The Working World of Nursing Unit Managers

Nursing unit managers (NUMs) occupy a first-line management position in many healthcare services worldwide. In this role, they are responsible for the nursing and administrative operations of a ward. The literature suggests that while the position has evolved into a complex and multifaceted one, the scope and authority of the role are poorly understood. Few studies have explored the working world of NUMs or considered how the well-documented oppression of nurses might impact on them as managers. Using a feminist approach, and individual interviews, this qualitative study, which focused on the construct of power, explored the working world of twenty nursing unit managers employed in the public healthcare system of New South Wales, Australia

Health and Illness Perceptions of Patients suffering their First Acute Myocardial Infarction and Undergoing Primary Percutaneous Coronary Intervention in Queensland: A Qualitative Study

As a result of advances in technology and treatment techniques, interventional cardiology has led to significant changes in the treatment of patients suffering a heart attack (or Acute Myocardial Infarction - AMI). The current treatment often involves primary (emergency) Percutaneous Coronary Intervention (angiogram and angioplasty) followed by a rapid recovery. Patients often do not experience significant pain during recovery, have markedly reduced hospital stay and return to work sooner than in the past. Therefore it is plausible that they may dismiss the significance of their cardiac illness and its long-term implications. Therefore the meaning that these patients assign to their experience of having a heart attack and emergency treatment in the form of PCI plays a pivotal role in their subsequent health behaviour, including cardiac rehabilitation attendance, medication adherence and functional status. This qualitative study used hermeneutic phenomenology to explore participants' experiences and gain an understanding of their perceptions of the event and beliefs about their subsequent health and illness. Semi-structured, in-depth interviews were conducted three to six months following discharge with thirteen participants (ten males and three females). Four key themes emerged from the data, illustrating the physiological, emotional and social adjustment experienced by the participants. These included confusion about the expected and experienced symptoms of AMI, a realization of their vulnerability to sudden death, amazement at the speed of intervention and physical recovery and a gradual understanding of the need to modify risk factors and revalue priorities in life. It is anticipated that the findings will contribute to the provision of effective and streamlined cardiac education that are tailored to the needs of this group of patients

The working world of nursing unit managers: responsibility without power

The paper seeks to explore the responsibility and power of the role of nursing unit managers (NIMs) in rural New South Wales using Kanter's theory of organisational power as a framework. Using in-depth individual interviews with twenty NUMs, data were analysed from four perspectives to gain a deep understanding of the NUMs' working world. The findings show that the NUMs' role is substantive, encompassing both clinical and managerial functions. Overall, the findings indicate that the participants lacked power commensurate with their role responsibilities

The Working World Of Nurses As Managers: Issues of Organizational Power

Nurses worldwide are being expected to assume first-line management positions that require them to have a wider range of responsibilities than ever before, within healthcare organizations. In Australia, as in many other countries, nursing unit managers are responsible for managing the human, physical and financial resources of a ward or unit within a hospital or healthcare facility. In this study twenty nursing unit managers were individually interviewed and asked to describe what is like to be a nursing unit manager, as there is a paucity of literature that explores the roles of nurses who assume management positions. The findings indicate that nurses experience conflict between their roles as nurses and the expectations of them as managers. Furthermore, these conflicts were exacerbated by a lack of organizational power to get the job done. Using a theory of organizational power the narratives of the participants provide insight into some of the issues faced by this group of nursing unit managers

Developing Clinical Judgement: A Case Scenario Approach

The purpose of this book is to provide healthcare students with a resource that will assist them to apply their knowledge and skills to clinical scenarios in order to develop clinical judgement. Clinical judgement is the application of critical thinking and reasoning to healthcare situations and its development takes practice, lots of practice! In healthcare professions, it is the application of knowledge and skills that is required in order to become a competent clinician. Thus, this book is designed to challenge students to consider not only what they know about patient care in certain situations, but also what they will do with that knowledge. I call this the 'action step' and I have written this book expressly to help students to move from what they know about health and health care to the actions they will perform in a variety of clinical situations. The idea for this book came from feedback I received from students that 'off the cuff' clinical scenarios that I regularly used in classroom discussions were really valuable in helping them to see how to apply their newly acquired knowledge and skills in real clinical situations

Nursing unit managers: responsibility without power?

Study background: The Australian Healthcare workplace culture: • Traditional roles in healthcare (Diers 2004) • Nurses' lack of voice and input into the decisions of healthcare organisations (Buresh & Gordon 2000; Diers 2004; Sullivan 2005) • Gendered nursing image and identity (Speedy 2006). Study topic: The working world of nurse managers. I explored perceptions of the role from those in the position, I was interested in hearing about: • Workload/organisational expectations • Workplace geography • Education/support for the role • Identify as a nurse or a manager? • Is power commensurate with responsibilities? • Job satisfaction level • Challenges/concerns • Achievements/rewards • Rural focu

An exploration of the role that expert knowledge plays in the assessment of undergraduate clinical competence: registered nurses' experiences

Introduction: This phenomenological study, conducted in rural Australia, explored the experiences of registered nurses (RNs) responsible for assessing the clinical competence of undergraduate nursing students. The purpose of the study was to gain insight into the experiences of a group of registered nurses who assess student competence by exploring how they perform the assessment process. A key assumption on which this study was based is that the participants are 'expert nurses', as defined by Benner. Method: Participants were recruited using purposive sampling from a population of registered nurses who assessed the clinical performance of undergraduate nursing students studying at a rural university in New South Wales, Australia. Individual unstructured interviews were conducted and audiotaped with the participants’ permission. The analysed data were given to all participants to check for accuracy and validation and a thematic analysis of the data was conducted. Results: Four themes were identified; the major theme, described in this article, was identified in all the narratives. The participants all acknowledged that they use their expert nursing knowledge to assist them when assessing the clinical competence of nursing students. The participants used a variety of terms to describe this type of knowledge such as intuition, instinct, gut feeling and ‘just knowing’. Conclusions: While the findings of this study confirmed that experienced nurses unconsciously use their expert nursing knowledge when making decisions about students’ competence, the findings also indicated a lack of awareness or underestimation of the value of expert clinical knowledge. These findings reinforce the need for further investigation to determine the role of expert nursing knowledge in the clinical competency assessment process. This is particularly significant for rural registered nurses employed in small health-care facilities, who often assume the role of assessors of student clinica

Using a Voice-Centered Relational Method of Data Analysis in a Feminist Study Exploring the Working World of Nursing unit Managers

In this article, we discuss the application of a data analysis method used in a feminist study that explored the working world of nursing unit managers in Australia. The decision to use a voice-centered relational approach to the data was based on a desire to delve into the working world of nursing unit managers and uncover the layers within the narratives that specifically related to their perceptions of themselves, their world, and the context in which they work. Throughout this article, the focus is on how this method was applied to uncover multiple layers of meaning within the data, rather than on the researchers' and participants' roles in the coconstruction of interview data. An excerpt from an interview transcript is used to illustrate how the stories of the participants were explored using this method

The experiences of those following Acute Myocardial Infarction and Primary Percutaneous Coronary Intervention

Objectives: •Discuss Interventional Cardiology in relation to the treatment of Acute Myocardial Infarction (AMI) •Discuss the background to this research •Outline Hermeneutic Phenomenology as the methodological and philosophical basis for this research •Discuss the preliminary findings of this researc

The experiences of those following Acute Myocardial Infarction and primary Percutaneous Coronary Intervention

As a result of advances in technology and treatment techniques, interventional Cardiology has made huge inroads into the treatment of patients admitted to Coronary Care Units. The management of Acute Myocardial Infarction (AMI) often involves primary Percutaneous Coronary Intervention (PCI) followed by a rapid recovery. Patients often do not experience significant pain during recovery, have reduced hospital stay and return to work sooner than in the past and they may therefore dismiss the significance of their cardiac illness as just a passing event. The meaning that these patients assign to this event plays a pivotal role in their subsequent health behaviour, including Cardiac Rehabilitation attendance, medication adherence, functional status, return to work and physical functioning