Nurse Managers' Leadership Model and Its Connection to Nurses' Job Satisfaction: A Pilot Study

Monday, 30 October 2017

Tarja Kvist, PhD, MSN, BSN, RN
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
Jaana Peltokoski, PhD
Nursing administration, Central Finland Health Care District, Jyväskylä, Finland
Anu Nurmeksela, MHS
Central Finland Central Hospital, Central Finland Health Care District, Jyväskylä, Finland

Aims: To describe the relationship between the nurse managers’ leadership model and nurses’ job satisfaction.

Background: Nurse managers’ aim is to contribute to the health and welfare of the patients by evidence-based, patient-centered, safe and impressive nursing services. They also create prerequisites for effective, high-quality, and cost-effective nursing, although it is a challenge to manage evidence-based practice and to introduce methods that integrate evidence into practice. Nurse managers’ work is in transition. Restructuring of health care means that nurse managers have a broader range of responsibilities, extending their roles and increasing their workloads. According to previous studies, high quality nursing leadership can promote nursing outcomes, improve work performance, patient safety, and job satisfaction. Nurse managers can promote the motivation of employees, support their commitment to work, increase their job satisfaction, and improve work performance. Nurse managers should be more visible and work closer to their staff and give them more direct feedback about their work. When nursing management activities focused on the daily routines and human resources management, nurse managers do not have enough time to support and manage nursing staff in their clinical nursing activities. Nurse managers’ and assistant nurse managers’ roles need to be clarified and the content of the nursing management and leadership needs to be standardized.

Design: The pilot study included three pediatric units at one acute care hospital in Finland. The study engaged all nurses and practical nurses (N=78) in the children's section, children's outpatient department and neonatal intensive care unit.

Methods: The job satisfaction data was collected with Kuopio University Hospital Job Satisfaction -Scale (KUHJSS) as a paper questionnaire. The research data were analyzed by using SPSS statistical program.

Results: The response rate was 65.5%. The respondents' average age was 43 years. Nurses comprised 78% of the sample and practical nurses 22%. Permanent contract of employment was 76%, 24% temporary job. Nurses assessed the management of nursing to be fairly good. The most needs for improvement in the nurse managers’ work consisted of providing constructive feedback (24%) and relaying information concerning the working unit (22%). The most critical of nurse managers’ support were employees over 40 years of age. The issues causing most dissatisfaction were the distribution of the workload (37%) and the new employee orientation (49%). There were differences between work units in job satisfaction as in the children's intensive care unit; there was more dissatisfaction than in the other units.

Employees were fairly dissatisfied with the possibility of career advancement in the hospital district (37%). Most of the employees were dissatisfied with remuneration (84%) and support from the senior management (59%). There were no differences between the units in terms of this result.

Nurses gave an average nursing quality rating of 8, on a scale of 4-10. Overall, nurses’ job satisfaction was at a good level, although more than a quarter of nurses experienced work-related stress. Employees agreed or strongly agreed that feedback from the patients motivated them in their work (98%), that their work was interesting (98%), and that they appreciated their own work (98%).

Conclusions: Nurses’ job satisfaction was at a good level, although they need more support from nurse managers. During the pilot study, nurse managers (N=4) and physicians (N=4) will be interviewed concerning their experiences and opinions in pilot units. In addition, the staff job satisfaction survey will be conducted again in the middle and the end of the pilot. The results of the pilot study can be utilized in the reconfiguration and development of nursing management practices.