Dramatic changes have occurred in the healthcare environment over the last decade. Healthcare organizations have been faced with the need to redesign their traditional organizational models in an effort to control costs and improve efficiency and outcomes. These organizations are recognizing that the key to their effectiveness lies in their ability to assemble and retain a highly motivated, involved, and satisfied workforce; most notably, the staff nurses who provide the bulk of patient care. A large number of factors have been identified as contributors to staff nurse job satisfaction, including salary, working conditions, and opportunities for advancement. However, another vital factor that has not received as much attention is the leadership provided by front-line managers. Therefore, the purpose of this descriptive, correlational study was to identify the management styles of front-line nurse managers as perceived by staff and to evaluate the relationship of these styles to staff nurse job satisfaction.
A survey of all full-time and part-time registered nurses working in the medical-surgical and critical care areas of a large, university-affiliated acute-care hospital was conducted. Participants completed two questionnaires. The Profile of Organization Characteristics was used to identify the nurses' perceptions of their managers' management style. The Munson-Heda Staff Nurse Questionnaire was used to measure job satisfaction. A total of 98 nurses completed the survey. The typical respondent was 36 years old, held a baccalaureate degree in nursing, and had worked at the hospital for an average of 8.2 years. The majority of respondents perceived their manager to have a consultative management style, which reflects the manager's use of staff ideas and opinions and their frequent involvement of staff in decision making. The perception of a consultative style indicates that the participants had a positive relationship with, and substantial confidence in, their unit leadership. Analysis of the satisfaction data revealed a statistically significant relationship between management style and job satisfaction (r = 0.58; P < .001). In other words, the more participative the nurses perceived their managers' leadership style to be, the more satisfied they were. The results of this study support the need for continued transformation of the traditional nurse managers' role. Transformed nursing leaders get their staff involved through sharing of information and vision, challenging them to think creatively, and coaching them in problem solving. The resulting participatory environment gives staff more autonomy and the opportunity to develop their professional status further. The current nursing shortage has refocused healthcare organizations' attention on strategies to retain their valuable nursing resources. The findings of this study suggest that efforts to retain nurses should also include further development of nursing leaders. The challenges of today's healthcare environment require different leadership skills than were required in the past. The development of new approaches and skill foundations for nurse managers can lead to more effective and more satisfied nurses and, ultimately, to more positive patient outcomes.
Lisa A. Dolan MSN, RN
-Ms. Dolan is the AVP for medical/surgical nursing at Jewish Hospital, 200 Abraham Flexner Way, Louisville, KY 40202. She can be reached at 502-587-4011. This abstract was written as part of her studies at Bellarmine University, Lansing School of Nursing and Health Sciences in Louisville, Ky.