| Learning Objective #1: Understand the effects on nurses of hospital restructuring that leads to layoffs | |||
| Learning Objective #2: Understand the impact that leadership competencies and emotional intelligence can have to mitigate these effects |
Objective: The purpose was to determine the extent to which leadership styles mitigate the effects of hospital restructuring on nurses.
Design: A theoretical model of causal relationships between hospital restructuring and nurses’ work and health was developed and estimated as a structural equation model.
Sample: The sample was drawn from registered nurses in acute care hospitals in Alberta, Canada, accessed through their professional association using annual mandatory reporting information (n= 6526 nurses; 53% response rate).
Concepts: Causal variables included hospital restructuring events, being laid off, changing units, years worked in the hospital, part time/fulltime status, and age. Outcome variables included unmet patient care needs, freedom to make patient care decisions, professional efficacy, emotional and physical health, teamwork with physicians and other nurses, job mobility options, satisfaction and security, intent to quit and satisfaction with supervision, financial rewards, and time to spend with patients.
Methods: Thirteen leadership competencies were used to create 7 databases reflecting different leadership styles; 4 resonant, 2 dissonant and 1 unknown. The theoretical model was tested using structural equation modeling against the data for each style.
Findings: Nurses who worked for dissonant leaders reported significantly more emotional exhaustion and psychosomatic symptoms, poorer levels of emotional health, decreased workgroup collaboration and teamwork with physicians, decreased satisfaction with supervision and their job, and increased unmet patient care needs, than did nurses who worked for resonant leaders.
Conclusions: Despite experiencing relatively similar hospital restructuring events, nurses who worked for resonant leaders experienced significantly fewer negative effects of hospital restructuring, than those who worked for dissonant leaders. Resonant leadership styles mitigated the effects of hospital restructuring on nurses.
Implications: These findings have implications for recruitment, training and accountability expectations for hospital leaders and for the development of practice environments, health and retention of nurses and ultimately patient care outcomes.
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