Prime minister urged to re-examine safe staffing

Nursing leaders have pressed new prime minister Theresa May to re-examine key issues affecting the profession as a matter of urgency.

College seeks 'exceptional nurse leader' to fill chief executive post

A worldwide search is on for a new general secretary and chief executive of the RCN to succeed Peter Carter when he leaves the college in October.

BME nurses get ready to move up to top jobs on leadership course

A year-long leadership programme launched last week is aiming to help black and minority ethnic (BME) staff, including nurses, move into top NHS jobs.

The case for renewed investment in the district nursing specialist practitioner qualification

District nursing as a profession has been under significant threat over the last few years due to a lack of foresight and funding, resulting in an undervalued and underinvested workforce. The once-heralded specialist practitioner programme was slowly decommissioned in all but a handful of universities, leaving no alternative but for community trusts to employ staff nurses in team leader roles without the development the added qualification gave them. In light of the renewed focus on the fundamental advancement of district nurses and recent Government publications clearly reinforcing the district nurse's role, this article argues for the need for educational commissioners and workforce planners to commit to continued investment in this vital profession.

Advancing leadership capacity in nursing

To address the potential shortage of nurse leaders, the profession must evaluate current strategies in both education and practice. While many new graduates dream of becoming a nurse practitioner or nurse anesthetist, few transition into practice with the goal of becoming a nurse leader. To increase the number of nurses capable of leadership, the profession must address 2 critical issues. First, effort must be made to augment faculty and students' conceptualization of nursing such that leadership is seen as a dimension of practice for all nurses, not just those in formal leadership roles. In so doing, leadership identity development would be seen as a part of becoming an expert nurse. Second, a comprehensive conceptual framework for lifelong leadership development of nurses needs to be designed. This framework should allow for baseline leadership capacity building in all nurses and advanced leadership development for those in formal administrative and advanced practice roles. The knowledge and skill requirements for quality improvement and patient safety have been explored and recommendations made for Quality and Safety Education for Nurses, but parallel work needs to be done to outline educational content, objectives, and effective pedagogy for advancing leadership development in nursing students at all levels.

Succession planning: moving the dial from "should" to "must"

The reality of organizational life can preempt efforts to develop others on a sustained basis. The result is that an institution's future leaders may not be prepared or interested in assuming key roles when they are needed. This article describes why succession planning is important and how it can be achieved regardless of an organization's commitments and available resources. It begins with the imperative of preparing leaders who can achieve the vision for nursing as articulated by the Institute of Medicine's 2010 report Future of Nursing. It continues with compelling ways to think about and promote succession planning inside an organization. It also provides practical options for leadership grooming that can be used in whole, in part, or in customized form to fit an organizational budget of any size. Finally, the article offers strategies for managing barriers that can disrupt or prevent an institution from fulfilling its goal of developing future leaders.

Reflections on leadership talent: a void or an opportunity?

Nurses, the largest group of clinicians in the health care workforce, are increasingly called on to fill a number of strategic leadership roles. As nurses' roles and prominence in health care increase, the development of future generations of nurse leaders becomes ever more vital. Learning how to thrive, not simply survive, in this era of health care reform that is changing the landscape of care across the continuum requires all leaders and managers to possess new knowledge and skills. Preparing tomorrow's leaders must now begin with an organizational commitment to inspire the next generation of nurse leaders.

Succession planning for the future through an academic-practice partnership: a nursing administration master's program for emerging nurse leaders

A global nursing leadership shortage is projected by the end of this decade. There is an urgent need to begin developing emerging nurse leaders now. This article describes the work of an academic-practice partnership collaborative of nurse leaders. The goal of the partnership is to develop and promote an innovative enhanced nursing administration master's program targeted to young emerging nurse leaders, who have not yet moved into formal leadership roles. An action research design is being used in program development and evaluation. Qualities needed by emerging leaders identified through research included a need to be politically astute, competency with business skills required of nurse leaders today, comfort with ambiguity, use of a caring approach, and leadership from a posture of innovation. The current curriculum was revised to include clinical immersion with a nurse leader from the first semester in the program, a change from all online to online/hybrid courses, innovative assignments, and a strong mentorship component. Eighteen young emerging nurse leaders began the program in January 2012. Early outcomes are positive. The emerging nurse leaders may be uniquely positioned, given the right skills sets, to be nurse leaders in the new age.

Exploring social support and job satisfaction among associate degree program directors in California

A troubling trend noted in California has been an increase in the number of open positions for program directors of associate degree registered nursing (ADRN) programs. Positions remain open for extended periods of time, and the number of qualified applicants for such positions is insufficient. The loss of and ensuing slow replacement of ADRN program directors can put these programs in jeopardy of student admission suspension, or, worse yet, closure by the state nursing board. In this exploratory study, variables of social support and job satisfaction were studied. Variables were found to be limited opportunities for peer interaction, expressed discontent, and retention concerns. A significant positive relationship between job satisfaction and social support was noted. Recommendations for future research are offered.

Preparing pediatric nurse leaders for practice

The growing prevalence of chronic conditions in childhood underscores the urgent need to educate pediatric nurse leaders to address the complex issues these children and families face. This article describes a model of graduate education for preparing pediatric nurse leaders who are equipped to manage and advocate for these children and families. Fifty-one master's prepared graduates completed a Strategic Plan Needs Assessment Survey in 2007 and were asked to indicate specific clinical and leadership competencies that they perceived were essential for pediatric nurse leaders in their areas of practice. Results revealed the highest priority for continuing education and outreach regarding pediatric health to be clinical updates and management of children with special healthcare needs (CSHCN), followed by health promotion for CSHCN and care coordination/case management. The highest priority for continuing education and outreach regarding leadership in pediatrics was evidence-based practice, followed by team care/interdisciplinary practice. The challenge for current nurse leaders is to be cognizant of the urgent need to prepare and retain future pediatric nurse leaders who are experts in the care of CSHCN and their families.

Alert--return of 1990s healthcare reform

Remember the 1990s? In case you don't, there was a major recession and hospitals found themselves squeezed for funds. A movement called "healthcare reform" was instituted across Canada to reduce costs and balance budgets. Nurses bore the brunt of the so-called reforms, which resulted in * merging of hospitals and loss of nursing positions; * elimination of nurse managers' positions and expansion of the span of control of those who remained, so that they found themselves managing two to four units and responsible for 100 to 200 nurses; * elimination of RN positions and substitution of licensed practical nurses or non-regulated workers; * replacing full-time RN positions with part-time positions without fringe benefits; * absence of nursing positions for new graduates and nurses who had been displaced, driving them to seek employment in the United States (the majority did not return to Canada); * collapse of the applicant pool to schools of nursing, which took a decade to rebound to pre-reform days (the drop in graduates over several years during this period is in part responsible for the shortage of nurses today); * dramatic loss of job satisfaction by nurses, which has still not recovered; and * a prevalent sense that nurses were disposable and mattered little in the broad healthcare system.

CNO burnout

For nurse executives, the burdens of the job have become incredibly heavy. Improving quality of care is largely the responsibility of the nursing staff--and ultimately their top managers. Then there are budget concerns, complex new technologies and an RN shortage. Any wonder some CNOs are calling it quits? Filling the void is a huge challenge for hospitals.

Chief nursing officer retention and turnover: a crisis brewing? Results of a national survey

Anecdotal evidence suggests growing concerns about chief nursing officer (CNO) dissatisfaction, intent to leave, and turnover. However, little evidence documents the magnitude of the problem or whether CNO turnover requires direct action. This article reports the results from the first phase of a three-phase study examining CNO turnover and retention in U.S. hospitals. CNOs were invited to complete an online survey to gather data about their experiences with turnover and to identify CNO retention issues. Our sample includes responses from 622 CNOs employed in hospitals and healthcare systems across the United States. Approximately 38 percent of the respondents reported having left a CNO position-13 percent within two years before the survey and 25 percent within five years before the survey. Of these, approximately one-quarter had been asked to resign, had been terminated, or had lost their jobs involuntarily. When asked about the context of their departure, a high percentage reported leaving their position to pursue another CNO position (50 percent) or for career advancement (30 percent); approximately 26 percent reported leaving because of conflicts with the chief executive officer. Of great concern is the finding that approximately 62 percent of respondents anticipate making a job change in less than five years, slightly more than one-quarter for retirement. Respondents clearly indicated that CNO turnover is a problem that requires attention. The knowledge gained from this study can be used by healthcare leaders to develop strategies and policies aimed at recruiting and retaining CNOs and easing the transition for CNOs and others in the organization when CNO turnover does

Nursing Academic Administration: Who Will Take on the Challenge?

To address the shortage of qualified candidates interested in nursing academic administration, this study explored factors that influence nursing faculty to pursue administrative positions. Nursing academic administrators and full-time faculty from randomly selected accredited nursing programs in private colleges and universities in the United States participated in this study. Administrators completed the Leadership Practices Inventory-Self and a recruitment questionnaire, whereas faculty completed the Leadership Practices Inventory-Observer and a career aspiration questionnaire. Most faculty respondents (63%) indicated that they would not consider a position with greater administrative responsibility. Respondents identified workload and conflict-related issues as factors likely to discourage their pursuit of administration. Respondents identified additional challenge/variety of work, opportunity to influence organizational climate for change, opportunity to facilitate faculty growth and development, and mix of administration with teaching as likely to encourage their pursuit of administration. Faculty interest in a position with greater administrative responsibility was significantly increased for those who had completed additional course work beyond their highest degree. Practice recommendations included making leadership development opportunities available for faculty interested in administration, exploring methods to manage workload and conflict, and exploring methods to maximize factors identified as likely to encourage the pursuit of academic administration.

Reasons to leave: the motives of first-line nurse managers? for leaving their posts

OBJECTIVE

To study the reasons for first-line nurse managers to resign, their perceptions of difficult situations, experience of support and satisfaction with work.

BACKGROUND

The intentions of first-line nurse managers' to stay at their posts varied between 45% and 75% in different studies.

METHODS

Data were collected by questionnaire and letters from 32 first-line nurse managers who had left their posts. Qualitative content analysis was used to analyse the letters.

RESULTS

Eleven first-line nurse managers resigned due to reorganization or other changes and 19 due to their own accord. Reasons to leave were personal, organizational, as well as lack of support from and relations to the head of department. Difficult situations were unclear conditions, lack of support from supervisors and, implementation of changes, staff matters and economy. Important support was personal, organizational, practical and to have opportunities for development and education. The perception of work satisfaction was higher after resignation.

CONCLUSIONS

The dominant reason to leave was reorganization and other changes. The relation to the head of department influenced the first-line nurse managers' overall work situation.

The Geriatric Training Academy: Innovative Education for Certified Nurse Aides and Charge Nurses

Quality care for the rapidly growing number of older Americans is a major challenge facing the health care industry today. With the baby-boom generation "coming of age"--older age-the need for quality long-term care workers is on the rise. It is estimated that the number of persons needing assisted or alternative living arrangements will increase from 15 million in 2000 to 27 million in 2050 (U.S. Department of Health and Human Services [HHS], 2003). In response to the rising demand for quality long-term care workers, the Geriatric Education and Training Academy (the Academy) was created at Texas Tech University Health Sciences Center (TTUHSC) to provide advanced geriatric education and training for certified nurse aides (CNA), licensed vocational nurses (LVN) and registered nurses (RN) who work in long-term care facilities. This article describes how the Academy is addressing the need for the recruitment, education, and retention of long-term care workers for the expanding geriatric population in West Texas.

Nursing leadership succession planning in Veterans Health Administration: creating a useful database

An electronic database was developed for succession planning and placement of nursing leaders interested and ready, willing, and able to accept an assignment in a nursing leadership position. The tool is a 1-page form used to identify candidates for nursing leadership assignments. This tool has been deployed nationally, with access to the database restricted to nurse executives at every Veterans Health Administration facility for the purpose of entering the names of developed nurse leaders ready for a leadership assignment. The tool is easily accessed through the Veterans Health Administration Office of Nursing Service, and by limiting access to the nurse executive group, ensures candidates identified are qualified. Demographic information included on the survey tool includes the candidate's demographic information and other certifications/credentials. This completed information form is entered into a database from which a report can be generated, resulting in a listing of potential candidates to contact to supplement a local or Veterans Integrated Service Network wide position announcement. The data forms can be sorted by positions, areas of clinical or functional experience, training programs completed, and geographic preference. The forms can be edited or updated and/or added or deleted in the system as the need is identified. This tool allows facilities with limited internal candidates to have a resource with Department of Veterans Affairs prepared staff in which to seek additional candidates. It also provides a way for interested candidates to be considered for positions outside of their local geographic area.

Organizational Commitment and Turnover of Nursing Home Administrators

In this investigation, the associations between organizational commitment (OC), intent-to-turnover, and actual turnover of a large sample of nursing home administrators (NHAs) are examined. Data used come from a mail survey, from which 632 responses were received from the NHAs (response rate = 63%). The one-year turnover rate of NHAs was 39 percent, and in almost all cases (87%) these NHAs had also exhibited low OC scores. The intent-to-turnover results show thinking about quitting comes before searching for a new position, which in turn both comes before the intention to quit. Multivariate analyses show work overload has a strong and robust association with both intent-to-turnover and turnover of NHAs, and may indicate that NHAs are leaving their positions because they are understaffed.

Impact of management development on nurse retention

PURPOSE

Nurse retention is essential to maintain quality healthcare organizations. In an effort to mitigate the loss of nurse managers, a management education program was created for new and transitioning nurse managers that included scholarships for nurses from long-term and rural acute care settings. Program evaluation was based upon the outcomes of anticipated turnover and employee satisfaction.

DESIGN AND METHODS

Using a preprogram and postprogram evaluation, the Index of Work Satisfaction (IWS) and the Anticipated Turnover Scale (ATS) were used to survey participants. Descriptive statistics as well as Wilcoxon statistics for group comparisons were used for analysis.

FINDINGS

ATS scores were significantly reduced (P < .05) for all program participants. Further analysis of scholarship recipients indicated that the management program significantly increased their intent to stay (P < .08) in their current positions. However, because of a large rate of attrition, findings can only be considered preliminary.

CONCLUSIONS

While the high level of attrition among the scholarship recipients is disappointing, potential attendance barriers are discussed, particularly from long-term care settings. Management development programs may improve the satisfaction and retention of critically needed managers and enhance development of future nursing leaders.

Nurse requirement planning: a computer-based model

RATIONALE

The paper considers the recent debate on mandating patient-nurse ratios in inpatient units of hospitals, and highlights the need for a comprehensive approach to requirement estimation, which can facilitate the implementation of mandated patient-nurse ratios in hospitals.

AIM

After considering the available methods for nurse requirement planning, this paper intends to discuss an alternative approach for estimating nurse requirement when certain patient-nurse ratios have been prescribed.

METHODS

Once the required information becomes available, the next task is to estimate unit-wise and overall nurse requirement. As the computational effort is quite considerable, the paper develops and elucidates a computer-assisted nurse requirement-planning model, which helps in systematizing and accelerating the estimation process.

RESULTS

The computer-based nurse requirement-planning model enables planners to respond objectively and promptly to requests for more nurses by nursing administrators (who perceive nurse shortages).

CONCLUSIONS

The paper demonstrates the unique advantage of this computer-based approach over conventional methods, especially when the planner wishes to pre-evaluate alternative decision options by simulating manpower implications under alternative scenarios.

Mentoring the minority nurse leader of tomorrow

Diversity is crucial to the future of nursing. And fortunately, a shift in the composition of the nursing workforce so that it more accurately mirrors the composition of America's patient population is already taking place. However, this emerging multiculturalism brings an important issue to the forefront-the leadership tier in healthcare organizations must also reflect the ethnic and cultural changes taking place. Movement in this direction makes prominent the importance of the mentor role in the life of the minority nurse seeking a leadership career path. Acknowledging the present demographics of the profession, it is most unlikely that the mentor and mentee will be a cultural or ethnic match. The good news is that this should not be viewed as an automatic barrier. This article describes the 5 Cs of mentoring a minority nurse professional, that is, candor, compromise, confidence, complexity, and champion-the specific competencies that promote a mentor-mentee relationship focused on career success.

Perceptions of work-time and leisure-time among managers and field staff in a UK primary health care trust

AIMS

The aims of the research were to explore the issues around the perception of District Nurses in an inner London Primary Health Care Trust of their use of work-time and leisure-time, and to reveal how the boundaries between these two aspects can become blurred and impinge on each other.

BACKGROUND

Time use is helpful in considerations of wider issues such as satisfaction at work and work-life balance.

METHODS

The data were collected by a questionnaire to seek the views of managers and field staff on issues such as the impact on the quality of patient care of the nurses' perception of work-time and leisure-time.

RESULTS

The research identified the different perception of "work-time" that employees have in relation to their place within the hierarchical structure.

CONCLUSIONS

The findings answered the question of whether time is perceived differently, dependent on one's occupation within the Trust.

Nurse managers: the ties that bind

The staff nurses' immediate manager directly influences an NICU's ability to attract and retain professional nurses. This makes it especially important that nurse executives and administrators identify opportunities to better meet the needs of their nurse managers and measure the impacts of their decisions. Data about front-line manager turnover need to be measured, reported, and examined. No longer can organizations afford to view managers as another expense; they are an asset on the balance sheet. Strategic planning for the recruitment and retention of nurse managers will be vital both to an organization's healthy bottom line and to the quality of its patient care.