Acute Pain Management Service, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
Nursing Institute, Cleveland Clinic, Cleveland, OH, USA.
J Clin Nurs. 2021 Jun;30(11-12):1573-1583. doi: 10.1111/jocn.15705. Epub 2021 Feb 25.
AIM & OBJECTIVE: Explore leadership self-perception of clinical nurses at the bedside and their perception of leadership on patient care and outcomes.
According to Institute of Medicine Future of Nursing Report, nurses are called to exhibit leadership at every level. Published research on nursing leadership is primarily focused on formal leaders. Research examining leadership at the clinical nurse level has either tested application of a particular leadership model or studied nurses who have been identified as informal clinical leaders. We took an inductive approach without any prior knowledge if participating clinical nurses viewed themselves as leaders.
Descriptive qualitative method was used.
Four focus groups were conducted with a total of 20 clinical nurses from 2 hospitals within an integrated health system using a convenience sampling method until saturation was reached. The Consolidated criteria for Reporting Qualitative research (COREQ) was used to report findings.
All participants identified qualities they admired in leaders. Fifty percent did not initially view themselves as leaders until they realised that they often demonstrated those same leadership qualities in providing nursing care to patients and families. Participants struggled to make a connection between their leadership at the bedside and patient outcomes.
Clinical nurses assume a formal title is required to be a leader. Findings from this study imply that leadership attributes required at point of care are embedded in the nursing practice and look similar to servant leadership.
Leadership is in the nature of nursing practice, and more work is required to increase awareness that every nurse is a leader. Further efforts need to be pursued to help clinical nurses become self-aware they are leaders in order to impact patient outcomes and transform health care from bottom-up and inside-out.
探索临床护士对自身领导力的认知,以及他们对患者护理和结局的领导力认知。
根据美国国家医学科学院未来护理报告,护士在各个层面都需要展现领导力。已发表的护理领导力研究主要集中在正式领导者上。研究考察临床护士层面的领导力,要么测试特定领导力模型的应用,要么研究被确定为非正式临床领导者的护士。我们采用了一种归纳方法,在没有任何先验知识的情况下,研究参与的临床护士是否认为自己是领导者。
描述性定性方法。
采用便利抽样法,在 2 家综合卫生系统医院中,对 20 名临床护士进行了 4 次焦点小组访谈,直至达到饱和。采用统一报告定性研究的标准(COREQ)来报告研究结果。
所有参与者都确定了他们钦佩领导者的品质。直到他们意识到,在为患者和家属提供护理时,他们经常表现出同样的领导品质,他们中的 50%最初并没有将自己视为领导者。参与者难以将他们在床边的领导力与患者结局联系起来。
临床护士认为担任正式职务是成为领导者的必要条件。这项研究的结果表明,在护理点所需的领导属性嵌入在护理实践中,类似于服务型领导。
领导力是护理实践的本质,需要做更多的工作来提高认识,即每个护士都是领导者。需要进一步努力帮助临床护士自我意识到他们是领导者,以影响患者结局并从基层和内部推动医疗保健的变革。