Sherman, Rose O.

The American Association of Colleges of Nursing (2016) contends meeting the
challenge to transform care will require the successful leadership development,
preparation, and role support of the next generation of nurse leaders. Despite the urgency
to transform care, meeting the challenge to lead this charge cannot be accomplished
without the successful recruitment and retention of Millennial nurses to leadership
positions. Identifying the leadership role expectations and support variables that are
important to these young managers and creating the milieus that support these views
serve to address many pressing succession planning needs.
This study explored the experience of being a Millennial nurse manager, seeking
to understand how these young nurse managers make meaning of their lived experience.
This was a qualitative interpretative phenomenological research study. Three theoretical
perspectives contributed ideologies that framed this inquiry: Ray’s (1989) theory of
bureaucratic caring, generational cohort theory (Strauss & Howe, 1991), and authentic leadership theory (Avolio & Gardner, 2005). A purposeful targeted national sample of 25
Millennial nurse managers with a minimum of one year of nurse manager experience in
the role participated in audio-recorded telephone interviews. Content analysis identified
seven themes: Coming into the Role, Learning as I Go, Having the Support of My
Director, Making an Impact, Helping Staff Succeed, Managing Change, and Trying to
Stay Balanced.
Findings from this study suggest Millennial nurse managers gauge role success
and satisfaction in relation to their perceived levels of support and development and their
ability to master role expectations. Additional findings suggest adequate succession
planning for the nurse manager role remains challenged by the lack of formal mandated
requisites for the role.
The nurse manager role as it stands varies significantly among organizational
settings regarding responsibilities, mechanisms of support, number of direct reports, and
span of control. Recommendations included the need to address the nurse manager role,
academic requisites, and developmental variances in practice. Additionally, re-evaluating
the organizational responsibility to the leadership development of these young nurse
leaders is recommended to ensure their retention and success in the role.

Creating a safety culture is the focus in the current healthcare environment. An inhouse,
around-the-clock laborist service delivery model has been associated with positive
outcomes, but little is known about the laborist structure’s contribution to the labor-anddelivery
working environment. The purpose of this descriptive correlational study was to
explore the effects of physician service delivery model on safety culture, nurse-physician
collaboration, and nurses’ job satisfaction. An additional purpose was to examine
associations between nurses’ perceptions of safety culture, nurse-physician collaboration,
and job satisfaction. Ray’s (1981, 1989) Theory of Bureaucratic Caring and Homan’s
(1974) Social Exchange Theory guided this study. A survey consisting of demographic
questions, the Collaborative Practice Scale (Weiss & Davis, 1985), the Hospital Survey
on Patient Safety Culture (Agency for Healthcare Research and Quality, 2015;
HSOPSC), and the McCloskey and Mueller Satisfaction Scale (McCloskey & Mueller,
1990) was distributed to registered nurses (RNs) nationwide. The results indicated that nurses in facilities using the around-the-clock model had higher perceptions of nursephysician
collaboration, but not of safety culture or job satisfaction in relation to the
physician service-delivery model. Significant moderate-to-strong correlations between
nurses’ perceptions of patient safety and job satisfaction, and a weak correlation between
bedside nurses’ perceptions of nurse-physician collaboration and job satisfaction were
demonstrated. Additional significant correlations were found between the instrument
subscales. Control/responsibility in the MMSS scale was positively associated with both
management support for patient safety, supervisors’ and managers’ expectations and
actions promoting patient safety, and overall perceptions of safety in the HSOPSC scale.
Praise and recognition in the MMSS scale were positively associated with
supervisor/manager expectations and actions promoting patient safety in the HSOPSC
scale.
Further appraisal is needed to understand the mechanism by which the laborist
model affects patient care and work environment. Recommendations for future research
include replicating the study with a larger sample sizes in specific groups based on the
role and scheduled shift, conducting the study in a single system or location to mitigate
the effects of other variables; and exploring physicians’ perspectives on the variables
being studied.

The highly complex role of the Chief Nursing Officer (CNO) requires the refinement of a multitude of competencies and leadership skills in this unprecedented time of healthcare reform. As the senior most patient advocate in our medical centers the CNO is responsible for translating research into practice, policy development and implementation creating value based patient-centric strategies to transform health care.
The ability to sustain and thrive in this role is essential in repositioning nursing as a
knowledgeable discipline actively contributing to the redesign of healthcare. This exploratory descriptive phenomenological study was designed to explore and
describe the elements that contribute to the sustainment of CNOs in their practice of
nurse executive leadership. Ray’s (1989) Theory of Bureaucratic Caring, Authentic
Leadership Theory (Wong & Cummings, 2009), and Resiliency Theory (Earvolino-
Ramirez (2007) provided the theoretical lens through which this study was grounded. Semi-structured telephonic interviews were conducted with twenty CNOs all with
two consecutive years experience in their current role. Six themes emerged after thorough content analysis which describes the lived experience of sustainment. Each theme was supported by several subthemes. Themes emerged as: Loving the Profession, Having a Broader Impact Reflecting on One’s Own Work, Learning to Manage Conflict, Maintaining Work/Life Balance Working with Supportive Leaders.