|TITLE||Profile of an Excellent Nurse Manager: Identifying and Developing Care Team Leaders|
|RESEARCHER||Kathryn D. Kallas
Nurse Administration Quarterly (2014)
Vol. 38, No.3, pp. 261-268
Also available as an unpublished doctoral dissertation
University of Minnesota: 2012
The purpose of this research was to identify the profile of an excellent nurse manager, one who can lead effective health care teams.
Thirty-six chief nurse executives, representing 40 Magnet hospitals, agreed to participate, along with 25 CNEs/on-site coordinators who recruited nurse managers representing 29 hospitals in 18 states. Group 1 was those nurse managers confidentially assessed and ranked as excellent by the CNE. In Group 2 were nurse managers with scores for the subscales Nurse Manager Ability, Leadership, and Support of Nurses (NDNQI-RN survey with Practice Environment Scale) or Supportive Nursing Management (NDNQI-RN survey with Job Satisfaction Scales) at or above the 75th percentile of the NDNQI database were identified as “excellent.” Those with scores between the 50th and 74th percentiles were ranked as “competent,” with the rest “in development.” Group 3 were nurse managers ranked as “excellent” by the CNE and with scores at or above the 75th percentile of the NDNQI-RN survey comprised group 3. Nurse managers were identified as “competent,” or “in development,” using the same criteria described in Group 2. This national, multisite sample of nurse managers included participants who were predominantly female, aged 50 years and older, and very experienced (in years) as an RN. They had been working several years within their current organization and in their current nurse manager role, were highly educated, and continued to pursue additional growth and development through formalized education programs.
Model the Way, Inspire a Shared Vision, Challenge the Process, and Enable Others to Act had significantly higher mean scores for excellent nurse managers compared with competent nurse managers as assessed by the CNE (Group 1). Across all nurse manager ratings, Enable had the greatest mean score, followed by Model, Encourage, Challenge, and Inspire. In Group 3, all five leadership practices were engaged in more frequently by excellent nurse managers compared with competent nurse managers and all but Inspire reached statistically significant levels of difference. Across all nurse manager ratings, Enable had the greatest mean scores followed by Model, Encourage, Challenge, and Inspire.
For Group 2, no statistically significant differences were found between the three groups. This finding might best be explained, according to the author: “By staff judging their nurse manager on criteria less aligned with leadership characteristics than with characteristics aligned with those of the staff themselves. On the basis of the findings in this group, team assessment alone is inadequate to distinguish excellent nurse managers” (p. 267).
The author concludes:
This study indicates that the use of the LPI Self to assess for the Five Practices of Exemplary Leadership is helpful in identifying excellent nurse managers based on the assessment of the CNE (group 1) and both the CNE and the team of RN staff (group 3). It is recommended that the LPI-Self be used, with permission, to identify, recruit, select, hire, develop, and retain nurse managers. The LPI-Self is effective and relatively easy to use.
The LPI-Self can be used to identify an individual’s scores on the Five Practices of Exemplary Leadership and then target for development of the gaps that exist in the various practices to reach the high range for each of the practices. A recommendation is made to use the LPI-Self with RN staff and assess where there is interest/aspiration to be a nurse manager, identify the gaps that exist within the practices to the profile of an excellent nurse manager, and develop and encourage earlier transitioning of RN staff into the nurse manager role. Additional longitudinal research should then be conducted to evaluate the effectiveness of this strategy. Curriculum could be developed and used to prepare the RN staff regarding the Five Practices of Exemplary Leadership. Identifying RN staff with leadership aptitude earlier and providing the support and development for these individuals early in their careers based on the Five Practices of Exemplary Leadership would address the need for excellent nurse managers to lead health care teams. There is also the strategy to have all nurse managers within a hospital complete the LPI-Self and then complete the same process for identifying alignment and/or gaps with the profile of an excellent nurse manager. On the basis of the gaps identified, a development plan could be created and educational opportunities/mentors/coaches provided to narrow the gaps and achieve the profile of an excellent nurse manager either for an individual nurse manager or the majority of the nurse manager team. Periodic retesting might be used to assess progress and/or transition nurse managers who simply are not suited to the role in a more timely and objective fashion. On the basis of the literature supporting the value of transformational leadership in health care and the validity of the LPI-Self to identify transformational leaders with exemplary leadership practices, this approach is expected to result in greater satisfaction and retention of the nurse managers and, ultimately, improve the following: (1) staff recruitment, satisfaction, and retention; (2) patient satisfaction, adverse health events, and complications; and (3) organizational performance (p. 267).