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Introduction: The term "cultural humility" is often used, but both society and professionals, including nurses, lack a clear understanding of its meaning. This study examined the relationships, predictors, and differences of nurse leaders' cultural humility in nursing practice, as perceived by hospital nurses., Methodology: A quantitative transverse and correlational study was implemented with a convenience sample of 350 Jordanian registered nurses (RNs)., Results: Nurses "agreed" on the presence of nurse leaders' cultural humility in nursing practice, but it was low. Working rotating shifts, holding a Baccalaureate degree in nursing or less, and having graduated from a private university predicted the perceived nurse leaders' cultural humility in nursing practice. Most differences in perceived nurse leaders' cultural humility in nursing practice came from nurses who worked rotating shifts when compared to those who worked day shifts., Discussion: Nurse leaders must practice open communication and embrace a receptive mind-set, as this will help eradicate the tendency of nurse leaders to believe they know "know-it-all.", Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Managerial ethical principles and behaviours guide the roles, duties, responsibilities, behaviours, and relationships of nurse managers in healthcare institutions., Research Objectives: The aim of this study was to establish the managerial ethical principles and behaviours for nurse managers., Research Question: What are the managerial ethical principles and behaviours for nurse managers?, Research Design: The Delphi method, one of the qualitative research methods, was used in this study. The Delphi process consisted of two rounds. Data were collected by e-Delphi technique., Participations: 42 experts were included in the first Delphi round and 39 in the second Delphi round. These experts consisted of nurse managers, academicians studying in the field of ethics and nursing management., Ethical Considerations: Participation in the study was voluntary and informed consent of the experts was obtained before the study. Approval was obtained from the ethics committee of the university at which the researcher worked (Approval date: 24.07.2020, Decision No: 2020/12-16)., Findings: At the end of the Delphi rounds, eight managerial ethical principles and 29 ethical behaviours of these principles were identified. The distribution of these behaviours and principles were: justice (six behaviours), equality (two behaviours), honesty (two behaviours), fairness (two behaviours), responsibility (eight behaviours), confidentiality (two behaviours), clarity (two behaviours), and humanity (five behaviours)., Conclusion: These managerial ethical principles and behaviours are intended to guide nurse managers when providing nursing services but should be updated accordingly in line with changing conditions and developments., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Formal nursing leaders play an important role in promoting and sustaining evidence-based practice (EBP) in the clinical context, particularly by creating a conducive environment for change and increasing clinicians' awareness of the positive results of EBP. However, nursing leaders encounter both barriers and facilitators in their work; therefore, it is important to understand their perceptions on this topic., Objective: The objective of this study was to understand the perceptions of formal nursing leaders about barriers and facilitators for EBP., Methods: A descriptive exploratory study with a qualitative approach was conducted. A convenience sample was obtained, consisting of formal nursing leaders from three Portuguese health care institutions. Data were collected through semi-structured interviews. Content analysis was conducted using MAXQDA Analytic Pro 2022 software., Results: Seventeen formal nursing leaders were interviewed. Five categories of EBP barriers were identified: (1) scarce resources and inefficient resource management; (2) non-conducive organizational culture; (3) distance between academia and the clinical context; (4) demotivation; and (5) resistance to change. Seven categories of EBP facilitators were identified: (1) availability of resources and efficient resource management; (2) conducive organizational culture; (3) partnerships between academia and the clinical context; (4) motivation and commitment; (5) leadership; (6) organization that regulates professional practice; and (7) multidisciplinary meetings., Conclusions: This study identified barriers and facilitators for EBP through the perceptions of formal nursing leaders. Collaborative multidisciplinary efforts by leaders, direct care professionals, academics, and researchers should be conducted to overcome barriers and strengthen facilitators for EBP., Spanish Abstract: http://links.lww.com/IJEBH/A242., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 JBI. Unauthorized reproduction of this article is prohibited.)

Aim(s): To identify and synthesize evidence available on nurse leaders' interpersonal communication competence., Design: Systematic mixed-methods review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist., Methods: The data were collected following predefined inclusion criteria. Two authors independently performed the study selection using Covidence software. Three authors assessed the quality using Joanna Briggs' Institute's critical appraisal tool and the mixed-methods appraisal tool. The data-based convergent synthesis design and narrative synthesis were used., Data Sources: CINAHL, PubMed, Scopus, Business Source Elite, Academic Search Premier, Communication & Mass Media Complete, PsycInfo, Web of Sciences, Medic and Finna.fi were searched and the screening of citations in relevant articles. The final searches were performed on 17 October 2022., Results: A total of 26 studies-15 quantitative, 9 qualitative and 1 of both mixed-method and multi-method-met the inclusion criteria. The nurse leaders' interpersonal communication competences described in the extant literature were categorized into three themes: message competence, relational competence and task competence. There were considerable differences in the levels of competence, as some competences were considered basic communication skills, while others required more advanced level competences. Furthermore, three competence levels were identified: novice, competent and expert., Conclusions: This study unravels a unique hierarchical description of communication skills across competence categories, supported by the assumption that communication skills are structured hierarchically. The studies reviewed herein had a narrow perception of nurse leaders' interpersonal communication competence and indicated a transmissional understanding of communication., Impact: This is the first mixed-methods systematic review that describes and synthesizes the evidence on nurse leaders' communication competencies hierarchically and across competence levels. The study suggests that further research should focus on a broader and more analytical understanding of the cognitive and affective aspects of interpersonal communication competence., Prospero Id: CRD42023385058., Patient or Public Contribution: No patient or public contribution., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background:  Providing care for adolescents living with intellectual disabilities (ALWIDs) within healthcare settings is a complex challenge. These adolescents require an environment that is specialised and conducive to their health, alongside tailored care, treatment and rehabilitation services. Nurse managers play a crucial role in supporting these adolescents, particularly given the difficulties parents face in meeting their unique needs., Objectives:  This study aims to explore nurse managers' perspectives on the creation of a healthy environment for ALWIDs in health facilities., Method:  An explorative qualitative study design was conducted. A purposive sampling method was used to select 13 nurse managers from three institutions relevant to the study's interests. Nurse managers with over 2 years of direct experience in the care, treatment and rehabilitation of ALWIDs were eligible to participate in the study. Selecting these nurse managers ensured the study captured their firsthand experiences and expertise in managing nursing services. Data were collected through face-to-face and telephonic semi-structured interviews, recorded digitally. Braun and Clarke's six-step thematic analysis was used for data analysis., Results:  A safe environment; multi-disciplinary team involvement; competent and adequate staff and a conducive physical environment for structural support are beneficial for ALWIDs., Conclusion:  To promote the well-being of ALWIDs, it is essential to establish a spacious and safe environment equipped with sufficient material and non-material resources. Engaging a multi-disciplinary team is vital for addressing their diverse needs.Contribution: This study provided information on what constitutes a healthy environment for ALWIDs to inform clinical practice, nursing education, policy makers and research.

Background: US nursing homes were ground zero for COVID-19 and nursing home leaders faced multiple challenges to keep residents and staff safe. Understanding the leader's role and their use of external resources to rapidly respond to the pandemic is important to better prepare for the next infectious disease outbreak emergency. The purpose of this study is to describe Missouri nursing home leaders' use of external resources to manage challenges encountered during the pandemic., Methods: This qualitative descriptive study uses data from semi-structured interviews conducted with leaders from 24 Midwestern nursing homes between March 2022 and March 2023. Interviews were transcribed verbatim and analyzed using Dedoose software. Directed content analysis, guided by Donabedian's Structure, Process, Outcome framework, was used for analysis. Interviews were conducted as part of a larger mixed-methods study focused on developing knowledge and recommendations to improve US nursing homes' capacity to respond to infectious disease outbreaks., Results: Forty-three interviews were conducted across the 24 homes. Participants included administrators (n = 24), nurse leaders (n = 19), and infection preventionists (n = 16). Six sub-categories of external resources/support were used by leaders to manage challenges during the pandemic:1) corporate support and communications, 2) statewide resources, 3) community-based resources, 4) health care coalitions focused on emergency response planning, 5) existing affiliations with local organizations i.e., hospitals, and 6) community members and families. Corporate support was a primary resource; however, it was limited to chain-based homes. Leaders from standalone homes seemed most reliant on statewide agencies, existing affiliations, and other community-based resources due to their lack of corporate connections. Health care coalitions were few, but when available, helped nursing homes prepare for the pandemic onset. Family and community members were vital despite being off-site from nursing homes at the pandemic onset., Conclusion: Leaders played a pivotal role in accessing and using external resources to manage challenges during the pandemic. Statewide and community-based agencies and existing affiliations were particularly critical for standalone homes who otherwise had little to no means of support. Federal, state and local agencies must consider opportunities to build multi-agency regional collaborations, local health care coalitions and community-based partnerships that include nursing homes as member. Finally, community members and family were important in providing support, thus closing visitation is a double-edged sword that needs careful, future consideration., (© 2024. The Author(s).)

Objective: To understand the socio-emotional competencies mobilized by nurse leaders during and after facing the Covid-19 pandemic in a university hospital., Method: Case study, conducted with sixteen nurses working in the leadership of units and services at a university hospital in northeastern Brazil. Data collected in two moments through semi-structured interviews. The interviews took place between August to December 2022 and January to August 2023. An inductive and coded thematic analysis was performed, according to the bucket theme technique, assisted by the NVivo12 software and supported by the grouping of twenty-five items included in the Socio-emotional competence scale., Results: During the fight against the Covid-19 pandemic, nurses expressed a mix of emotions due to their lack of knowledge about the disease. Faced with the climate of fear and the feeling of helplessness, they developed strategies that minimized the risks of illness and death. Two categories emerged: Emotional climate experienced by nurses and Coping strategies developed by nurses in the context of the Covid-19 pandemic., Final Considerations: The competencies of social awareness, regulation, self-control, creativity, and emotional awareness were identified in the nurses' reports. These skills contributed to coping with the pandemic period, through the participation, involvement, and integration of professionals.

Incivility is a major concern in healthcare, and it is vital that uncivil behaviour is recognised and addressed. Manifestations of incivility are wide ranging and can take the form of microaggressions, which are difficult to pinpoint but have significant repercussions. Research has demonstrated the negative effects of incivility on staff and patients. Uncivil acts and behaviour can create conflict, reduce performance, affect morale, decrease retention and jeopardise patient safety. The role of nurse managers in reducing incivility and promoting civility includes providing leadership, fostering psychological safety, creating a shared understanding of civil behaviour and managing uncivil behaviour as soon as it occurs. The input of employers is crucial to promote a compassionate and inclusive organisational culture and to support nurse managers to acquire the knowledge, skills and confidence to prevent and reduce incivility., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Background: Research shows that front-line nurses' workload and stress levels increased during the coronavirus disease 2019 (COVID-19) pandemic, however, there is little research of these factors in relation to nurse managers. Previous research undertaken in Austria found that some nurse managers working in nursing homes undertook clinical as well as managerial functions during the pandemic, a double burden that could have increased their stress levels and have had adverse psychological, physical and social consequences., Aim: To investigate the effects of the COVID-19 pandemic on nurse managers' workload, perceptions of teamwork and stress levels, and the physical, psychological and social consequences of working during the pandemic., Method: A cross-sectional design was used. Respondents (n=238) were sent an online questionnaire during the second wave of the pandemic (which in Austria was November 2020 to March 2021) containing questions on demographics and fear of infection, their current workload compared with pre-pandemic workload, their perceptions of the influence of the pandemic on teamwork, their levels of stress measured using the Perceived Stress Scale (PSS), and the physical, psychological and social consequences of working during the pandemic., Results: Most respondents (95%) had to undertake more or much more work than usual during the pandemic, while just over half (52%) perceived that the influence of the pandemic on teamwork had been positive throughout or partially positive. Overall, the respondents' level of stress was moderate, as measured by the PSS. Around 28% of respondents were afraid of infecting someone other than themselves, notably their families, employees and patients. Fear for themselves, their families and their patients or residents were commonly reported psychological consequences of working during the pandemic, while confusion due to information overload was the second most commonly reported psychological consequence., Conclusion: Comparing results with previous research is difficult due to the lack of research of nurse managers' experiences of the pandemic. Fear appears to have been a major issue for nurse managers during the pandemic, particularly in relation to infection and information overload. This emphasises the need for healthcare organisations to focus on the mental health and well-being of nurse managers, as well as front-line staff, during and after crisis situations such as a pandemic. Organisations may consider reworking and adopting already-established COVID-19 regulations, schedules and local guidelines, particularly in terms of communication and infection control, which could help to reduce nurse managers' fear in future crisis situations., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

The nursing profession is under growing pressure and many nursing staff find it increasingly challenging to maintain standards and provide safe, effective and efficient care that meets the needs of patients. Nurses' job satisfaction is predicated on feeling supported, including when there are concerns about practice - whether their own or that of their colleagues. This article discusses how nurse managers can support staff to challenge suboptimal practice, admit their own errors and learn from these by fostering a climate of psychological safety. This includes adopting a relational model of leadership; cultivating open communication; providing clarity on roles and expectations; ensuring transparency and fairness in performance management; having supportive 'tough conversations' with staff; demonstrating objectivity when investigating concerns; and promoting a 'just culture'., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

The aim of this article is to report on Italian nurses' perceptions of their performance and work-related behaviors. The data for the study were derived from a questionnaire that included the items from the Individual Workplace Performance Scale, which was distributed via the internet during March 2021. The analysis of the responses found that women complained more about their work than men. Older nurses reported concerns about keeping up-to-date; they also thought that they carried out their work more efficiently than younger nurses and that they were better able to come up with creative solutions for new problems. The nurses who had been working for 6 to 10 years reported feeling more vulnerable in their positions. Further research is needed to help nurse managers manage their staff and reach their organizational goals., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the authorship and/or publication of this review.

The COVID-19 pandemic introduced many new stressors to nurses in general, yet little is known about COVID-19-related stressors and resilience among nursing leaders. The aims of this study were to explore (1) the COVID-19-related stressor and resilience by personal and work demographics, (2) the relationship between COVID-19 stressors and resilience, and (3) resilience strategies used by leaders and their recommendations to other nurse leaders. This descriptive, cross-sectional study employed an electronic survey to measure COVID-19-related stressors and resilience and included qualitative open-ended questions. A total of 57 nurse leaders responded to the survey. Nurse leaders who were female, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest COVID-19 stress in most of subscales. Nurse leaders who were male, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest resilience scores. Nurse leaders with higher resilience levels had lower levels of COVID-19 stress in all subscales. Nurse leaders reported the top 3 resilience strategies as (1) prayer and faith, (2) social support, and (3) self-care and the top 3 recommendations to other nurse leaders as (1) disconnect, (2) positive and creative thinking, and (3) self-care., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Nurses' turnover has remained a concern in the healthcare sector worldwide. Nurse managers should adopt appropriate leadership styles that promote a positive working environment. The literature revealed that effective leadership styles have lower turnover rates and higher job satisfaction among nurses in healthcare settings., Aim: This research aims to investigate whether a direct association exists between servant leadership and nurse turnover in public and private hospitals. While conventional leadership prioritises organisational success, servant leadership works on employee empowerment, growth and engagement, to secure success and trust among healthcare workers., Method: A quantitative, cross-sectional study has been performed among 400 nurses from private and public hospitals in the northern parts of Jordan. A self-administered written survey was administered to those nurses in their departments. Structural equation modeling (SEM) using was used to analyse the data., Results: Findings revealed that servant leadership had a negative direct impact on nurse turnover intention. Servant leadership prioritises employee empowerment of nurses in their workplaces., Conclusion: Healthcare agencies and healthcare professional organisations could use the study findings to understand better what influences nurses' decisions and behaviours and what causes them to resign. Further findings of this study may assist nurse managers in developing appropriate retention strategies and reducing the likelihood of nurses resigning., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: This study aimed to determine clinical nurse and nurse manager perspectives on missed nursing care (MNC) during the COVID-19 pandemic., Design: This study utilized a qualitative exploratory descriptive design., Methods: Data were obtained through focus groups and virtual interviews. Purposive sampling was used to select nurse and nurse manager participants in COVID-19 units and the Emergency Department in one large healthcare organization in the northeastern United States of America., Results: A total of 15 nurses and nurse managers participated in the study. Results revealed five categories: medication delivery, turning patients, double checks, communication and rapport, and patient surveillance., Conclusions: A variety of factors contributed to the perceptions and experiences of MNC of COVID-19 patients during the early stage of the pandemic. The COVID-19 crisis put additional and unparalleled pressure on a strained nursing workforce. Hospital leaders are responsible for ensuring their frontline nurses have the resources they need to feel supported in their roles regardless of the presenting circumstances., Implications for the Profession: Nurse leaders should employ evidence-based strategies such as promoting and championing teamwork to support staff and reduce incidences of MNC during crises. Our current work may serve as a basis for informing future revisions of pre-pandemic measurement tools when applied in a pandemic-specific context., Reporting Methods: This manuscript adheres to the standards for reporting qualitative research (SRQR); a synthesis of recommendations., Public Contribution: There was not patient or public contribution for this study., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

In 2021, the first advanced practice nurses (APNs) specializing in psychiatry and mental health will have entered the vast field of practice of this discipline. Two years on, the missions entrusted to them within the establishments that have supported the development of their new skills are as varied as ever. While their scope of action remains to be defined in some places, the fact remains that collaboration between the APN and the local health executive is already proving to be a powerful lever for the successful completion of large-scale projects aimed at the continuous improvement of care in their shared field of practice. A look back at the deployment of a quality tool to improve care safety., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Aim: To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence-based practices, from the perspectives of potential programme participants and deliverers., Design: A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China., Methods: We conducted individual semi-structured interviews with unit-level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability., Results: After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi-modal training activities such as group work, experience-sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID-19 pandemic, and support from senior organizational leadership., Conclusions: The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success., Impact: The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally., (© 2024 John Wiley & Sons Ltd.)

Background: The mass redeployment of nurses was critical across countries necessitated by the acute health impact of Covid-19. Knowledge was limited regarding how to manage nurse redeployment or the impact that redeployment might have. Redeployment continues, particularly in response to the current staffing crisis and surges such as winter pressures. This study aims to address these gaps in evidence to inform guidance on how best to manage nurse redeployment in practice., Objectives: First, to understand the processes and underpinning decisions made by managers when managing nurse redeployment prior to and during the Covid-19 pandemic. Second, to identify the lessons that can be learned to improve the management of on-going nurse redeployment., Design: Qualitative study utilising semi-structured interviews and focus groups with nurse managers (ISRCTN: 18172749)., Setting(s): Three acute National Health Service (NHS) Trusts in England with geographical and ethnic diversity, and different Covid-19 contexts., Participants: Thirty-two nurse managers and four Human Resource advisors responsible for redeploying nurses or receiving and supporting redeployed nurses., Methods: Participants took part in face-to-face or virtual semi-structured interviews from February 2021 to November 2021 and virtual focus groups from July to December 2021. Qualitative data were analysed using reflexive thematic analysis., Results: Four themes were evident in the data, capturing four distinctive phases of the redeployment process. There was a fundamental mismatch between how different parts of the nursing and managerial workforce conceived of their decision-making responsibilities across different phases. This led to managers taking inconsistent and sometimes contradictory approaches when redeploying nurses, and a disconnect between nursing staff at all levels of the chain of command. Furthermore, in conjunction with limited guidance in operationalising redeployment and the distressing experiences vocalised by nurses, nurse managers found nurse redeployment logistically and emotionally challenging; and felt 'caught in the middle' of meeting both their managerial and mentoring responsibilities. This became increasingly challenging during subsequent phases of redeployment and remained challenging once the pandemic waned., Conclusions: The approach to nurse redeployment in response to the Covid-19 pandemic prioritised nurse staffing numbers over personal well-being. Key principles of good practice relating to nurse redeployment during the Covid-19 pandemic can be applied to improve future redeployment of nurses and support positive outcomes. Having a planned approach for staff redeployment during normal service delivery comprising operational guidance for those tasked with implementing redeployment, that is scalable in a crisis setting, would be beneficial for the nursing workforce., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: The aims of this study were to describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors., Background: Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff., Methods: A cross-sectional, descriptive correlational design was used. The Florida Organization for Nursing Leadership enabled distribution of a wellness survey to nurse managers., Results: There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. When compared with nurse managers with staff shortages, those without staff shortages were 6.11 times more likely to not screen positive for burnout., Conclusions: Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Aims: The leader's ability to act with self-awareness, lead with generosity, and consider others' opinions is what defines humility leadership. In recent healthcare literature, there has been extensive exploration of humility leadership and psychological safety, but these studies were non-nursing. It is crucial to understand how humble leaders can empower their staff's psychological safety, as inclusivity is a key aspect of humility leadership and is closely linked to psychological safety. Therefore, this study examined the association between nursing leaders' humility leadership and team members' psychological safety., Design: A quantitative cross-sectional design was used in the current study., Methods: To assess the studied variables, 245 nursing academics, nurses, and nursing leaders were recruited from different universities and hospitals using the convenience snowball sampling technique, yielding a response rate of 70%. After a pilot study, an online survey using Google Forms was hosted in 2022., Findings: The psychological safety of nursing team members was not found to be associated with the humility leadership of nursing leaders. Despite the participants' reports of their nursing leaders exhibiting humility leadership (mean = 3.57/5, SE = 0.055), the participants also reported that psychological safety was borderline (mean = 3.09/5, SE = 0.041)., Conclusion: The borderline nursing team members' psychological safety implies that different types of leadership may have an impact on the psychological safety of nursing team members. The lack of association between nursing leaders' humility leadership and the psychological safety of nursing team members highlights the need for further understanding and effort from nursing leaders to establish psychologically safe work environments., Impact: This research offers valuable insights into how the humility of nursing leaders impacts the psychological safety of nursing team members. The psychological safety of the nursing team members highlights the specific responsibilities that nursing leaders should assume to establish psychologically safe work environments., Patient or Public Contribution: There was no Patient or Public Contribution, as the sample included nursing academics, nurses, and nursing leaders recruited from different universities and hospitals., Implications for Practice/policy: A simple intervention that humble leaders can initiate is inclusivity, where subordinates' positive worth, strengths, and contributions are acknowledged. Inclusivity is a characteristic of humility leadership. Improving teams'' psychological safety calls to promote a culture of civility in the workplace. A random and larger sample is needed, including other types of universities and hospitals, using other research designs across other cultures., (© 2024 John Wiley & Sons Ltd.)

The aim of this study was to explore and describe nurse managers' perceptions of family and community nurse practitioners' impact on primary care teams and public health. A descriptive qualitative study was carried out. The participants were recruited by means of convenience sampling during the months of April and May 2023. 20 nurse managers from different autonomous communities in Spain were interviewed. The data were analyzed following a thematic analysis method using ATLAS.ti nine software. Two main themes and sub-themes were drawn from the data analysis: (1) Nurse managers' view of primary care: (a) The driving force of primary care and (b) Resistance to the integration of family and community nurse practitioners; (2) Proposals for improvement in light of the Family and Community Nurse Practitioner's unique situation. These specialists are highly qualified professionals in primary care teams, whose expertise is evident in how they deliver community and health education activities, empower patients, and lead the training of new specialists., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

Aims: To understand factors influencing nurse manager retention or intention to leave, develop a preliminary theoretical model and identify strategies and interventions for workforce planning., Design: Systematic review update of literature with integrated design of mixed research synthesis., Methods: We included peer-reviewed articles examining factors influencing retention or intention to leave for front-line, middle or patient care nurse managers. Authors independently screened articles for inclusion and assessed included articles for quality. We adhered to a convergent synthesis approach., Data Sources: Nine databases included MEDLINE, EMBASE, PsychINFO, CINAHL Plus with Full Text, ERIC, Health Source Nursing/Academic Edition, Scopus, ProQuest Dissertations and Theses and LILACS in January 2023., Results: Thirty-five studies published between 1990 and 2022, 22 quantitative and 13 qualitative or mixed methods, were included. 155 factors influencing nurse manager retention, intention to stay, or turnover were reported. Job satisfaction was most frequently examined (n = 7), followed by factors such as empowerment (n = 3), decision-making (n = 3) and resilience (n = 2). We developed a preliminary theoretical model demonstrating staff relations and leadership, organizational and job characteristics, socio-demographics, personal characteristics, well-being and nurse manager relationship with work influence managers' intention to stay or to leave., Conclusions: Nurse managers who were empowered, satisfied with their work, received constructive feedback and found meaning in their roles showed greater intent to stay., Implications for the Profession And/or Patient Care: Nurse administrators can ensure managers are provided with authority to make decisions that promote autonomy. Work cultures that allow for regular meaningful constructive feedback from staff and leaders may contribute to nurse managers feeling valued., Impact: Understanding factors that influence job retention or intention to leave may help nurse managers and their supervisors identify areas for strategy and intervention design to ensure sustainability of this workforce., Reporting Method: PRISMA 2020 Guidelines., Patient or Public Contribution: No patient or public contribution., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: The aim of the present study was to describe nurse managers' perceptions of the provision of mentoring for newly graduated registered nurses (NGRNs) and its contribution to the work environment in a hospital setting., Background: Nurse managers are responsible for the work environment and for supporting the staff's professional development, which includes giving NGRNs organizational support during their introduction to the workplace. Mentorship is one common way to provide support, but there is a lack of knowledge about how nurse managers view this support., Design/method: This was a qualitative descriptive study, using a semi-structured interview guide. Fifteen individual interviews with nurse managers were performed in hospital settings. The interview transcripts were analysed using qualitative content analysis. The COREQ guidelines and checklist were used., Results: The results describe the nurse managers' perceptions of the provision of mentoring in three themes: Ensuring and sustaining mentoring for new nurses' needs is a struggle in the harsh reality of healthcare, Identifying mentors who are willing and possess the necessary competence for the assignment and Promoting a secure and attractive workplace by mentoring new nurses., Conclusions: Our study confirms that nurse managers are important in the provision of mentoring for NGRNs' learning and professional development. Mentoring has a positive spillover effect on the entire unit as a sustainable approach to securing and improving the work environment. Our study also identifies challenges for nurse managers to structure mentoring provision., Implications for the Profession And/or Patient Care: This study highlights the importance of investment in mentoring for the NGRNs' professional development and for patient care. Support is needed from the top level of the organization, but how mentoring should be structured and facilitated needs to be investigated further., (© 2024 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Aim: To explore the perspectives of nursing managers in Korean hospitals on the Magnet Recognition Program using importance-performance analysis., Design: A descriptive quantitative cross-sectional design with a survey methodology was used to evaluate nursing managers' perceptions of the Magnet Recognition Program criteria., Methods: After the Magnet Recognition Program's content validity was confirmed, an online survey was administered to 150 nursing managers from 10 hospitals. The results were analysed using importance-performance analysis., Results: The average importance of the questionnaire for the developed Magnet Recognition Program criteria was 3.19 ± 135 and the performance was 2.90 ± 222. Items corresponding to the areas 'Concentrate here', 'Keep up the good work', 'Possible overkill' and 'Low priority' were identified using two importance-performance analysis frames. The items corresponding to 'Concentrate here' included evidence-based nursing practice, the nursing professional practice model, nurses' participation in improving turnover rate and cases of innovation in nursing., Conclusion: This study highlights areas for improvement within the Magnet Recognition Program as perceived by Korean nursing managers, emphasizing evidence-based practice, professional models and nurses' involvement in turnover reduction and fostering innovation., Public Contribution: To achieve Magnet recognition, hospitals must understand nursing managers' perspectives on the Magnet Recognition Program criteria. This study provides insights into enhancing the work environment for nurses in South Korean hospitals and lays the groundwork for developing effective Magnet certification programs. Introducing the Magnet program into South Korean hospitals may improve the overall nursing work environment and mitigate the serious problem of nursing staff turnover., Reporting Method: The findings were reported using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Aims: To explore the association between nurse managers' paternalistic leadership and nurses' perceived workplace bullying (WPB), as well as to examine the mediating role of organizational climate in this association., Background: There is a lack of empirical evidence regarding the relationship between nurse managers' paternalistic leadership, organizational climate and nurses' perceived WPB. Clarifying this relationship is crucial to understand how paternalistic leadership influences WPB and for nursing managers to seek organizational-level solutions to prevent it., Methods: A cross-sectional survey was performed from 4 January to 10 February 2022, in six tertiary hospitals in mainland China. Demographic information, Paternalistic Leadership Scale, Organizational Climate Scale and Negative Acts Questionnaire-Revised were used in the survey. Descriptive statistics, Spearman correlation analyses and a structural equation model were used for data analysis., Results: A total of 5093 valid questionnaires were collected. Moral leadership and authoritarian leadership have both direct and indirect effects on WPB through the mediating effect of organizational climate. The former is negatively related to WPB and the latter is positively related to WPB. Benevolent leadership was only negatively associated with WPB via the mediating effect of organizational climate., Conclusion: The three components of paternalistic leadership have different effects on WPB through the mediating effect of organizational climate. Nurse managers are recommended to strengthen moral leadership, balance benevolent leadership, reduce authoritarian leadership and strive to create a positive organizational climate in their efforts to mitigate WPB among nurses., Impact: This study enhanced our comprehension of the relationship between different leadership styles and WPB. Greater emphasis should be placed on moral leadership in the promotion of nursing managers and nursing leadership training programs. Additionally, nursing managers should focus on establishing a positive organizational climate that helps to reduce WPB., Patient or Public Contribution: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public., (© 2024 John Wiley & Sons Ltd.)

The ED has been increasingly recognized as a key setting for suicide prevention. Zero Suicide (ZS) is an aspirational goal to eliminate suicide for all patients within a health care system through utilization of best practices. However, there has been limited exploration of ZS implementation within the ED. As ED nurses play an important role in suicide prevention through their close contact with patients at risk for suicide, ZS implementation would benefit from tailored strategies for ED nurse leadership. We describe the ZS framework and provides strategies for nurse leaders to adapt each ZS component in the adult ED., Competing Interests: Declaration of competing interest The views expressed in this manuscript are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the National Institutes of Health, or the United States Government. The funding sources were not involved in the development, writing, or submission of this manuscript. The authors have no conflicts of interest to declare., (Published by Elsevier Inc.)

Objectives: This study was conducted to determine the effect of an education program developed to improve the problem-solving and decision-making skills of nurse managers through both self- and subordinate evaluations and to compare it with a control group without training., Background: The most basic skill that managers should have is effective problem-solving and decision-making skills. Nevertheless, studies indicate that nurse managers' problem-solving and decision-making skills are at a moderate level and need to be improved., Design: Randomized controlled, pre-test-post-test, intervention and control group design. The study was conducted at a tertiary hospital in Istanbul, Türkiye. The sample consisted of 60 nurse managers (30 intervention and 30 control groups) and 300 nurses or nurse managers working as subordinates., Methods: After assessing the problem-solving and decision-making skills of nurse managers in the intervention and control groups by themselves and their subordinates, educational intervention was provided to the intervention-group. The problem-solving and decision-making education consists of two full days of interactive training based on case studies. Subsequent to the training, nurse managers in the intervention-group underwent a second follow-up. The third follow-up for the intervention-group, as well as the second follow-up for the control-group and all subordinates, were conducted in the third month after the training. Data were analysed using descriptive tests, independent sample t-test and dependent sample t-test for comparisons and repeated measures analysis of variance for the effectiveness of the training program., Results: Significant differences were found between the mean scores of the intervention-group nurse managers in problem-solving and decision-making pre and post-test (t=-11.005, p<.001) and case evaluations (t=-10.03, p<.001). Moreover, significant differences were identified in the assessment of pre-training, post-training and 3-month post-training average scores of overall problem-solving (F=93.643, p<.001) and rational (F=7.331, p=.007), dependent (F=13.607, p<.001), avoidant (F=11.543, p<.001) and spontaneous decision-making style (F=4.393, p<.001). When evaluated by the subordinates of the nurse managers in the intervention-group, there was a notable difference in the mean scores of overall problem-solving (t=-16.237, p=.001) and rational (t=-3.472, p=.001) and dependent decision-making styles (t=4.161, p=.001) before and 3-months after the training., Conclusions: The study uncovered that the problem-solving and decision-making training provided to nurse managers led to enhancements in their respective abilities, a progression that was also noted by their subordinates. The findings underscore the significance of case-based training programs tailored to enhance the problem-solving and decision-making competencies of nurse managers., Competing Interests: Declaration of Competing Interest This study was produced from the doctoral thesis of Berra YILMAZ KUŞAKLI under the supervision of Associate Professor Betül SÖNMEZ., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: There is increasing research interest in the relationship between ethical leadership and deviant workplace behaviour. Ethical leadership encompasses altruism, courage, ethical orientation, integrity and fairness. Examples of deviant workplace behaviours include theft, fraud, sabotage, assault, abuse, manipulation and bullying. It appears that when leaders are fair and emphasise ethical conduct, followers are less inclined to engage in deviant workplace behaviour., Aim: To investigate the relationship between nurses' self-rated levels of deviant workplace behaviour and perceived levels of ethical leadership in managers., Method: For this descriptive correlational study, 355 nurses from one university hospital in Egypt responded to an online questionnaire comprising the Ethical Leadership Scale and the Workplace Deviance Behavior Scale. Descriptive and inferential statistics were used to explore results and examine the relationships between study variables., Results: There was a statistically significant negative relationship between respondents' self-rated levels of deviant workplace behaviour and their perceptions of levels of ethical leadership in managers. The results appeared to confirm previous research. Nurses who feel that they are treated fairly by their managers tend to have positive attitudes towards work, colleagues and management., Conclusion: Ethical leadership on the part of managers is a significant determinant of nurses' behaviour in the workplace and should therefore be fostered by healthcare organisations., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Background:  Teamwork and collaboration among nursing managers, nurses, doctors and peripheral hospitals treating mining patients is pivotal. A case study of specific mining primary healthcare clinics revealed a lack of teamwork among the doctors and nursing managers, even on decisions that show productivity., Objectives:  The aim of this study was to explore and describe nursing managers' perceptions of teamwork and collaboration in mining primary healthcare clinics in Gauteng., Method:  A qualitative, exploratory, descriptive and contextual research design was adopted to conduct this study. Data were collected by conducting semi-structured individual interviews with 10 participants and thematically analysed. Data saturation was reached by the seventh participant and confirmed with three more interviews. Trustworthiness measures and ethical considerations were preserved as protocols because of the nature of the study., Results:  Three themes emanated from the study: (1) team coordination and support improve teamwork and collaboration in primary healthcare clinics, (2) there is a lack of involvement from the nursing team, negatively influencing teamwork and collaboration and (3) collaboration can improve the quality of healthcare services rendered in mining primary healthcare clinics., Conclusion:  All mining primary healthcare clinic team members should be involved in operational activities to foster teamwork and collaboration.Contribution: This study revealed that teamwork and collaboration should be facilitated to improve the quality of healthcare service in mining primary healthcare clinics.

Purpose: Healthcare organizations require more proactive behaviors from nursing professionals. However, nurse managers' proactivity has rarely been analyzed in the literature and little is known about the antecedents and consequences of their proactive behavior at work. This study examines the relationships between job characteristics (i.e. job autonomy and job variety), psychological empowerment, proactive work behavior and job effectiveness indicators (i.e. innovative work behavior, job performance). We tested a model in which psychological empowerment and proactive work behavior sequentially mediate the relationship between job characteristics and job effectiveness., Design/methodology/approach: A cross-sectional study was conducted among nurse middle managers from a French hospital ( N  = 321). A hypothetical model was developed based on existing theory. Structural equation modeling was used to test the hypotheses., Findings: Results show that psychological empowerment and proactive work behavior fully mediate the relationship between job characteristics and innovative work behavior, and partially mediate the relationship between job characteristics and job performance., Originality/value: This study provides insights for understanding how job characteristics can contribute to fostering the proactivity of nurse middle managers and how their proactive work behavior can be positively related to innovative work behavior and job performance. Findings raise several implications for hospital administrators and upper management seeking new ways to enhance nurse middle managers' proactive work behavior and push further their effectiveness at work., (© Emerald Publishing Limited.)

Background: The potential positive impact military nurse officers (MNOs) make on the nursing profession, as well as lessons learned, often is unknown beyond inner military circles., Purpose: Describe the experiences of MNOs in the advancement of the profession of nursing and nursing education, and how military service influenced nurse leaders' impact on civilian practice., Method: A descriptive-interpretive qualitative study using semistructured interviews of MNOs (N = 21)., Findings: Analysis revealed three themes: Deliberately developing personal leadership capacity, Building bench strength through team investment, and Balancing people and systems to achieve the mission., Discussion: Leader development in the military afforded participants the necessary skills to advance the profession of nursing and nursing education in multiple ways that span individual, group/team, and organizational impact. Transferability and application of these skills to civilian settings may enhance leader development in nurses without military service., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Moral distress (MD) occurs when clinicians are constrained from taking what they believe to be ethically appropriate actions. When unattended, MD may result in moral injury and/or suffering. Literature surrounding how unit-based critical care nurse leaders address MD in practice is limited., Aim: The aim of this study was to explore how ICU nurse leaders recognize and address MD among their staff., Study Design: Qualitative descriptive with inductive thematic analysis., Results: Five ICU nurse leaders participated in a one-time individual interview. Interview results suggest that (1) ICU nurse leaders can recognize and address MD among their staff and (2) nurse leaders experience MD themselves, which may be exacerbated by their leadership role and responsibilities., Conclusions: Further research is needed to develop interventions aimed at addressing MD among nurse leaders and equipping nurse leaders with the skills to identify and address MD within their staff and themselves., Relevance to Clinical Practice: MD is an unavoidable phenomenon ICU nurse leaders are challenged with addressing in their day-to-day practice. As leaders, recognizing and addressing MD is a necessary task relating to mitigating burnout and turnover and addressing well-being among staff within the ICU., (© 2024 British Association of Critical Care Nurses.)

The provision of modern health care in the United States faces significant challenges, as evidenced by multiple national reports of a workforce in distress. In response to these challenges, the practice of coaching emerges as a transformative skill, recommended for individuals in high-stress environments. Coaching in health care focuses on developing nurses and building teams by fostering self-understanding, deploying strengths, improving relational strategies, and gaining moral clarity. It serves as a potent strategy for nurse leaders to navigate the complexities of their systems. This paper explores the practice of coaching as an important mindset and skill. A coaching mindset is characterized by trust, deep listening, curiosity, embracing both/and thinking, discernment over judgment, and fosters an environment where nurses can flourish. It promotes a shift from telling to asking, empowering individuals to contribute innovative ideas and solutions. Additionally, the paper provides guidance for coaching and tools for maintaining a coaching mindset in the face of chronic stress. By fostering a coaching mindset, employing powerful questions, and using tools to sustain emotional integrity, leaders can empower nurses to thrive in complexity, enhance workplace well-being, and contribute to a resilient health care culture., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

This review demonstrates the impact of The DAISY Award and how meaningful recognition (MR) through gratitude affects nurse engagement, healthy work environments (HWEs), and patient/families' (PFs) experiences. MR has mutual benefits for nurses and PFs, promoting therapeutic healing and resiliency. MR in HWEs can impact organizations' care quality, fiscal health and influence public perceptions. Nurse leaders should create an environment where MR is a core strategic imperative that impacts nurse, patient, and organizational outcomes., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: In the rapidly evolving healthcare landscape, the capacity to foster innovative work behavior among nurses is increasingly important. This study examined the dynamics between inclusive leadership, psychological safety, collectivism, and innovative work behavior among nurses., Design: The study used a cross-sectional, correlational design., Methods: This study utilized data from 730 medical-surgical nurses who provided direct care to patients. Standardized instruments were used to assess key study variables. Statistical analyses, including moderated mediation regressions, were employed to investigate the complex interplay among these variables., Results: We found a positive association between inclusive leadership and innovative work behavior, and psychological safety mediated this relationship. Collectivism moderated inclusive leadership's direct relationship with psychological safety and its indirect relationship with innovative work behavior. The results revealed that nurses with lower levels of collectivism were more responsive to their managers' inclusive behaviors, strengthening the relation between inclusive leadership, psychological safety, and innovative work behavior., Conclusion: Our findings suggest that promoting inclusive leadership behaviors among nurse managers to create a psychologically safe environment can motivate nurses to engage in innovative work behavior. However, it is also important to understand that the effectiveness of leadership may differ depending on the collectivist values of individual nurses., Clinical Relevance: Nurse managers should adopt inclusive leadership behaviors, such as valuing trust, open communication, and diversity, in order to foster psychological safety and innovative work behavior among nurses., (© 2024 Sigma Theta Tau International.)

Introduction: Ageist attitudes negatively affect the quality of care for service users and the working conditions of older nursing staff. Clinical leaders' perceptions of older service users and nursing staff are unknown., Aim: To map research evidence on ageist attitudes in healthcare towards service users and older nursing staff, from the leadership perspective., Material and Methods: A systematic mapping review with database searches in March 2021 and May 2023). Nineteen articles (qualitative n = 13, quantitative n = 3, mixed methods n = 3) were analysed and mapped to the Nurse Executive Capability Framework., Results: Future planning, team building, and self-awareness are leadership categories requiring consideration. Guidelines and policies addressing the holistic needs of older service users and older nursing staff are lacking., Conclusions: Organizational planning, team building, and self-awareness are crucial for the holistic care of older service users and for creating attractive workplaces for older nursing staff., Competing Interests: Declaration of competing interest None of the authors have any competing interests to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

To identify the relationship between leadership and work readiness in a cohort of new head nurses in China. This cross-sectional study enrolled 225 newly appointed head nurses in public tertiary hospitals in China, which were selected using convenience sampling. Data were collected using online questionnaires that included a sociodemographic characteristics form, the Nursing Managers Leadership Scale (NMLS), and the New Nurse Leaders' Job Readiness Scale (NNLJRS). IBM SPSS v.25 was used for statistical analysis. The overall mean scores of NMLS (100.50 ± 17.64) and NNLJRS (111.90 ± 15.84) of the 225 new nurse leaders were at moderate levels. The results of the Pearson correlation analysis and the hierarchical regression analysis further indicated that there was a significant positive correlation between leadership and work readiness of new head nurses (r = 0.85, P < .001), as well as charisma (β = 0.19, P < .01), affinity (β = 0.18, P < .01), coordination ability (β = 0.32, P < .01), and motivational ability (β = 0.21, P < .01) in leadership were found to be positively associated with work readiness. This study found that the leadership and work readiness of the new head nurses still needed improvement. A significant relationship was found between these 2 variables, and charisma, affinity, coordination ability, and motivational ability in the leadership ability of the new head nurses facilitated the level of work readiness. Nursing administration should create a leadership development series program focusing on the development of charisma, affinity, coordination ability, and motivational ability to support the work readiness of new nurse managers and help them with role transition., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)