Solbakken Rita, Bergdahl Elisabeth, Rudolfsson Gudrun, Bondas Terese
Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway (Ms Solbakken and Drs Bergdahl, Rudolfsson, and Bondas); Department of Health Sciences, Division of Nursing, University West, Trollhättan, Sweden (Dr Rudolfsson).
Nurs Adm Q. 2018 Oct/Dec;42(4):E1-E19. doi: 10.1097/NAQ.0000000000000314.
To explore and derive new conceptual understanding of nurse leaders' experiences and perceptions of caring in nursing.
What is caring in nursing leadership from the nurse leaders' perspectives? There is a paucity of theoretical studies of caring in nursing leadership. Noblit and Hares interpretative meta-ethnography was chosen because of its interpretative potential for theory development. Caring in nursing leadership is a conscious movement between different "rooms" in the leader's "house" of leadership. This emerged as the metaphor that illustrates the core of caring in nursing leadership, presented in a tentative model. There are 5 relation-based rooms: The "patient room," where nurse leaders try to avoid patient suffering through their clinical presence; the "staff room," where nurse leaders trust and respect each other and facilitate dialogue; the "superior's room," where nurse leaders confirm peer relationships; the "secret room," where the leaders' strength to hang on and persist is nurtured; and the "organizational room," where limited resources are continuously being balanced. Caring in nursing leadership means nurturing and growing relationships to safeguard the best nursing care. This presupposes that leaders possess a consciousness of the different "rooms." If rooms are not given equal attention, movement stops, symbolizing that caring in leadership stops as well. One room cannot be given so much attention that others are neglected. Leaders need solid competence in nursing leadership to balance multiple demands in organizations; otherwise, their perceptiveness and the priority of "ministering to the patients" can be blurred.
探索并获得对护士领导者在护理工作中关怀经历和认知的新的概念性理解。
从护士领导者的角度来看，护理领导中的关怀是什么？关于护理领导中关怀的理论研究匮乏。选择诺布利特和哈雷斯的解释性元民族志方法是因为其在理论发展方面的解释潜力。护理领导中的关怀是领导者“领导之屋”中不同“房间”之间的一种有意识的动态过程。这一过程以一种隐喻的形式呈现，说明了护理领导中关怀的核心，并在一个初步模型中得以体现。有五个基于关系构建的房间：“患者房间”，护士领导者在这里通过临床在场来努力避免患者遭受痛苦；“员工房间”，护士领导者在这里相互信任和尊重，并促进对话；“上级房间”，护士领导者在这里确认同伴关系；“秘密房间”，在这里培养领导者坚持和坚守的力量；以及“组织房间”，在这里不断平衡有限的资源。护理领导中的关怀意味着培养和发展关系以保障最佳的护理服务。这预先假定领导者具备对不同“房间”的意识。如果对各个房间没有给予同等关注，动态过程就会停止，这象征着领导中的关怀也随之停止。不能过度关注一个房间而忽视其他房间。领导者需要具备扎实的护理领导能力，以便在组织中平衡多种需求；否则，他们的洞察力和“照顾患者”的优先级可能会变得模糊。
