The study involved a mixed method approach, starting with a quantitative data collection and concluding with a qualitative data collection. Quantitative approach was employed to study the impact of leadership development package on the leadership competencies of undergraduate nursing students and head nurses and to find the organizational climate prevalent in the institution towards leadership and leadership development as expressed by the subjects. Qualitative approach was employed to find the satisfaction of subjects with the leadership development package and to find the commitment and readiness of key management personnel in implementing LDP in their institution. A descriptive design was selected to assess the organizational climate prevalent in the institution towards leadership and leadership development and also to describe the qualitative data which was collected to find the satisfaction of participants with the LDP and the commitment and readiness of key management personnel to adopt LDP. Tools used to collect the data were the organizational climate rating scale, the focus group discussion format with leading question to find the satisfaction of participants with the LDP and organizational commitment and readiness interview schedule prepared by the researcher. Validity and reliability of the tools were established before the commencement of the data collection process.
Results: Following intervention, the communication skills scores achieved by interven- tion group were 127.5 ± 7.10 at pretest and increased to 134.11 ± 7.32 after the intervention (P < 0.01). The mean score of the communication skills did not alter significantly in the control group. Moreover, no significant change was observed in the mean scores of job satisfaction of head nurses in the intervention group compared to those of the control group (P = 0.102).
Abstract: Head nurses` who apply transformational leadership find innovative approaches that enhance staff nurses` performance at their highest level to achieve a vision of quality health care. Also, transformational leader has a major impact on the staff nurses' behavior to achieve health care organization goals as, this leader setting new direction, inspiration, and behaviors for their health care organization. Aim: to assess the transformational leadership educational program for head nurses and its effect on nurses' job performance. Research design: A quasi experimental design. Setting: The study was conducted in all units at Benha University Hospital. Sample: all the available head nurses and their assistants (103) and the convenient staff nurses (138) from the above mentioned setting. Tools: Three tools were used: (1) transformational leadership knowledge questionnaire, (2) the multifactor leadership questionnaire Form 5X Short (MLQ leader form), and (3) nurses’ job performance evaluation (Observation Checklist). Results and Conclusion: showed that there was highly statistically significant improvement in head nurses` knowledge scores and skills regarding transformational leadership immediate post program and three months follow up the program than pre program scores. Also, there was highly statistically significant improvement in scores of job performance elements among staff nurses immediate post program and three months follow up the program than pre program scores as observed by the researcher. Recommendations: Conduct continuous in-service training and education programs for refreshing and increasing head nurses’ knowledge and skills about the transformational leadership style.
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Different Studies assessed that the private sectors is typically more proficient, responsible, or therapeutically successful than the public sector; anyhow health care professionals in general sector shows lack suitability and kindness for patients (Basu, Andrews, Kishore, Panjabi, & Stuckler, 2012). A study was conducted in South Africa, among 175 head nurses about the 51 management competencies proficiency in Public and Private Hospitals. The head nurses from public hospitals founded competent and proficient in controlling, planning and self-management as compare of legal and ethical competencies. Whereas the head nurses in the private hospitals feels competent and proficient in self-management, planning, leading and less competent in the skills of health care and ethical/legal competencies. The head nurses in private hospitals are more competent then head nurses of public hospitals (Pillay, 2008). In the UK, the core competency framework designed by the Royal Academy of Nursing which contains of 6 dimensions. The 6 areas are leadership, mutual respect, caring for colleagues and patients, team work, professional development and change each aspect is divided into different levels, each level is composed of behavioral indicators (Sullivan & Schoelles, 2013).There were only two medical colleges and mostly nurses migrated toward India. Only 350 nurses left including retired and in service. First nursing school was established in 1948 at Sir Gahgaram Hospital Lahore. In 1973 PNC (Pakistan Nursing Council) established that deals all nursing dealing, rules, regulation at
significantly (p < 0.05) higher job satisfaction. The operating conditions were related negatively to the style of leadership. Pay, fringe benefits and nature of work were not related to the style of leadership. The nurses were moderately satisfied with their work and 23% of the variation in nurses' job satisfaction could be explained by the head nurses 6 leadership facets with positive effect of professional support, intellectual motivation, and management by correction and their laissez faire style. The study emphasized the importance of TF style of head nurses for increasing staff nurses' job provided more support and training for effective management of CCU. Saleh U, O'Connor T. et al (2018): In study “The impact of nurse managers' leadership styles on ward staff”, explored the nature of leadership styles used by the nursing management team, as perceived by nurses working at the bedside. The findings showed that the leadership style employed by nurse managers has a major impact on nurses' job satisfaction, turnover, and the quality of patient care they deliver. 30
Considering the significant relationship between head nurses’ awareness of their management principles and their employment status in this study, it may be due to the fact that the type of employment status (impermanent, contract, and permanent) plays a significant role in this regard. Dependency and affiliation to the relevant organization cause the staff to seek to increase their awareness of managerial tasks, Undoubtedly nursing managers also no Exceptional From this rule. On the other hand, considering the competencies and merits of nursing managers in order to improve the level of employment and pay attention to this issue will make Updating the managerial scientific and practical information of the respective managers, as well as improving the quality of nursing care and ultimately the satisfaction of healthcare clients. The results of the study indicate that most head nurses have completed managerial workshops and obtained their information on the principles of management through in-service education. But the results of the study show that head nurses did not participate did not participate in management training courses .
vital place in the field of management. The key to concise conceptualization of effective leadership remains elusive. Yet, the effectiveness of leadership lies in the manners with which leaders see and act on their own and their followers' values and motivation. Also, the genius of leadership refers to the extant by which a person believes that his or her actions can influence out Another factor equally important is the concept of locus of control. Aim, the study aimed to eadership style and their locus of control. Research design, Descriptive (two test survey designs in the Main Tanta University Hospital was used to f the leaders). Tool. Two tools were used. The leadership style questionnaire and the Rotters locus of control scale were administered. Result .The results showed that an moderate internal locus of control were associated with democratic direction style. It also showed that an external locus of faire leadership style. Recommendation, it was recommended that the head nurses must be knowledgeable about different types of leadership styles and the levels of locus of control. Development of highly effective leader through leadership training
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studies have been conducted on the role of head nurses in motivating ICU personnel and on the mental stresses resulting from working in this particular unit, there is no qualitative studies which investigated head nurses’ particular experiences of the meaning of an ICU through a descriptive or exploratory approach. The question therefore arose as to how a person in charge of both coordinating and supervising special nursing care and motivating the personnel to provide the optimum care describes the ICU. The descriptive phenomenological method enables the researcher to discover individuals’ experiences of daily life and answer the question. 10 From a knowledge development
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Because administrative workers do not staﬀ indi- vidual departments, department and head nurses must complete all health insurance documenta- tion. In study Markova and Eislerova (2001) found that department nurses spend most of the time (207 minu tes) of devoted to nursing care and educa- ting patients and their families. The organization of health care takes nearly 2 hours per day. One hour department nurse devotes to the ward sister to en- sure material supply and equipment machines. Hotel services take more than half an hour. Com- municating and information of the staﬀ takes 26.5 minutes per day. Education takes 11.25 minutes. Management of staﬀ occupies almost the smallest part of the time (7.00 minutes).
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The range of higher education achieved does not diﬀ er greatly in the hospitals analysed. High school edu ca tion predominated (in average around 80 %) in the case of nurses, department nurses and head nurses as well. The ratio of nurses with university degree is according this research very small and it will be very insuﬃ cient in future, because requirements for these management positions are increasing. The length of practice of the target nursing group is much better. More then 70 % nurses have work- ing practice in health care of more then 5 years. Working relationships in hospital have an informal character agree both nurses and head and department nurses in all hospitals. Nurses in management positions added that in 81.1 % cases (103 nurses) prefer informal relations during communication with their subordinates. In communication between department nurses with head nurses the situation was very similar but 36.1 % (41 department nurses) prefer a formal style of communication. The ma- na ge rial style of department nurses is, according to the opinion of nurses in 67.7 % cases (595 nurses) democratic. On this statement agree head and department nurses who said that they use a predomi- nately democratic managerial style (87.2 %, 109 head and department nurses). Nurses and department nurses are satisﬁ ed with the management skills of their superiors. Department and head nurses in selfevaluation questionnaire said that are in the most cases satisﬁ ed with own level of management skills (totally 73.4 % department and head nurses).
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The main researcher conducted 12 sessions of participant observation in all four hospitals. Observations were con- ducted during the different shifts in emergency, medical, surgical and intensive care units and involved not only the nurses interviewed but also the other nurses present in the shift. Observations were carried out on the days appointed for interviewing the participants. The researcher was present in the ward with permission of the head nurse from the beginning of the duty hours, so that in two to three hours time before starting the interview the researcher could observe the dealings and behaviors. Observation involved sitting in a corner of the ward and observing, or following individual nurses around. The researcher was asked by the head nurses not to care for- mally for patients, although at times assistance was given to the nurses at their request. The focus of participant observation was on nurses' interactions and dealings with their patients, colleagues, head nurses, supervisors and doctors, with particular emphasis on nurses' participation in decisions related to patient care and care setting. The researcher took notes during observations, with detailed observations written up the same day. These detailed notes were used as data concurrently with the interviews. Data analysis
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Because the Hudson Valley region in- cludes a single tertiary care children’s hospital, most infants with suspected abusive head injuries resulting from shaking are taken or transferred to that hospital for evaluation and treat- ment. It follows that an increase or de- crease in the frequency of such inju- ries observed at Maria Fareri Children’s Hospital would reﬂect a cor- responding increase or decrease in the region overall. Therefore, this fre- quency served as the primary outcome measure, the key indicator of the pro- gram’s success. Additional outcome measures included the proportion of parents who received the educational materials in the hospital (program ex- posure) and the proportion of parents who, 6 months later, recalled learning about shaking injuries and indicated that the information had been helpful (perceived beneﬁt).
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While bringing the potential to expand nurse produc- tion, the involvement of private education institutions may also bring serious risks. In the Philippines, produ- cing an excess of nurses specifically for export has resul- ted in financial benefits, however, it has also resulted in a worsening skill mix in hospitals within the country . A significant number of experienced nurses have left to work overseas, sometimes resulting in ward or hospital closures. Before migrating to work internationally, nur- ses in the Philippines need to gain work experience. This shortage of senior nurses to supervise new graduates re- sults in a high number of newly registered nurses experi- encing bottlenecks; they are unable to gain experience to meet the requirements for overseas work and under- qualified to fill domestic vacancies .
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This theory is supportive of indigenous nurses, for Maori nurses there is a recognition of the importance of being Maori within the workplace inclusive of cultural awareness and identity, the support of and access to Maori networks inclusive of matauranga Maori for the benefit of tangata whaiora and the adoption of Maori models of health (Simon, 2006). Also, Native American nurses overtly immerse their cultural world into nursing practice (Lowe & Struthers, 2001; Struthers et al., 2005; Sherwood & Edwards, 2006).Their nursing concepts invoke a holistic approach to health incorporating the spirit, the emotion, the physical and the family. The use of traditional knowledge entails the acknowledgement of relationship, respect, wisdom and values. As well as connection, viewed as the characteristic that assists to honour people in the past and of the present through sharing and anticipating, by building, taking risks, creating togetherness, cohesiveness, unfolding, interrelating with all, healing, interweaving and transforming. Other integral dimensions of care respect and trust complete seven dimensions of one Native American nursing model (Lowe & Struthers, 2001).
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Nurse staffing is based on the workload because if there is a high workload, then the nurses need help in caring adequately for their patients. The workload depends on various factors, as mentioned in section 6.2. In order to examine how these factors influence the workload a regression model was attempted. Before such a model can be built, however, the assumptions mentioned in section 6.2.1 need to be controlled for violation. Neither the scatter plot nor the residual plots showed linearity, and therefore the multiple linear regression model could not be built. The variables were transformed with the logarithm, square roots and reciprocal transformation. The values of the variables were widespread and so it was difficult to find a relationship between the variables and the workload. Therefore the values of the variables were converted, as described in Section 6.2, Table 27. After converting the variables it was found that the multiple linear regression model could not be built, and for the same reason as with the previous model: the transformation of the variables resulted in a violation of the assumptions. Despite the violations of the two regression models, they were run in order to check the fit of the model and the independent variables that predict the workload. Table 35 presents the results for both regression models with and without transformed variables. All the models have little or no fitness with the model (R square from 0 to 0.237). It is remarkable that in most models only the average intensity of care points are equal to the variable for the predicted workload.
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positive attitudes in comparison to their mental health trained colleagues within the same age ranges; although this study did not identify any statistically significant association between ages of ED nurses and attitudes towards suicidal behaviour. More recently, McCarthy & Gibels (2010) focussed on specific age ranges and found that based on overall scores using the Attitudes Towards Deliberate Self Harm Questionnaire, ED nurses aged 41-50 years had more positive attitudes towards patients who self harm than those in younger age groups. The authors also noted that ED nurses between the ages of 31-40 years had more positive attitudes due to the belief that they could in fact work effectively with this patient group. Conlon et al. (2010), using the Self Harm Antipathy Scale to study 87 randomly selected ED nurses’ attitudes from four hospital sites towards patients who self harm, found that those aged 41-60 years demonstrated overall scores indicating more positive attitudes than those aged <40 years old.
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Perception is a process by which individuals organize and interpret their sensory impressions in order to give meaning to their environment. A motivated person is ready to act. How the motivated person actually acts is influenced by his or her perception of the situation. Perception depends not only upon the physical stimuli, but also on the stimuli’s relation to the surroundings field and on the condition within the individual. People’s behavior is based on their perception of what reality is, not on reality itself. Perception is understood as the act of seeing what is there to be seen which is influenced by the individual, the object and the situation. Perception is the process by which an individual selects, organizes, and interprets the information inputs to create a meaningful picture of the world. In simple terms, perception is why the same universe is viewed differently by different people. The perception is measured by instruments considering role efficacy. Researches show that persons with high role efficacy seem to experience less role stress, anxiety and work related tension The present study was undertaken with an aim of understanding and comparing the role efficacy of nurses at various levels in a famous hospital in Ludhiana, Punjab (India). All the 120 nurses and 35 head nurses in this hospital were studied for the role efficacy they experience. The outcome of this process is discussed in this paper.
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Studies of job satisfaction within the health care industry have focused more on job characteristics of nurses and less on their personal characteristics. Stress, low pay, inadequate staffing, unreasonable workload, lack of autonomy, poor support from supervisors, and strained relations with coworkers are some of the factors often cited as causes of job dissatisfaction among RNs (Fletcher, 2001; Sochalski, 2001; Ingersoll, Olsan, Drew-Cates, DeVinney, & Davis, 2002; Aiken et al., 2001; Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Needleman, Buerhaus, Mattke, Stewart, & Zelevinsky, 2002; Rogers et al., 2004; Steinbrook, 2002). Aiken et al. (2001) found that U.S. nurses reported the highest levels of dissatisfaction (41%), whereas job dissatisfaction among nurses in Scotland, England, Canada, and Germany were 38%, 36%, 33%, and 17% respectively. Surprisingly, however, and for all the countries in the study, a greater proportion of the nurses who planned to quit within one year of the survey were under 30 years of age. Given the ageing workforce, this result has implications for health care administrators: (1) that improving job characteristics can no longer be ignored, and (2) that meaningful efforts should be placed on retention of satisfied older and more experienced RNs to serve as mentors to younger RNs.
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Protesting for incremental salary increases in Pakistan is not a new phenomenon (Pakistan-Today, May 11, 2011). Yet, despite such campaigns there has been little effort to listen to, or address, grievances and only symptomatic measures are offered. Nurses working in Pakistan have been found to suffer from mild to moderate anxiety and depression (Khan et al., 2012), and studies have shown low levels of job satisfaction (Khowaja et al., 2005). Bahalkani et al. (2011) conducted a study at one tertiary care hospital in Islamabad and found 86% of Pakistani nurses were not satisfied, and 26% were highly dissatisfied, with their working lives. Among contributing factors for these figures were poor working environments, low salaries, lack of training opportunities, improper supervision, time pressures, and few financial rewards (Bahalkani et al., 2011). Similarly, Khowaja et al. (2005), noted that Pakistani nurses exhibited stress associated with taxing workloads and biased management, lack of appreciation or financial incentives, and authoritarian styles of leadership.
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In some studies elsewhere, nurses’ knowledge about the risk factors of breast cancer has been found to be low [14, 16, 20] whilst other studies have reported nurses’ knowledge about risk factors of breast cancer to be high . The fact that there are many risk factors of breast cancer  and new factors have been found to be associated with breast cancer might have affected the knowledge of the nurses. The unit they work may influ- ence their knowledge. In the present study, nurses who worked at Orotta Maternity Hospital had the highest knowledge about the risk factors of breast cancer while nurses who were working at Orotta surgical ward had the lowest knowledge. Therefore, efforts need to be taken to increase the knowledge of nurses about the risk factors of breast cancer. Short on-site courses prioritiz- ing those nurses who work outside maternity units/ wards and nurses with associate level could help to up- date their knowledge.