Nursing services--Administration

The purpose of the research was to explore the social process of trust between the
chief nursing officer and the nurse manager in the hospital setting. The researcher used
the grounded theory method to analyze the nurse manager-chief nursing officer
relationship from the perspective of the nurse manager.
A total of 12 participants were interviewed by the researcher. The sample
consisted of nurse managers employed in hospitals in the southeastern United States.
Data analysis consisted of open coding and constant comparative analysis. Resulting
categories consisted of preparing to trust, co-creating trust and co-creating the trusting
environment. The basic social process of the nurse manager-chief nursing officer trusting
relationship in healthcare was the substantive theory of Striving to Live the Golden Rule
which refers to living the nurse manager-chief nursing officer ethical relationship in a nursing environment where trust may be difficult to establish. The formal theory
generated was the essential link between Striving to Live the Golden Rule to Living the
Golden Rule as Unveiling the Mystery of Covenantal Trust. The overall results of this
research demonstrated the process of trust between the nurse manager and chief nursing
officer as essential to the overall relationship and to the success of both.

It is estimated that there will be a 20% shortage of full time equivalent registered
nurses (RN) by 2015. Retention of nurses is a priority in health care, so a better
understanding of factors that contribute to job satisfaction and intent to leave is needed.
One possible factor is the quality of the interpersonal relationships that occur among
managers, peers, and nurses. A negative quality would be acts of hostility or horizontal
violence, which is nurse-to-nurse aggression. This is theorized to be a result of oppressed
group behavior. These behaviors may influence job satisfaction and the intent to stay on
the job and in the profession.
The overall purpose of the study was to explore relationships between horizontal
violence, oppressed group behavior, job satisfaction and intent to leave a position or
nursing in the next 12 months. This pilot study examined factors that influence registered nurses ' job satisfaction
and intent to leave a position or nursing. Convenience sampling was used to obtain the
sample of registered nurses from a BSN completion program and a Novice Nurse
Initiative Program (n=99). Written stories of conflict between nurses were obtained and
analyzed with linguistic analysis and word count (LIWC) software and various
standardized instruments were used including the Nurses Workplace Behavior Scale
(NWBS), the Organizational Climate for Caring Scale (OCCS), the Peer Group Caring
Interaction Scale (PGCIS), The McCloskey/Mueller Satisfaction Scale (MMSS) and two
visual analogue scales (VAS).
Significant relationships were found between job satisfaction and intent to stay in
a position and nursing (p<.01), oppressed group behavior and intent to stay in nursing
(p<.01), oppressed group behavior and job satisfaction (p<.01). Manager and peer caring
behaviors were related to intent to stay in a position and nursing (p<.01). Using stepwise
multiple regression, both manager and peer caring behaviors were found to influence the
relationship between job satisfaction and intent to stay in a position or nursing.
The findings of this study suggest that the quality of interpersonal relationships
between managers, peers and nurses can influence job satisfaction and intent to stay in a
position or nursing.

The ability to gain payment for services is strongly linked to the ability of a
profession to define the value of its service. Valuation as an economic term is used to
define an entity's worth or value. As an approach, valuation encourages a company to
document the financial value of both the tangible and intangible assets associated with
the services provided. Today there are a limited number of studies that document the
value of nursing services. Valuation studies related to nursing are challenged by the need
to include the complexity of patient services that causes variation in research results. This
historical case study examines one nursing initiative undertaken by the Daughters of
Charity who were trained in nursing and finance and were able to demonstrate their value
to the community of Jacksonville, Florida. In 1916, the Daughters of Charity came to
Jacksonville to provide health care to the sick and the poor. They endured the hardships
found in this southern city and endeared themselves to the community. They purchased a 42-bed Sanatorium and expanded this facility into a 528-bed hospital and health system.
Across ninety years, the community supported and demonstrated their willingness to pay
in order to sustain the Sisters mission. The themes identified in the study included an
unwavering commitment to Jive the mission of the Daughters of Charity, an implicit
authority allowing these Sisters to enter into business arrangements, an emphasis on
ensuring that all Sisters gained education and mentorship in finance and nursing, the
growth of a strong bond with the community of Jacksonville, and an ability to obtain
funding needed to carry out their mission. Themes appearing to be in opposition to the
Sisters mission included racial separation and the limited recognition given to nurses at
the Sisters' hospital. In conclusion, the study tells the story of Sisters who were able to
enhance their valuation by blending their knowledge of the health care business and
nursing, while successfully obtaining the funding needed to fulfill their mission.

A descriptive study of caring in nurse managers as described by staff nurses is presented. Five participants provided data from semi-structured, open ended, audiotape recorded interviews. The transcribed interview data were coded, concepts were identified, and the conceptual unit of meaning emerged. A conceptual model was developed and subsequently was analyzed in relation to Boykin's and Schoenhofer's (1993) Nursing as Caring Theory. It was discovered that staff nurses respect a nurse manager when she participates in direct nursing care, provides for the overall needs of the unit by negotiating with administrators, and nurtures nurses through listening to, encouraging, supporting and role modeling. Recommendations for nursing administration, practice, education and research are presented.

The purpose of this study was to describe the values identified by nurses in middle management positions at a Florida for profit hospital. Latent content analysis was the method used to describe values identified by ten nurses in middle management positions. The analysis revealed a total of eight value themes. Two themes emerged as overarching: the value of economics and the value of caring. Six other value themes were interwoven into the overarching themes and consisted of commitment, compassion, competence, patience, respect for the other and technology.

The purpose of this study was to describe the practice of nursing and the factors that influence nursing practice in one patient care setting where the Director is not a nurse. A qualitative design employing the methods of grounded theory was utilized. Reaching for Completeness was the core concept that emerged from the analysis. Reaching for Completeness describes the directionality of nursing practice in this setting. It includes: coming to Know the Client, Responding to the Immediate Needs of the Client, and Pulling it All Together. Factors that appeared to influence the practice of nursing in this setting were the management styles of the director and nurse manager, shared expectations of professionalism, and a shared sense of satisfaction in what the patients and staff accomplished together each day. The results of this study suggest that the main factor affecting the development of nursing practice in a patient care setting may not be whether the director is a nurse, but rather, whether nursing retains ownership of the practice of nursing.

The purpose of this study was to describe how nurses in middle-management positions rate caring attributes of nursing staff. A convenience sample of 99 nurses from three acute-care hospitals was asked to rate caring attributes of nursing staff using the Nyberg Caring Assessment Scale, a 20 item 5-point Likert scale instrument. Fifty-nine nurses in the sample volunteered to participate in the study. Participants rated the attribute communicating a helping, trusting attitude toward others as extremely important, and the attribute consider relationships before rules as somewhat important. The remaining eighteen items were rated very important caring attributes to be exhibited by nursing staff in relations with patients and others in acute-care facilities. The study adds to the literature on caring and contributes to the nursing profession by expanding information about caring-based practice.