Nurse Managers’ Perceptions and Experiences Regarding Staff Nurse Empowerment: A Qualitative Study

AimTo study nurse managers’ perceptions and experiences with staff nurse structural empowerment and the impact on the nurse manager leadership role and style.BackgroundNurse managers’ leadership roles may be viewed as challenging given the complex needs of patients in the context of staff nurses’ involvement in clinical as well organizational decision-making processes, in interdisciplinary care settings.DesignQualitative phenomenological study MethodsIndividual semi-structured interviews of 8 medical or surgical nurse managers were conducted in a 600-bed Belgian university hospital between December 2013 and June 2014. This organization was undergoing a transformational process to convert from a classic hierarchical and departmental structure to one that was flat and interdisciplinary.ResultsNurse managers were familiar with and held positive attitudes about nurse structural empowerment in the hospital. They conveyed the positive impact of empowerment on their staff nurses that in turn improved the quality of care and patient safety. Structural empowerment was supported by several change initiatives at the unit and hospital levels and nurse managers’ experiences with these initiatives was reported as mixed because of the changing demands on their manager role and leadership style. In addition, pressure was experienced both by staff nurses and nurse managers through direct patient care priorities, tightly scheduled projects and miscommunication.ConclusionNurse managers reported a favourable impact of structural empowerment on staff nurses’ professional attitudes and the safety and quality of care on their units. However, they also reported that the empowerment process, created changing demands in the manager role as well as daily practice dilemmas with regard to needed leadership styles. Clear organisational goals and dedicated support for nurses as well as nursing unit managers will be imperative to sustain an empowered practice environment achieving th

Nurse Work Engagement Impacts Job Outcome and Nurse-Assessed Quality of Care: Model Testing with Nurse Practice Environment and Nurse Work Characteristics as Predictors

Key words: burnout,job satisfaction, nurse retention, nurse practice environment,quality of care, acute health care,structural equation modelling. Aim:To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption.Background: Understanding to support and guide the practice community in their daily effort to answer most accurate complex care demands along with a stable nurse workforce are challenging.Design: Cross-sectional survey.Method:Based on previous empirical findings,a structural equation model designed with valid measurement instruments was tested.The study population was registered acute care hospital nurses(N = 1201) in twoindependent hospitals and one hospital group with six hospitals in Belgium.Results: Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care.Analyses were consistent with features of nurses’ work characteristics including perceived workload,decision latitude,and social capital,as well as three dimension of work engagement playing mediating roles between nurse practice environment and outcomes.A revised model adjusted using various fit measures explained 60 % and 47 % of job outcomes and nurse - assessed quality of care,respectively.Conclusion: Study findings show that aspects of nurse work characteristics such as workload,decision latitude and social capital along with nurse work engagement(e.g.vigor, dedication and absorption) play a role between how various stakeholders such as executives,nurse managers and physicians will organize care and how nurses perceive job outcomes and quality of care