The Perceptions of Professional Leadership Coaches Regarding the Roles and Challenges of Nurse Managers.

OBJECTIVE: The purpose of this study was to explore professional coaches' perceptions of nurse managers (NMs) and the NM role. BACKGROUND: Nurse Managers are often inadequately prepared, developed, and supported in their roles. Professional coaching is a strategy that may prove beneficial to help prepare NMs for their roles. METHODS: A qualitative design using researcher-participant interviews of 11 professional coaches provided data regarding coaches' perceptions of NMs and the role development needs. RESULTS: Coaches reported why they made the decision to coach NMs, why NMs sought coaching services, how the NM experience differed from that of higher level leaders, and what the coaches believed was their most valuable contribution when working with NMs. CONCLUSION: Findings suggest that coaches can provide needed support to NMs to maximize their role effectiveness and preparedness.

Using nurse managers' perceptions to guide new graduates toward positive nurse relationships.

One of the greatest challenges new graduates confront when transitioning to practice is establishing positive relationships with experienced nurses. Nursing faculty must prepare graduates for this challenge. However, nursing faculty are often removed from everyday practice and must rely on the perceptions of those entrenched in practice in order to ground teaching endeavors in authenticity. Nurse managers are well positioned to provide knowledgeable insights to nursing faculty regarding nurse relationships. The purpose of this qualitative, descriptive study was to explore nurse managers' perceptions regarding new graduates' relationships with more experienced nurses. Researcher-participant audiotaped interviews were conducted with 13 nurse managers. A content analysis revealed that all participants believed nurse relationships were significant, that factors such as perceived inequities and stressful occurrences triggered poor relationships, that new graduates were often targeted for negative relationships, and that reasons for targeting of new graduates included prolonged dependence on experienced nurses and either over or under confidence of the new graduate. Providing a supportive, protective environment and hiring practices that promote team unity were posed as strategies that could help to prevent targeting of new graduates. Findings provide real-life, practice based information that can underpin nurse educators' teaching regarding nurse relationships and relationship building.

Nurse Managers Speak Out About Disruptive Nurse-to-Nurse Relationships.

OBJECTIVE: The purpose of this study is to explore nurse managers' (NMs') perceptions regarding disruptive nurse-to-nurse relationships. BACKGROUND: Nurse managers play a pivotal role in creating and sustaining healthy practice environments. They must understand how to recognize and confront disruptive nurse relationships that can threaten the health of their units. METHODS: A qualitative study design using researcher-participant interviews of 13 NMs from 5 institutions provided data regarding NMs' views on nurse relationships. RESULTS: Nurse managers reported how they became aware of disruptive nurse relationships, their strategies for dealing with those relationships, and the impact that confronting disruptive relationships had on them personally. CONCLUSION: Findings can be helpful to NMs who are faced with addressing disruptive nurse-to-nurse relationships as they endeavor to create and sustain healthy work environments.

Nurse managers' insights regarding their role highlight the need for practice changes.

AIM: The purpose of this study was to understand the insights of nurse managers regarding the nurse manager role. BACKGROUND: Nurse managers are vital to the success of healthcare organizations. Vacancy rates of nurse manager positions are on the rise. Recruiting and retaining qualified individuals for these positions requires an understanding of the perceptions of nurse managers regarding the role and the issues embedded in the role. METHODS: A descriptive, qualitative investigation was conducted. Data were analyzed using content analysis. FINDINGS: Although desired, role orientation, mentorship, and a strong foundational knowledge, were often lacking. Personal attributes viewed as important for success in the role included seeking opportunities and intentional self-growth. Lessons learned while in the role included the art of managing role demands and that comfort comes with time. CONCLUSION: Concerns regarding the preparation for, introduction to, and support in the nurse manager role highlight the need for practice changes.

Understanding nurse-to-nurse relationships and their impact on work environments.

INTRODUCTION: Nurse-to-nurse relationships are a key component in determining the health of a work setting. Because of the impact that such relationships can have on patients, health care organizations, nurses, and the nursing profession, it is imperative to understand how nurses relate to each other. PURPOSE: The purpose of this article is to present findings from a study that explored how direct-care nurses relate to each other in everyday interactions on patient care units. METHOD: This study used a mixed method research design. Both quantitative and qualitative data were collected, but only qualitative findings are presented. Eighty-two staff registered nurses responded to a researcher-developed online questionnaire. A qualitative content analysis was conducted. Data were categorized according to questions then analyzed for key thoughts. Common themes were determined. FINDINGS: Findings revealed participants had considered leaving the profession, and had considered leaving or had left a nursing unit because of poor nurse relationships. Participants identified environmental characteristics necessary for good relations. The crucial role nurse managers play in establishing good nurse relations was highlighted. Participants cited new graduate actions that could enhance relationships with expert nurses. Participants also noted missing factors on many nursing units that are essential for good nurse-to-nurse relationships. CONCLUSION: Positive nursing relationships are the key to establishing a healthy place of work. Only when positive nurse-to-nurse relationships are established can healthy work environments be created and sustained for nurses in the future.

Implementing the new clinical nurse leader role while gleaning insights from the past.

This qualitative study explored the experiences of clinical nurse leaders (CNLs) as they implemented this new role. Twenty-four CNLs participated. Data were collected via an e-mail-distributed questionnaire. Data from open-ended questions were used to conduct a qualitative content analysis. Data were categorized according to question, key thoughts and phrases were established, and themes were determined. Findings revealed that nonsystematic role introduction was common. Two challenges to role implementation included role confusion and being overworked. The most positive aspect of the role was remaining close to the point of care. Participants noted that the overall response of the health care team to the role was positive despite participants' belief that the greatest roadblock to role success was the lack of support by nurse administrators. The support of nurse administrators and clear role expectations were viewed as essential for role sustain-ability. Understanding the experiences of CNLs as they launch this new role can provide insights for educators, administrators, CNLs, and other health care providers regarding the success and sustainability of the role. In addition, understanding the similarities between the clinical nurse specialist (CNS) role initiation in the past and the CNL role initiation today can foster the development of strategies for confronting the challenges of new role implementation.

Second degree prelicensure master's graduates: what attracts them to nursing, their views on the profession, and their contributions.

This qualitative study explored second degree prelicensure master's graduates' attraction to the nursing profession, views on nursing, and thoughts regarding their contribution to nursing. Fourteen individuals participated from a cohort of master's students enrolled in a second degree program with a Clinical Nurse Leader focus. Data were collected through researcher-participant interviews. The researchers categorized data according to interview questions using constant comparison. Within each category, central themes emerged. Findings revealed that participants were drawn to nursing because of the opportunities and the caring nature of nursing. Participants felt prepared and excited to start a second career despite having to overcome challenges. They believed that their previous education enhanced their communication abilities and broadened their views; however, they encountered difficulties integrating previously held perspectives into a nursing worldview. They found poor nurse-to-nurse relationships among some experienced nurses and the difficulty of nursing education surprising. The opportunity to help others and the people for whom they provided care were the two features the participants most liked about nursing. Understanding such insights is important to continue to attract individuals from other careers to nursing. Findings highlight the important contributions that these individuals bring to the profession.

Second-degree prelicensure master's graduates and their transition to practice.

OBJECTIVE: The purpose of this study was to gain an understanding of the transition-to-practice experience of second-degree prelicensure master's graduates. BACKGROUND: Second-degree graduates are increasingly joining the nursing workforce. Scant empirical literature exists regarding this group. METHODS: Using a qualitative design, second-degree prelicensure master's graduates were interviewed 3 times through a 10-month period regarding their transition to practice. RESULTS: Participants chose nursing positions based on their perceived ability to grow. Two strengths of the participants included their ability to think critically and to establish relationships. Participants expressed typical novice nurse concerns. Residency and intern programs enhanced their transition to practice. Participants perceived their interactions with the health team as positive, and graduates urged administrators to use their knowledge gained from previous degrees. CONCLUSIONS: Findings enhance understanding of how second-degree prelicensure master's graduates transition to practice. Understanding their transition is imperative if these graduates are to be recruited and used at their fullest potential. Such insights can also help nurse administrators better support these new hires during the transition process.

Driving strategies used by older adults with macular degeneration: assessing the risks.

Older adults with macular degeneration use multiple driving strategies. A secondary analysis focused on driving strategies was conducted on data from two studies that had explored the experience of visual impairment in older adults diagnosed with macular degeneration. Findings revealed 24 driving strategies. Twelve categories emerged, reflecting two themes: (1) strategies used while performing the task of driving and (2) strategies used to continue driving. By understanding these strategies, nurses can assess the conditions under which these older adults drive and the risks taken. Findings guide nurses to counsel and educate older adults regarding driving.

The ethics of using cybernetics and cyborg technologies: what every rehabilitation nurse should know.

Cybernetics and cyborg technologies are rapidly developing in the field of biotechnology. Such developments have yielded a wide variety of devices and prosthetics that have promoted the quality of life for many individuals with physical limitations and generally have been applauded by society and the rehabilitation field. However, such rapid developments have given rise to multiple ethical concerns. Understanding these ethical concerns and the implications they have for rehabilitation nurses is imperative. While the potential benefits of advances in technology are great for those with disabilities and chronic conditions, ethicists suggest that skepticism must be balanced with the zeal that often accompanies cutting-edge developments. As Hook notes, "We must show not a fear of technology, but a courageous control of technology, and refuse to let technology control us" (2002, p. 67).

Older men's experiences of living with severe visual impairment.

BACKGROUND: Little is known about how men react to their health and illness experiences. Lack of information about the lives of older men is unfortunate considering the anticipated growth of the older male sector of society and the fact that older men age differently than older women. One health-related experience common to many older men is severe visual impairment caused by macular degeneration, a chronic eye disease that affects central vision. Understanding the health experiences of older men is imperative if nurses are to provide quality care to this growing segment of society. AIM: The purpose of this study was to gain an understanding of the experience of severe visual impairment from the perspective of older men with macular degeneration. METHOD: A phenomenological approach was used to investigate the experience of severe visual impairment in eight older men with macular degeneration. Data were gathered through audiotaped interviews and analysed using a modified Giorgi method. FINDINGS: The resultant general structural description revealed six central themes: (1) older men's lives were circumscribed by what they could and could not see and could and could not do, (2) cherishing of independence, (3) creation of strategies, (4) acknowledgment of the progression of visual impairment, (5) confrontation of uncertainties, skepticism, and fears about their diagnosis and treatment, and (6) persistence with hope and optimism. CONCLUSIONS: A thorough nursing history and assessment must be completed, including information about the progression of the visual impairment, strategies used for living with visual loss, and presence of other health problems that may complicate life with visual impairment. Nurses must be aware that older men with macular degeneration are often sceptical about their diagnosis and treatment. Therefore, careful education and clear communication are essential.

Conducting research with visually impaired older adults.

Due to the frequency of eye disorders among older adults, qualitative researchers who involve older individuals in their work must be sensitive to the multiple ways in which visual deficits can influence the research process. The author addresses some of the difficulties encountered, insights gained, and strategies developed while conducting a phenomenological study in which all the participants were severely visually impaired. The author's insights, drawn from personal experiences, reflections, and log entries kept throughout the study, are shared to help other researchers design and implement studies in which the voices of individuals with severe visual impairments can be skillfully tapped.

Perspectives of caregivers of stroke survivors: implications for nursing.

The majority of stroke survivors receive home care. To offer better support, home caregivers and nurses must understand the caregiving experience. This knowledge will enable nurses to help home care givers provide more effective care and conserve their own resources.