Creating a Healthy Work Enironment for Nurses Transitioning from Staff Nurse to Management

Healthy work environments are essential for recruitment and retention of nurse managers in the United States and internationally. Nurse managers are in key positions to positively influence patient outcomes and costs. In addition, the role of nurses as managers is becoming increasingly important in the retention of staff nurses because of their critical influence on the quality of the work environment (Roche, Duffield, Dimitrelis, & Frew, 2015). There is an expectation that new nurse managers will become competent immediately and meet those same high performance standards as experienced nurse managers (Doria, 2015). Yet many nurses are leaving their manager roles to resume a staff nurse position or to withdraw from the nursing profession completely (Djukic, Jun, Kovner, Brewer, & Fletcher, 2016). In addition, with the nursing shortage predicted to continue, the number of nurses choosing to enter management may decline (Wong, et al., 2013). Research has demonstrated that frequent turnover of nurse managers in a hospital can lead to a disruption of nursing staff performance and negatively impact patient care (Buffenbarger, 2016). This presentation focuses on a qualitative bounded case study that was implemented to explore nurse managers’ experiences with turnover in order to identify strategies for enhancing retention. Two conceptual frameworks that guided the study were work empowerment and servant leadership. Research questions focused on nurse managers’ perceptions of empowerment and servant leadership characteristics that were important in decisions to assume and remain in a management/leadership role. Data collection included audio-recorded interviews with 7 current or past full-time nurse managers and observation of 3 of the participants at a leadership meeting. Interview transcripts were open coded and thematically analyzed. Observation data were categorized according to empowerment and servant leadership characteristics. Five themes were identified that related to research questions: Struggling to make a difference while pulled in all directions; Opportunity for transformation; Committed but powerless; Embarking unprepared on an unplanned journey; and The presence to serve, to lead others. Findings guided development of a 12-month program for new nurse managers that integrates characteristics of servant leadership reflective of a healthy work environment. Healthy work environments are essential for patient safety and financial viability of an organization (AACN, 2016). Our presentation will address strategies that help to create a healthy work environment to assist novice nurse managers in gaining new skills and self-confidence in their role. By giving voice to the challenges and opportunities embedded in the role of the nurse manager, findings and recommendations from this research can assist both new and experienced nurse managers to work collaboratively to create a healthy work environment.