Profile of an excellent nurse manager: identifying and developing health care team leaders.

The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.

The notion of time in symptom experiences.

BACKGROUND: The experience of unpleasant sensations associated with the presence of symptoms prompts self-care or help seeking to obtain explanations for the symptoms, manage emotional responses, or obtain treatment for symptom alleviation and elimination. OBJECTIVE: The purpose of this article is to summarize and comment on three existing symptom theories, with special attention to temporal factors. METHODS: Existing theories are synthesized as the time dimensions of symptom experiences and symptom management processes are elucidated. Clinical examples and findings from empirical studies illustrate critical points. DISCUSSION: Existing theories describing the symptom experience and the process of symptom management refer implicitly to the role of time or use limited dimensions of time. Symptom experiences in time (SET) theory is proposed as a synthesis and extension of existing theories. The SET theory conceives the symptom experience as a flow process that explicitly incorporates temporal dimensions. Four dimensions of time are recognized: clock-calendar, biologic-social, perceived, and transcendent time. The four temporal dimensions are placed against a backdrop of "meaning-in-time" that brings forth the potential for transformation in a symptom experience. Increasing sophistication in design, measurement, and data analysis is required to test and evaluate SET theory-based propositions. CONCLUSIONS: The SET theory extends previous work by incorporating multiple temporal dimensions that reflect the human experience of health and illness manifested in the expression and management of symptoms.