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Aim: To identify competencies important for effective nursing management and to assess managers' proficiency therein., Background: A lack of management capacity has been identified as the key stumbling block to health delivery in South Africa. Despite nursing managers being central to overcoming the challenges facing health care, there has been a paucity of research that empirically evaluates their skill levels., Methods: A survey was conducted among 171 senior nursing managers in South Africa using a self-administered questionnaire., Results: Public sector managers assessed themselves as being relatively less competent than private sector managers. The largest skill gaps for public sector managers were for 'ethico-legal', 'task-related' and 'controlling' skills whereas those for private sector managers were for 'ethico-legal', 'health-related ' and 'task-related' skills., Conclusions: This research confirmed the lack of management capacity within the health sector and identified areas in which the skills deficit was most significant for both the public and private sectors., Implications for Nursing Management: These findings reflect the needs of nursing managers and will be useful in the conceptualization, design and delivery of health management programmes aimed at enhancing management and leadership capacity in the health sector in South Africa.

Aims This paper describes the perceptions of nurse managers about their dual role in nursing units as cost centres. Background The tertiary hospital in the Limpopo province is the first institution to appoint nurse managers with a dual role in cost centres. The development of a conceptual framework for a context-specific programme for Cost Centre Managers is the first of its nature in South Africa. Method A qualitative, exploratory, descriptive design was followed. The target population included nurse managers ( n = 35) formally appointed as cost centre managers with a dual role of delivering quality care and cost management. A focus group and individual interviews were conducted until data saturation occurred. Results Personal and professional distress, an empowering potential of being a cost centre manager, and the need for decentralized cost centre management were indicated as barriers for nurse managers that led to a framework for a context-specific training programme. Conclusion There is a need for a context-specific training programme for cost centre managers in a hospital with cost centres. Implications for nursing management The training of cost centre managers for their dual role in cost centres could enhance cost effectiveness, quality care and staff satisfaction. [ABSTRACT FROM AUTHOR]

Aims This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. Background The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. Method A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. Results The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Conclusion Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Implications for nurse managers Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. [ABSTRACT FROM AUTHOR]

tebid r., du plessis d., beukes s., van niekerk v. & jooste k. (2011) Journal of Nursing Management 19, 967-975 Implications for nurse managers arising from immigrant women's experience of midwifery care in a hospital Aim This paper focuses on implications for nurse managers to support midwives in delivering nursing care to immigrant mothers in some government hospitals in Gauteng, South Africa. Background Immigration and poverty in Africa has led to midwives providing nursing care to immigrant mothers in a culturally sensitive environment. This necessitates an environment in which nurse managers should support midwives in caring for these mothers as unique individuals. Method An exploratory, descriptive phenomenological design was followed. The target population included nine immigrant mothers living in the inner centre of Johannesburg who, for the first time, attended, had antenatal clinics, laboured and gave birth at a Government Hospital in the Gauteng province of South Africa. After purposive sampling, phenomenological interviews were conducted until data saturation occurred. Results The findings indicate that nurse managers should ensure that midwifery care of immigrant mothers comply with the ethical-legal context of the South African constitution. Actions should be taken in combating issues related to impaired maternal-midwife relationship, lack of cultural sensitivity and psychological distress. Conclusion The delivery of maternity care to immigrant mothers is below the standard expected in the South African context. Implications for nursing management The nurse manager should support midwives to ensure an environment to care for immigrant mothers in maternity wards. [ABSTRACT FROM AUTHOR]

Studying the sustainable employability of emergency nurses is important, given the precarious environment in which they work. This study used a cross-sectional survey of 204 emergency nursing professionals to investigate their sustainable employability in a South African context from the perspectives of precarious work, mental toughness, capabilities, and mental health. The Precarity Position Profile, Mental Toughness Questionnaire-Short Form, Capability Set for Work Questionnaire, and Flourishing-at-Work Scale-Short Form were administered. Three precarious work dimensions negatively predicted emergency nurses' capabilities. Significantly, precarious work conditions and professional development were associated with most work capabilities. Emergency nurses' capability set positively affected their mental health, with mental toughness moderating the effect of poor salary (a component of precarious work) on capabilities. Precariousness regarding salary, work conditions, and professional development affected emergency nurses' mental health indirectly and negatively through a poor capability set, while mental toughness indirectly and positively affected their mental health through a strong capability set. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore and describe the psychosocial support for frontline nurses during the COVID‐19 pandemic in the Tshwane district, Gauteng Province, South Africa. Background: The COVID‐19 pandemic has brought a lot of psychosocial distress for frontline nurses taking care of COVID‐19 patients. The frontline nurses were scared of being infected with COVID‐19, or exposing their families and loved ones to the risk of infection. A high number of nurses were infected with COVID‐19, and some died due to the virus. Evaluation: This study followed a qualitative, explorative, and descriptive research design. Data were collected using semi‐structured interviews and individual interviews were conducted. Seventeen participants, who consisted of all categories of nurses taking care of COVID‐19 patients, were interviewed until data saturation was reached. Non‐probability sampling method was used as a technique to select the participants. Data were analysed using Tesch's method of open coding. Key issues: The following five themes are identified: (1) acknowledgement, appreciation, and recognition of frontline nurses, (2) conducive managerial practices, (3) debriefing and training of frontline nurses, (4) human resources support, and (5) psychological and social support for frontline nurses and their families. Conclusion: The implementation of the psychosocial support for frontline nurses taking care of COVID‐19 patients is critical in improving patient care. Implications for nursing management: The findings of this study should alert nurse managers to plan the best way to support frontline nurses caring for COVID‐19 patients. [ABSTRACT FROM AUTHOR]

Aim This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. Background The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Method Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire ( CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. Results The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Conclusion Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. Implications for nursing management The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. [ABSTRACT FROM AUTHOR]

Aim To investigate the relationship between non-nursing tasks ( NNTs), nursing tasks left undone ( NTLU) and job satisfaction among professional nurses ( PNs) in South Africa ( SA). Background This study adds to the international debate about the relationship between non-nursing tasks, nursing tasks left undone and job satisfaction by studying the variables at individual nurse and hospital unit level. Method A cross-sectional survey design of 1166 PNs in 60 medical and surgical units in 55 private hospitals and seven public hospitals. Results Nationally, the three main non-nursing tasks performed were clerical duties ( M = 1.81), arranging discharge referrals and transport ( M = 1.38) and performing non-nursing care ( M = 1.31), while the main nursing tasks left undone were comfort/talk with patients (62.2%), educating patients and family (57.9%) and develop/update nursing care plans/pathways (51.6%). Nursing tasks left undone were only related to three non-nursing tasks, and job satisfaction correlated most highly with nursing tasks left undone. Conclusion Professional nurses conduct many non-nursing tasks, and leave several important nursing tasks left undone. Nursing tasks left undone cause the greatest degree of job dissatisfaction amongst professional nurses. Implications for nursing management Role overlapping and work performed by professional nurses below their skill level should be identified and re-organised; support services should be employed and efficiently used. [ABSTRACT FROM AUTHOR]

Aim To establish reasons for absenteeism amongst professional nurses, enrolled nurses and enrolled nurse auxiliaries in a general hospital in Durban, in order to recommend strategies that could decrease absenteeism. Background Nurses endure increased workload, resulting in burnout and absenteeism in workplace environments that already suffer staff shortages. Method This study was a quantitative, non-experimental survey. The study population consisted of 60 nurses, including professional and enrolled nurses and enrolled nurse auxiliaries. The survey consisted of closed-ended questions to options of 'agree' and 'disagree' and an open-ended section. Result Family matters, lack of motivation to attend work, illness, finance, favouritism, unfriendly nurse managers, long work hours, increased workload, unsatisfactory work conditions, lack of equipment, unfair promotions and selection of nurses for training, staff shortages, lack of a reward system and incoherent decision-making caused nurse absenteeism. Conclusion Personal, professional and organisational factors may cause nurse absenteeism, crippling the health sector further against the backdrop of human and mechanical resource shortage. Implications for nursing management Nurse managers have an important role in reducing absenteeism by addressing the employees' concerns, which can lead to productivity, increased staff morale, decreased medical hazards and satisfied patients. [ABSTRACT FROM AUTHOR]

Aim The aims of this study were to validate the Maslach Burnout Inventory - Human Services Survey ( MBI- HSS) for registered nurses in South Africa and to analyse the differences between the levels of burnout of different biographical groups. Background The nursing profession is seen as a stressful and emotionally demanding profession, which makes nurses susceptible to burnout. Method A cross-sectional survey design with a stratified random sample ( n = 818) was used. The MBI- HSS and a biographical questionnaire were administered. Results Exploratory factor analysis resulted in a three-factor structure of burnout, consisting of emotional exhaustion, depersonalization and personal accomplishment. Construct equivalence and reliability of the three factors were confirmed. Significant differences were found in burnout levels with regard to language, age, rank, job satisfaction, reciprocity, full-time employment and specialised training. Conclusions The MBI- HSS showed acceptable validity and reliability for South African nurses. Burnout is associated with specific factors, including language, age, rank, job satisfaction, reciprocity, full-time employment and specialised training. Implications for nursing management The use of the MBI- HSS is recommended to assess burnout of nurses in South Africa. Organisations employing nurses should intervene to prevent and/or manage burnout. [ABSTRACT FROM AUTHOR]

Aims This study discusses factors inhibiting computer usage for work-related tasks among computer-literate professional nurses within rural healthcare facilities in South Africa. Background In the past two decades computer literacy courses have not been part of the nursing curricula. Computer courses are offered by the State Information Technology Agency. Despite this, there seems to be limited use of computers by professional nurses in the rural context. Methods Focus group interviews held with 40 professional nurses from three government hospitals in northern KwaZulu-Natal. Results Contributing factors were found to be lack of information technology infrastructure, restricted access to computers and deficits in regard to the technical and nursing management support. The physical location of computers within the health-care facilities and lack of relevant software emerged as specific obstacles to usage. Conclusion Provision of continuous and active support from nursing management could positively influence computer usage among professional nurses. A closer integration of information technology and computer literacy skills into existing nursing curricula would foster a positive attitude towards computer usage through early exposure. Implications for nursing management Responses indicated that change of mindset may be needed on the part of nursing management so that they begin to actively promote ready access to computers as a means of creating greater professionalism and collegiality. [ABSTRACT FROM AUTHOR]

Aim This study was aimed at describing nursing leadership in an academic hospital in Gauteng, South Africa. Background Nurse managers' leadership styles affect nurses' attitudes, behaviour and work performance. However, little is known about how nurses experience nurse leadership and what leadership styles are found in academic hospitals in Gauteng. Methods The study was based on Maxwell's framework of leadership (relationships, equipping, leadership and attitude). A qualitative design was used in order to describe the experiences of registered nurses and nurse managers. The population of the study was all registered nurses and nurse managers of the hospital in which the study was conducted. In phase one of the study, a discussion group with 35 registered nurses using the nominal group technique was held to respond to the following statement: 'Please explain how you have experienced leadership by nurse managers in this hospital'. In phase two of the study, five nurse managers were interviewed individually, using a semi-structured interview guide. Results Some nurse managers were practising autocratic leadership in this hospital. Implications for nursing management The nurse managers need to be taught about contemporary leadership styles such as transformational leadership and visionary leadership and also about supervision, role modelling and caring. [ABSTRACT FROM AUTHOR]

Aim The aim was to determine whether nursing leaders met the criteria for transformational and/or transactional leadership. Background Many changes have occurred in South Africa and are reflected in the health-care systems. As a result, it has become crucial to source leaders who are able to manage the change process effectively so as to ensure the success and survival of our health-care organizations. Methods The 45-item Multifactor Leadership Questionnaire (Rater) was completed by 41 respondents out of a population of 121. A proportional stratified simple random sampling technique was used to select the raters of seven leaders. Results Most nursing leaders role-modelled the culture of the organisation but did not stimulate their followers intellectually and did not demonstrate innovative motivation or individual consideration. Consequently, their followers may exhibit a lack of commitment to collective goals, with detrimental effects on the health-care organisation as a whole. Conclusions and implications for nursing managers Nursing leaders should be trained to become transformational leaders so as to encourage their followers to become innovative and motivated to render high quality nursing care. [ABSTRACT FROM AUTHOR]

jooste k. & jasper m. (2012) Journal of Nursing Management 20, 56-64 A South African perspective: current position and challenges in health care service management and education in nursing Aim The present study discusses the current context of South African nurse managers' working environment, exploring the challenges of disease demographics, service change and development, and educating a nursing workforce to meet healthcare delivery demands. Background Post-apartheid South Africa has a legacy of inequalities in access to healthcare; increasingly poor morbidity and mortality demographics; and inadequate numbers of qualified nurses to provide a service to meet the Millennium Development Goals outlined by the Government in 2010. Evaluation The present study discusses the current position and developments pertaining to nursing management relating to both healthcare challenges and educating a nursing workforce. Key issues Collaborative action by various stakeholders in the development of nursing management will ensure a nursing workforce and service environment fit-for-purpose in delivering the healthcare outcomes envisaged in the transformed South Africa in the future. Conclusion Different role players are involved in critical issues regarding the management and education of nursing in South Africa. Nurse managers are central to the success of service redesign, delivery and education. Implications for nursing management Nurse managers need to influence policy decisions regarding nursing service design and delivery, and the education required to prepare the next generation of practitioners for these new services. [ABSTRACT FROM AUTHOR]

AIM: This overview article aimed at outlining the image of an effective future-orientated nurse leader in the health care context through a pragmatic approach. The future nurse leaders on different levels in health care institutions is challenged in the current health care environment of culturally diverse countries, such as South Africa. This article should make all nursing leaders more aware of their important role in taking the lead in challenges faced in the current health service environment. BACKGROUND: Leaders have the essentials of authority, power and influence to lead followers to their goals. The use of these essentials has changes from the past, to the present and into the future health care environment. Different changes and challenges are facing nurse leaders and they need to implement an effective leadership style in a complex health care environment. EVALUATION: This overview article focuses on key elements of an effective future leader using a conceptual framework as departure, incorporating relevant literature. It analyses and evaluates the efficiency of past and present roles of authority, power and influence in leadership and summarizes a new perspective of a future nurse leader. Solutions and future actions are indicated for the future role of the nurse leader. KEY ISSUES: The past, present and future leadership setting, role of authority, power and influence in leadership, components of the arch of leadership and solutions to effective leadership in a future dimension is all domains that is presented with the intention of motivating future nurse leaders. CONCLUSION: It was identified that a different kind of leader should emerge to lead in a new way, different from those leadership styles that we have known in the past. The 21st century is a new timeframe and different timeframes demand different leadership approaches. [ABSTRACT FROM AUTHOR]

klopper h.c., coetzee s.k., pretorius r. & bester p. (2012) Journal of Nursing Management 20, 685-695 Practice environment, job satisfaction and burnout of critical care nurses in South Africa Aim To describe the practice environment, job satisfaction and burnout of critical-care nurses (CCNs) in South Africa (SA) and the relationship between these variables. Background CCNs are more sensitive to job satisfaction and burnout, and several studies have been published on the relationship between these variables. However, the research that was undertaken did not focus exclusively on the practice environment of CCNs or the context of SA. Method The RN4CAST survey was used. A stratified sample of 55 private hospitals and seven national referral hospitals were included in the study. A total of 935 CCNs completed the survey. Results The practice environment is positive, except for staffing and resource adequacy, and governance. The greatest job dissatisfaction is experienced with regard to wages, opportunities for advancement and study leave. CCNs have a high degree of burnout. Conclusion The high degree of burnout is related to dissatisfaction with wages, opportunities for advancement, study leave and a practice environment with inadequate staffing and resources, and lack of nurse participation in hospital affairs. Implications for nursing management Managers should ensure that adequate numbers of CCNs are on the staff allocation and provide opportunities for CCNS to participate in policy and governance of the hospital, while giving attention to good salaries and providing opportunities for advancement and study leave. [ABSTRACT FROM AUTHOR]