The evaluation and development of the nurse managers’ management activities are necessary to maintain the attractiveness of nursing management and to improve the nursing outcomes in the complex care organizations environment. In her doctoral dissertation, MHSc Anu Nurmeksela developed and tested an instrument which evaluates the management activities of a nurse manager, examined the connection between nurse managers’ management activities and nursing outcomes, and researched the nurse managers’ views on their work in the future. The study showed that the head nurses management activities are complex and contain a great area of responsibility.
The new instrument shows the focal points in management
The instrument titled Nurse manager work content was developed and tested in the study. The instrument was based on a literary review and it was tested against two separate sets of material. This resulted in a reliable instrument containing 75 arguments. The instrument subscales include duties related to a new employee, daily management, personnel management, decision making, clinical care, development, planning of processes and evaluation, collaboration, ensuring knowledge, evidence-based management, ensuring care quality, and financial management. Based on the study, the nurse managers’ management activities focused mainly on the subscales of collaboration, personnel management and daily management. The subscales least related to the nurse managers’ work were clinical care and ensuring knowledge.
Several nurse managers’ management activities were connected to the nurse’s job satisfaction, patient satisfaction and medication errors. For example, when the nurse managers job entailed a lot of care development, the nurse’s satisfaction with the job requirement factors decreased. More active communication was also connected to a weaker work atmosphere and overall job satisfaction. Investments in job well-being also deteriorated the patients views on the personnel collaboration and decreased overall patient satisfaction. When the nurse managers’ work focused more on planning of processes and evaluation, there were more medication errors.
There were differences between hospitals in terms of work atmosphere experienced by the nurses, and in the incidence of medication errors. The numbers of care staff lead by the nurse manager were connected to how satisfied the nurses were with management and atmosphere. The fewer nurses in the unit, the worse the experienced atmosphere. On the other hand, nurses in small units were more content with management.
"Upon reviewing the results, it can be stated that the nurse manager's work is diverse and complex, and it is affected by several background variants, as well as cultural- and atmospheric factors in the organization. As managers of care, the nurse managers can work toward a new angle, which can achieve good results in care by recognizing and combining these complex connections," says Nurmeksela.
The nurse managers’ views on management in the future were connected to the themes of shared governance, evidence-based leadership, proactive action and attractiveness, thereby touching upon the management ideology, as it is employed in the management of magnet hospitals.
The operational environments in health care are in a state of change, and they challenge us to reform management. The national social and health care services reform, the development of health technology, digitalization and the ongoing magnet hospital projects are challenges of the future. "The themes of maintaining nursing attractiveness and keeping nursing staff in the field are already present in the contemporary public discourse. As far as they are concerned, the nurse managers can with their own management, have an influence on these things. It is important to evaluate and develop nursing management and leadership to make sure it meets with the requirements of today and the future," Nurmeksela states.
The doctoral dissertation of Anu Nurmeksela, Master of Health Sciences, entitled Nurse managers’ managerial work and its relationship to nursing outcomes in specialized health care will be examined at the Faculty of Health Sciences at the University of Eastern Finland. The Opponent in the public examination will be Oppinent Docent Marita Koivunen of the University of Turku, and the Custos will be professor Tarja Kvist of the University of Eastern Finland. The public examination will held in Finnish in the Nova auditorium, Jyväskylä, on 27 August 2021, starting at 12 noon, and it will be streamed online.
