The “Learning on the Fly” Approach: Is it Ethical? The Selection, Preparation, and Support of Nurse Managers

Sunday, 17 November 2013: 11:40 AM

Linda Weaver Moore, PhD, RN, CNS, CNL
Cathy Leahy, MSN, MEd, BSN, RN, CNL
Cindy Sublett, PhD, MSN, BSN, RN, CNL
School of Nursing, Xavier University, Cincinnati, OH

Learning Objective 1: Discuss perceptions of Nurse Managers regarding selection and preparation for the role and support while in the role.

Learning Objective 2: Discuss strategies for consistently and ethically selecting, preparing, and supporting Nurse Managers in the role.

Nurses holding middle nursing management positions play a pivotal role in the creation of healthy work environments. These Nurse Managers set the overall tone for the unit and are often a key factor in staff nurse retention. Because of the crucial role that Nurse Managers play in the workings of a nursing unit, it is imperative that nurses are carefully selected, prepared, and supported in this role. Little empirical attention has been devoted to exploring Nurse Managers’ perceptions regarding how they were selected and prepared for their role. The purpose of this presentation is to share findings from a descriptive, qualitative investigation that examined the perceptions of Nurse Managers’ regarding their experience. Thirteen Nurse Managers from five acute care facilities participated in in-depth, semi-structured, audio-taped researcher-participant interviews. All interviews were transcribed and transcripts served as the data. A content analysis was conducted and data were coded and categorized. Themes were determined. Findings revealed that the selection of Nurse Managers was often spontaneous and non-deliberative while orientation to the role often followed a “learning on the fly” or “by the seat of the pants” approach. Findings also revealed Nurse Managers’ “wished for” resources and factors that Nurse Managers believed helped them grow despite often shaky beginnings. Findings suggest that current practices may sabotage efforts to hire and retain the most qualified nurses for the role. Findings will be discussed in relation to an ethical framework focusing on the principles of respect for person, beneficence, and fidelity. Strategies will be discussed regarding how to more consistently and ethically select, prepare, and support nurses to fulfill this pivotal role. In an era of healthcare complexities, hiring and retaining the most qualified individuals to oversee nursing units is imperative if high quality, effective, and efficient nursing care is to be provided in the future.