R. A. FEAT HER, P. R. EBRIGHT
manager’s role in solving work issues when they occurred dur-
ing a shift. And yet the nurses seemed to want more connec-
tion and communication with the manager. These findings are
consistent with a study by Sellgren et al. (2006), who found
that, when both subordinates and managers were provided the
same survey on leadership behaviors, thesubordinates preferr-
ed different leadership behaviors from those that managers
thought were appropriate. In another study by Gormley (2011)
significant differences were indicated between nurses and the
nurse manager’s perceptions of the work environment. Man-
agers rated the environment higher than the staff on all sub-
scales. Both of these studies also revealed a disconnection be-
tween the perceptions of the nurses and the beliefs of the nurse
managers.
A study by Schmalenberg and Kramer (2009) found that if
the nurse manager is involved in roles or behaviors that are not
perceived by the nurses as part of their job, then the nurse
manager is seen as being non-supportive. In a study by Shirey,
Ebright and McDaniel (2008) where nurse managers were in-
terviewed about their roles on the unit, they stated the need to
spend an adequate amount of time on the unit in order to be
aware of and prevent issues from growing into bigger problems.
However, unrealistic expectations of their roles by administra-
tion (being in meetings, putting out fires, taking on additional
responsibilities) may keep them from being present on the unit
as much as they would like to be (Shirey, Ebright, & McDaniel,
2008).
Given the findings of this study, and potential for similar si-
tuations in other complex healthcare settings reflected in re-
cent literature on the nurse manager role, stress and work (Shi-
rey, Ebright, & McDaniel, 2013), staff nurse perceptions of the
manager role have important implications for nursing education
and service settings. First, staff nurses may not understand the
role of the nurse manager and therefore may have unrealistic
expectations of their nurse manager. Second, how do we enable
nursing management to carry out both the task and leadership
functions described by Hersey and Blanchard (1977) that may
assist them in fulfilling the perceived expectations of the RN
staff? Because supportive roles and behaviors of nurse manag-
ers may vary, or be non-existent, among hospitals and patient
care units, an extrinsic list of supportive behaviors must be built
and validated for comprehensiveness and to diminish the lack
of understanding of the nurse manager role by staff nurses
(Schmalenberg & Kramer, 2009).
In a study by Shirey, Ebright and McDaniel (2008) managers
expressed that younger nurses often did not find the role of the
nurse manager to be desirable, and that they often asked man-
agers “what do you do” and “is it worth it” (p. 128). Managers
expressed in the same study that a lack of clarity of their roles
creates ambiguity with their position as different people expect
different things from the nurse manager (Shirey, Ebright, &
McDaniel, 2008), thus possibly leading to the disconnect that
occurs between RN perceptions of the role and the actual role
expectations of the nurse manager by hospital administration.
The participants in our study indeed did not seem to have an
understanding of the roles of management, indicating a need for
a dialogue between the nurse manager and the nursing staff to
occur so that perceptions and expectations of RNs can be clari-
fied to improve the effective performance of the nurse ma-
nager (Schmalenberg & Kramer, 2009; Utriainen & Kyngas,
2009).
Very few of the RNs mentioned the manager as their go to
person to assist them in solving problems related to staffing,
patient care, or negative physician relationships. Findings re-
flected staff perceptions of managers as out of sight, out of
mind and not being there to provide support for patient care or
to meet the individual needs of the staff.
The most important implication from these study findings is
related to the ability and capacity for nurses in the nurse man-
ager role to carry out functions that capture both leadership di-
mensions (task and relationships) described by Hersey and
Blanchard (1977). The manager who is office bound and has
rigid rules with authoritative styles of communication under-
mines the morale of the staff by increasing feelings of power-
lessness, emotional exhaustion and decreased levels of job sat-
isfaction (Stuenkel, Nguyen, & Cohen, 2007). Are nurse man-
agers working in our current healthcare settings, with their con-
stant change and complexity, realistically able to attend to the
dimension of the role that includes being employee oriented
with a focus on relationships, building teamwork, and employee
identification with the organization?
There is a need for nurse managers to discuss the roles and
expectations or perceptions of the RNs with administration as
they also affect the support a nurse manager can provide to the
nursing staff (Schmalenberg & Kramer, 2009). Nurse managers
describe their jobs being stressful due to the perceived demands
of their roles by staff and administration, and not having the
time or resources to meet those demands (Shirey, Ebright, &
McDaniel, 2008). Organizations that require participation by
nurse managers in meetings and other time spent away from the
direct care areas decrease availability of the manager. Lack of
presence on the unit affects the ability of the nurse manager to
build relationships, assess teamwork and resulting patient care
outcomes, and also engage staff in problem solving about care
issues, organizational decisions, and new initiatives that affect
them. Management must be allowed to delegate tasks to others
so that leadership behaviors as perceived by RNs as important
to them can be maintained by the nurse manager (Schmalen-
berg & Kramer, 2009).
Conclusion
The purpose of this study was to identify RN perceptions of
their nurse manager behaviors that influenced the RNs’ job
satisfaction. In addition to learning about the RNs expectations
of their nurse manager, the study also revealed a disconnection
between what the RNs perceived the managers doing in their
role and how it related to their daily work. This disconnect may
demonstrate a lack of understanding of the manager’s role by
staff RNs, as well as reflect the difficulty for managers in ful-
filling both dimensions of the leadership role (task and relation-
ships with staff) due to the complexity and demands required in
healthcare environments. Because the nurses believed increased
visibility should be an expectation of the nurse manager, the
level of job satisfaction for the RNs may decrease, especially
during busy times if the nurse manager is not there to assist
with issues and problem solving on the unit. This study pro-
vided findings important to staff nurses, nurse managers and
administration. There is a need for administrator support for
nurse manager’s ability to spend more time on the unit with
RNs to attend to direct care provider relationships and team
building through communication with staff is a recommended
approach for decreasing the disconnection between RNs and
nurse managers.
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