Date of Degree
PhD (Doctor of Philosophy)
Sue Ann P. Moorhead
Building on a previous 1994 study, this descriptive study reflects on the ever-shifting sands of the nurse manager role. This national survey is based on the Katz (1955) conceptual framework of interrelated technical, human and conceptual competencies. An instrument developed by the investigator for determining important nurse manager competencies was validated using an expert panel of AONE nurse manager Fellows. The research used a web-based survey to collect information from hospital nurse managers via a self-administered competency instrument. Eighty one completed the online survey with complete data for a response rate of thirteen percent.
Findings suggest the highest self-reported nurse manager competency ratings included effective communication, retention strategies, effective discipline and decision-making. In contrast, the lowest self-reported nurse manager competencies included nursing theory, case management and the research process. The associations of nurse manager competencies with individual and organizational variables were studied. The impact of organizational variables of hospital size and span of control had a medium effect. Magnet status impact was unremarkable. Individual variables of gender, age, education, tenure as an RN, and tenure in current position also did not significantly impact competency ratings. A large and medium effect was noted between tenure in the management role on all the competency ratings within the five constructs. The Chase Nurse Manager Competency Instrument underwent psychometric testing as none had been done since the original 1994 study. The 1994 and the 2010 study data was used to determine reliability and validity assessments with positive results. A crosswalk was also completed between the Chase Instrument and the 2005 AONE Nurse Manager Leadership Collaborative Framework and due to the similarities in the five categories the Chase Instrument was revised to reflect the parallel similar headings support the consistencies between the models.
Study findings reveal Nurse managers have to deal with finance and budgeting, patient safety, quality improvement, staff retention, and many other tough topics. They are expected to achieve a blend of clinical and business management with little to no training. Based on the findings the following ten recommendations are provided and include, Provide realistic expectations of the role; Provide a skill assessment and form a plan based on competency development; Provide a structured orientation and development program which includes 30/60/90 day checkpoints; Establish long term mentorship building on the key ingredients of inspiration and role modeling; CNO involvement is critical; Teach Influence; Teach implementation strategies; Create the culture; Invest in Nurse Manager support for Development of Staffing, Financial Acumen and Compliance; Enhance communication skills at every level. Among nursing leadership, the nurse manager role has been identified as critical in the provision of high-performing, effective and efficient care in the patient care delivery setting. This individual is the unit-based CEO responsible for quality, safety, satisfaction and financial performance in alignment with regulatory and accrediting body requirements. Excellence in horizontal and vertical communication is required as this role represents the voice of the direct care nurse at the leadership table as well as the voice of the board of trustees at the unit level.
Copyright 2010 Linda K. Chase