Scott Anne, Timmons Stephen
Leicester, England.
University of Nottingham Business School, England.
Nurs Manag (Harrow). 2017 Mar 30;24(1):31-37. doi: 10.7748/nm.2017.e1569.
Aim This article reports the results of a study that gives an insight into ward leaders' perspectives of their leadership role and explores how they deliver leadership at ward level within organisational constraints and processes. Previous studies have been evaluations of clinical leadership in general, or literature reviews of the ward leader role. The aim of this study was to examine the leadership role of ward sisters and to understand how they lead improvements in quality of care on their wards. Methods A qualitative methodology was used, incorporating 19 in-depth interviews with ward leaders and modern matrons. Results Three main themes were identified: empty conformity, authority and autonomy, and visibility and leading by example. Participants aimed to be role models in leading and maintaining standards of care for patients, but this was sometimes constrained by organisational processes, lack of authority and autonomy, and lack of support and preparation. Conclusion Perceived differences between nursing and health service management mean that ward leaders' efforts to lead improvements in quality care are often undermined. Ward leaders must strike a balance between leading high-quality nursing care, in the context of organisational and political performance requirements, and the demands of administrative work, while often lacking autonomy and authority.
目的 本文报告了一项研究的结果，该研究深入洞察了病房领导者对其领导角色的看法，并探讨了他们如何在组织限制和流程范围内在病房层面发挥领导作用。以往的研究一般都是对临床领导力的评估，或者是对病房领导者角色的文献综述。本研究的目的是审视病房护士长的领导角色，并了解她们如何在病房中引领护理质量的提升。方法 采用定性研究方法，对19名病房领导者和现代护士长进行了深入访谈。结果 确定了三个主要主题：表面服从、权威与自主、可见性与以身作则。参与者旨在成为引领和维持患者护理标准的榜样，但这有时会受到组织流程、缺乏权威和自主以及缺乏支持与准备的限制。结论 护理与卫生服务管理之间的认知差异意味着病房领导者提升护理质量的努力常常受到破坏。病房领导者必须在组织和政治绩效要求的背景下引领高质量护理、行政工作需求之间取得平衡，而他们往往缺乏自主权和权威。
