Front line nurse clinical managers are considered to have one of the most complex roles in healthcare, with responsibilities for administrative and clinical leadership, oversight of first-level nursing care, translating strategic goals and objectives into practice, and 24-hour accountability for unit activities. Transformational leadership is noted to inspire followers to perform beyond expectations while transcending self-interest for the good of the organization. Front line nurse clinical managers are challenged to inspire clinical nurses across shifts to perform above expectations.
There is a dearth of literature acknowledging leadership, leadership skills, or perceptions of leadership specific to the night shift nursing workforce, comparing night shift to day shift perceptions of leadership, or comparing night shift, day shift and front line nurse clinical managers perceptions of leadership. It is worth consideration that leadership practices aimed at the unique needs of the off shift workforce may impact success with patient outcomes. The Leadership Practices Inventory (LPI®) is an instrument that helps a leader gain perspective on how they perceive themselves and how others view their leadership practices. Transformational leadership is noted to inspire followers to perform beyond expectations while transcending self-interest for the good of the organization. In the clinical arena of nursing leadership, 360° leadership assessment provides leadership practice feedback on influence and effectiveness from directors, front line nurse clinical managers, peers, and both night and day shift nursing staff.
The primary aim of the research study is to compare perceptions of leadership practices among front line nurse clinical managers self-assessment and those of the night, and day shift nurses. The secondary aim of this study is to identify gaps in perceptions of leadership practices, and implement need specific interventions to improve leadership practices. The research question is: “What are the differences in perceptions of front line nurse clinical managers (FLNCM) leadership practices among FLNCM self-assessment, and those of the night shift (NSN) and day shift staff nurses (DSN)?”
Methods:
This descriptive, comparative study is a secondary data analyses of LPI®, 2018 established data set. The LPI® is a 30 item instrument measuring leadership behaviors aligned with five exemplary leadership practices: model the way, inspire a shared vision, challenge the process, enable others to act and encourage the heart. Data collected in Spring 2018 from FLNCM and NSN and DSN in a semi-rural acute care hospital are utilized. The comparative descriptive design is selected based on the available data from the descriptive LPI® survey, the non-random assignment of groups- FLNCM, NSN, DSN; structured quantitative data collection- LPI® survey.
Results:
The subjects were comprised of FLNCM (n=16), NSN (NSN) (n=36), and DSN (DSN)(n=61), peers (P) (n=94), and senior leaders (SL) (n=16). The analysis of group aggregate scores for each of the five exemplary leadership practices: model the way, inspire a shared vision, challenge the process, enable others to act, and encourage the heart; identified that DSNs perceive their FLNCM as very slightly more adept at challenging the process (50.22) than the FLNCM think of themselves (49.38); the DSNs think more poorly of FLNCM in the inspire a shared vision (48.43) and modeling the way (49.96) sections and overall the DSNs have a lower perception of the FLNCM, than FLNCM have of themselves (49.25; 50.81) . Comparatively, NSNs line up near identical with the FLNCM’s perception of themselves. SLs across the board have higher aggregate scores for each section of perception of leadership practices- model the way (54.19), inspire a shared vision (52.75), challenge the process (54.50), enable others to act (55.81), and encourage the heart (56.13); than the FLNCMs have of themselves- model the way (50.81), inspire a shared vision (49.25), challenge the process (49.38), enable others to act (42.94), and encourage the heart (50.38).
An innovative approach to data analytics and animated data visualization will be applied to compare aggregate scores. These comparisons also identify opportunities to draw linkages between leadership perceptions, and established organization evaluation tools.
Conclusion:
The session will demonstrate the implementation of a valid and reliable instrument to assess perceptions of FLNCM leadership practices in a semi-rural acute care hospital, with a novel approach application of findings within the framework of transformational leadership, aimed to support FLNCM in achievement of a healthy work environment, while attaining positive patient outcomes and achieving organizational goals. The opportunity for transformational leadership skills development to support the ANA and WHO vision of creating Healthy Work Environments for nurses where they can practice in an environment that is safe, empowering and satisfying. Further, case-study examples will be applied to demonstrate how assessment of leadership practices can elucidate perspective of leadership and how these perspectives can be applied for realization of succession planning, coaching, mentoring, training and development, senior leadership practices, and empowerment programs. Opportunities for further research will be presented with strategies to enhance managerial competence of front line managers.