for meeting their unique challenges. Conclusions Understanding the different generational groups may allow nursing leaders and managers to consider what drives, motivates or hinders nurses from different generations. Implications Recruiting and retaining a workforce increasingly made up of nurses from many generational groups is a challenge that can be tackled with a deeper understanding of each of the commonly identified generational groups.     

Exploring leadership capability and emotional intelligence as moderators of workplace bullying

Aim This study aimed to explore the potential for emotionally intelligent leadership as a way to mitigate bullying behaviour within nursing workplace environments. Background As the body of evidence about bullying continues to grow there is an increasing need for researchers to direct their attention to developing theoretical frameworks that explain how bullying and victimization occur, and the types of strategies that may address the problem. Evaluation The narrative synthesis of the literature presented in this paper is forwarded as supporting the need for strengthening leadership capability, especially those capabilities associated with emotional intelligence, as a means of diminishing experienced bullying within nursing. Key issues Stemming from our expanding understandings about bullying is an appreciation of the range of factors within organizations that influence the occurrence of bullying, and an awareness of the need to understand the expression, experience and management of emotions in the workplace. Conclusions While both leadership and emotional intelligence capabilities offer real potential to mitigate bullying behaviour, disparity exits between clinical and managerial nurses toward preferred leadership styles and emotional intelligence is open to challenges towards its content validity. Implications for nursing management Nursing management is challenged to build upon procedural responses to bullying to include a ground up approach to leadership enhancement capability, better responses to emotions in the workplace and supporting the interpersonal and intrapersonal capabilities of the nursing workforce.     

实施护理变革型领导的研究进展

就变革型领导的概念、评价工具进行了系统的阐述,分析并总结了其对护理管理者的要求、在护理管理中的应用效果、影响因素及相关措施,并对现存的问题和未来的研究趋势分别作出了思考与展望。     

Authentic leadership and nurses' voice behaviour and perceptions of care quality

wong c.a ., laschinger h. & cummings g.g . (2010) Journal of Nursing Management 18, 889–900
Authentic leadership and nurses' voice behaviour and perceptions of care quality Aim The purpose of the present study was to test a theoretical model linking authentic leadership with staff nurses’ trust in their manager, work engagement, voice behaviour and perceived unit care quality. Background Authentic leadership is a guide for effective leadership needed to build trust and healthier work environments because there is special attention given to honesty, integrity and high ethical standards in the development of leader–follower relationships. Methods A non-experimental, predictive survey design was used to test the hypothesized model in a random sample of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario. Results The final model fitted the data acceptably (χ² = 17.24, d.f. = 11, P = 0.10, IFI = 0.99, CFI = 0.99, RMSEA = 0.045). Authentic leadership significantly and positively influenced staff nurses’ trust in their manager and work engagement which in turn predicted voice behaviour and perceived unit care quality. Conclusions These findings suggest that authentic leadership and trust in the manager play a role in fostering trust, work engagement, voice behaviour and perceived quality of care. Implications for nursing management Nursing leaders can improve care quality and workplace conditions by paying attention to facilitating genuine and positive relationships with their staff.     

Challenges and leadership strategies for managers of nurse practitioners

AIM: The aim of this paper is to report on the findings from our research into the recent introduction of nurse practitioners in Alberta, Canada. Through an organizational research perspective, we identify the critical role of health care managers in developing a sustainable nurse practitioner role. BACKGROUND: Previous literature has focused on nurse practitioners themselves as the key factor in their integration into the health care system. Although they are qualified and organizationally well placed, managers of nurse practitioners have been overlooked as a critical part of implementation strategies. KEY ISSUES: We interviewed 25 nurse practitioners and seven of their managers. Through our data analysis we identified three major challenges for managers: (1) clarifying the reallocation of tasks; (2) managing altered working relationships within the team; (3) continuing to manage the team in an evolving situation. Associated with these challenges, we propose leadership strategies that managers may find useful as they work through the consequences of introducing the nurse practitioner role. These strategies are: * encourage all team members to sort out 'who does what'; * ensure that task reallocation preserves job motivating properties; * give consideration to how tasks have been allocated when issues identified as 'personal conflict' arise; * pay attention to all perspectives of the working relationships within the team; * facilitate positive relationships between team members; * lead from a 'balcony' perspective; * work with the team to develop goals that are not over focused on the nurse practitioner; * regularly share with other managers the experiences and lessons learned in introducing nurse practitioners. CONCLUSION: For managers to be most effective, they need to address three challenges that are of a managerial, not clinical, nature. By implementing specific leadership strategies, managers of nurse practitioners can facilitate the introduction of the new role and improve its sustainability in health organizations.     

Staff members' perceptions of a ICT support package in dementia care during the process of implementation

Aim  The aim of the present study was to describe staff members' perceptions of an information and communication technology (ICT) support package during the process of implementation.
Background  ICT in dementia care will likely increase in the future. The diffusion of new innovations can be better understood through diffusion research.
Methods  Fourteen staff members in dementia care were interviewed, in groups, once before the new ICT, twice during its implementation and once after. Data were analysed using qualitative content analyses. The ICT included monitors/alarms: passage alarms, fall detectors, sensor-activated night-time illumination of the lavatory, and communication technology: Internet communication and additional computers.
Results  The results showed two themes 'Moving from fear of losing control to perceived increase in control and security' and 'Struggling with insufficient/deficient systems'.
Conclusions  Staff perceptions of ICT were diverse and changed during the implementation. Benefits were more pronounced than disadvantages, and improvements were described both in care and in staff job situation.
Implications for nursing management  Functioning and use of ICT may relate to design as well as by application and the surrounding structure, and the whole system: the organizational structure, the employers and the new product needs to be taken into consideration when implementing new technology.     

Modernizing the school health workforce. Staff perceptions of a rapid roll-out redesign programme

Aims To explore the perceptions of staff participating in an NHS school health workforce modernization rapid roll‐out redesign programme. Background The health and well‐being of children is central to national policy and focuses upon multi‐agency working. As part of the NHS modernization programme, a rapid roll‐out workforce redesign model was developed for the school health workforce and introduced in northern England. Methods An evaluation approach using electronic distributed questionnaires and telephone interviews was utilized. Results Respondents reported that the approach was a valuable and fast way of introducing change to the workforce. Benefits for participants in providing networking opportunities were reported. Limitations of the study Data were collected from one programme and local factors may have influenced the findings. Conclusion The rapid roll‐out approach appears to be a successful way of introducing change to the school health workforce. Implications for nursing management Workforce redesign using a rapid roll‐out approach is a fast and effective approach, additionally providing benefits for staff participating in the process.     

Shared governance and shared leadership: meeting the challenges of implementation

New forms of leadership are required if staff are to be effectively engaged and involved in decision-making and promoting clinical effectiveness. One such mechanism is shared governance and shared leadership to ensure practice is both practitioner owned and organizationally supported. Empowering staff is a great challenge requiring effective planning, preparation and commitment. Establishing the process of shared governance requires effective leadership, implementation of a suitable framework, multidisciplinary working and examination of the organization's structure and culture. This paper discusses the challenges of implementation, preparation of staff, and alignment with the organizational agenda. It emphasizes that shared governance is an ongoing and fluid process, requiring continual assessment and re-evaluation in order to be flexible and responsive to an ever-changing environment. The Christie model provides a sustainable framework for moving practice forward and successful implementation has led to greater coordination of practice development and sharing of best practice.