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Support for direct care by middle management
MATOUŠKOVÁ, Amalia
The thesis deals with the problematic of support of the direct nursing by middle management. Head nurses - middle-level managers are responsible for the quality of the provided nursing care, and therefore their interest is to lead their subordinate nurses in a way, that the quality of the nursing care is preserved or constantly improved and that not only by control activities or material security but mostly by support. The objective of the thesis was to find out how nurses perceive the support from middle management within ensuring good-quality direct nursing care. The objective was fulfilled using quantitative and qualitative methods. Quantitative part of the research was made up of 195 respondents. We have compiled the survey which was distributed to practical and general nurses. It was based on in advance laid down ten hypotheses which were connected with the objective of the thesis. At nine hypotheses was proven their validity and the last, tenth hypothesis was not confirmed. Qualitative part of the research was made up of interviews with seven head nurses which informed us about their view on support of the direct nursing care. The result of the research was finding that head nurses more use the control activity than the supporting one. Despite the fact, they consider the support to be sufficient. The greatest obstacle in the support by a head nurse is lack of motivation. The nurses would welcome having the option of feedback, further education and that the head nurse herself would participate in the direct care. From the perspective of management, we found out using which tools and ways they help subordinate nurses to improve the quality of the direct nursing care. Here they get to conflict of answers of subordinate nurses and head nurses. Head nurses think that they motivate their subordinate nurses, enable them to further educate themselves or if it is possible directly participate in the direct nursing care. They are convinced that subordinate nurses do not lack nothing special in the support and if they do it is probably understanding or their constant presence at the department. The output of the thesis is suggestion of recommendation for support of the direct nursing care by middle management which was made on the basis of analysis of the research.
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Psychological aspects of people management with a focus on leadership styles
Kuntová, Anna ; Vrzáček, Petr (advisor) ; Furmaníková, Lada (referee)
This diploma thesis deals with the psychological aspects of management focusing on the styles of leadership at the gynecological-obstetric department, specifically at the maternity hospital. The aim is to find out what kind of leadership is used by the senior and station nurses. This thesis explores how they interpret the management grid GRID and how they perceive themselves in terms of how midwives perform. For this research were choosen two hospitals, public and joint-stock company. That is why the objective was also to compare the interviews with midwives regarding their motivation, satisfaction and conflict occurance. Therefore the information was received that touched upon these topics and presented the perception of the workers in obstetrician. The theoretical part introduces the psychological aspects of leadership, so that the reader goes through chapters focusing on manager personality, management, leadership, work environment, work teams, motivation, workplace conflicts, stress, burnout syndrome, etc.. The empirical part is presented as part of the qualitative research, which presents the way of senior and station nurses with the help of the inspiration by design of the case study. Further a case study at the state hospital and a case study at joint-stock company are being developed with...
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Origin and Evolution of the Head Nurse Position
Chýšková, Eliška ; Marková, Eva (advisor) ; Heczková, Jana (referee)
The theme of the bachelor thesis "Origin and Evolution of the Head Nurse Position" is a more detailed description of the origin and development of the head nurse from the beginning of the position until present time. An integral part of the work is the beginnings of nursing in the monasteries that are related to origins of the position. Historical development is divided from the beginning of the 19th century until World War II, then through the development of post war years until today, when the view of the head nurse role is mainly in the mid-level manager. The head nurse leads the clinic or department and is responsible for planning and professional growth of staff and evaluation of quality of care. It cannot be omitted the education of head nurses, which was influenced by the Act No. 20/1966 Coll., on the obligation of health professionals to continual education. Education is divided into undergraduate and postgraduate. In the practical part, there are discussed in more detail the main goals of the thesis, that is the analysis of the work of head nurse and education of the head staff since the beginning of the 20th century, by one of the methods of qualitative analysis in the form of analysis of written documents. The goal was to find out the content of the work of head nurse in the changes of...
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The role of a medical nurse in the hospital department's run
KRÁLOVÁ, Mirlinda
This bachelor thesis is focused on a role of a ward nurse during the performance of a ward. The focus is on specifics of the ward nurse's work, the pre-qualifications before obtaining this job and way how ward nurse solves conflicts on the ward in particular. The current ward nurse's work includes mainly administrative work, medical team leadership and responsibility for the performance of the whole wards and the quality of treatment. Ward sister is the first manager line. The theoretical part of this thesis deals with history of nursing; the main task of nursing, which is the complexity and systematic work to satisfy biological, psychological, social and spiritual needs of a treated person. Next, it is focused on the profession of a general nurse and the nurse's role. The largest part is dedicated to a ward nurse, who is a leading worker of whole nursing unit and is a direct subordinate to the nurse in charge. This nurse performs a highly specialized nursing care, organizes and does directive activity. A ward nurse leads her own nursing team. Furthermore, it is necessary to mention the chapter of Presumptions of ward nurse and her manager skills, which contains sub-chapters dealing with organizing, controlling and leading, planning, checks and time management. The necessary part is also a chapter dealing with communication. Communication plays an important role in lives of many people. A ward sister applies this several times; because it is a key part of her occupation and it belongs to her most important attributes. For this bachelor thesis, there were three aims set: 1. Find out the specifics of ward nurse's work. 2. Find out how a ward nurse solve conflicts in her work environment. 3. Find out the presumptions for a ward nurse's performance. Three research questions were asked: 1. What are the specific features of a ward nurse? 2. What ways does a ward nurse use to solve work-place conflicts? 3. What skills does a nurse need to become a ward nurse? The empiric part of this thesis is worked out in a quantitative method, in a form of half-structured dialogue. The dialogue was carried out based on pre-prepared questions with 8 ward nurses. Of those eight, four ward nurses were 4 from surgical fields and four from intern fields. During the analyses a method "paper and pencil" was used. Processed results were divided into categories and subsequently into sub-categories. To summarize, it is possible to say, that to be nominated as a ward nurse, it is suitable to have not only a long experience and practical knowledge, but also in respect to the medical development and the health a university degree is suitable or a particular field specialization. During conflict solution at the ward, it would be suitable to involve or at least inform the nurse in charge, even if it is "only" a staff problem. This way some misunderstandings can be avoided. The results show some imperfections in communication. This bachelor thesis might serve as a resource to prepare seminars for wards, which would concern conflict solving.
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Struktura pracovních a manažerských činností zdravotních sester v řídících funkcích
Kotrba, Tomáš
Thesis deals with structure of working and managerial activities of department and head nurses in Czech hospitals. As the managers in the first line and middle level they have a huge influence on the total level and quality of nursing health care. Therefore their level of managerial activities is very important. The aim of the thesis is to create and apply a methodology of monitoring of the work structure independent on the founder, hospital size and department/clinic orientation. For these reasons, the author cooperated with the Faculty hospital of St. Anna in Brno, Faculty hospital Brno, Army hospital Brno, Faculty hospital Ostrava, Hospital Trebic and Hospital Znojmo. There is used auto screening method, in the thesis. Measurements were proceeded for all department nurses and head nurses in Hospital Znojmo and Army hospital Brno. In order to achieve the aim of the thesis there were used the above-mentioned auto screening method and analysis of internal hospital documents, questionnaire research and interviews. The questionnaires were filled-in before beginning the auto screening and they investigated own estimation of working time consumptions of department and head nurses. Results were compared with statistical results of auto screening. The statistical results, proposals and recommendations were given to the deputy-managers for health care. In praxis we can often hear the statement, that nurses in the Czech Republic are overloaded with administrative tasks. The analysis of structure of working and managerial activities should either confirm or falsify this statement. The hypotheses were postulated to confirm or falsify correlation of variable load of administrative/managerial activities with the variables number of subordinates, total length of health care praxis or praxis in a managerial function.
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Working strategies of nurses on manager posts
MARKOVÁ, Eva
The thesis "Working strategies of nurses on manager posts" deals with issues of the professional role and manager position of a head nurse. With regard to changes in the area of health policy and health care providing, as well as is the relationship with the issue of professional fulfilment of women on the labour market generally, it is important to know views, ambitions, and motivations of nurses, and their working strategies on managing positions. It includes aspects of harmonizing their family and work roles, as these are the moments determining the position of most women in our working conditions to a significant extent. It is to say, managing of the nursing personnel and health care is a typical feminine position in the Czech Republic, adapting to given rules of the work organization and hierarchical structure of health institutions. The purpose of the thesis is to outline such a frame of reference, which would enable to better understand values and attitudes of head nurses. An indispensable part of this outlook is to understand, how their carriers developed, to identify their managing styles and guiding of the nursing team, as well as to map how their personal and professional roles pervade and affect each other. In this process, revealing long-term working strategies of head nurses is an important source of knowledge and at the same time, an attitudinal reflexion of these contexts by nurses themselves. Therefore, the development of the role of a nurse - manager (specifically, the head nurse and the ward sister) was described as the first item in the framework of the professional live of managing nurses; and conclusions of a series of research studies, focused on these issues, were presented. Additionally, the specificity of management in the nursing conditions was analyzed, including changes after 1989, and possibilities of education of nurses - managers. Finally, an empiric probe into the explored points at issue was carried out. Data acquired by means of semi-structured interviews with selected head nurses in faculty hospitals were integrated with the help of one of classical approaches, through so-called Grounded theory method. On basis of the data analysis, a model of professional paradigm was created, demonstrating several phases of the professional career, through which a head nurse passes, which were called for illustration: Seeking of domain, Circle (changing of nursing lines and sites), Virtue of necessity (situation, where a nurse caring of a child chooses a workplace, which enables such care), and Anchoring in the nursing branch. Then, the manager's career of the nurse unwinds form the "Anchoring in the nursing branch" phase. Life stories of head nurses, built on information from qualitative interviews, include predisposing factors for a managing position. Last but not least, it is also about some imprinting aspects from the childhood and adolescence (e.g., number of siblings, reasons for the selected study). After certain time, a nurse becomes a shift leader and a deputy ward sister, and subsequently, a ward sister and a head nurse. According to circumstances, she uses a combination of several managing styles in this position, like authoritative, democratic, and consultative. The theoretical model of professional paradigm of head nurses, construed on basis of empiric data analyses, opens a trail for further investigations, where it may be possible to examine some consequences in more detail, like the course of the professional career of nurses, their managing styles, etc. The acquired and classified evidences contribute to enriching current state of knowledge of certain segments of nursing issues. For instance, the top management of health institutions may use them in planning and implementation of some policies in the area of human resources, or educational institutions may use it for better and more accurate setting of educational concepts of future head nurses.
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Effect of middle management in nursing quality of nursing care
FLANDEROVÁ, Hana
The subject of this thesis is called ?The influence of the middle nursing management on the nursing care quality?. The theoretical part focuses on head nurses, their preferred characteristics, skills, competencies, leadership styles and the way of implementing changes. The component of the theoretical part is also a description of the nursing care quality, and some ways how to achieve it. The practical part focuses on the influence of head nurses on the nursing care quality. For the processing the thesis has been used the combination of both qualitative and quantitative surveys. Our inquiry was conducted in the South-Bohemian hospitals and head nurses were the respondents. During the questioning survey and interviews we have managed to achieve all our pre-defined targets. Through the interviews we have managed to answer all given research questions. We found that all interviewed head nurses have the professional knowledge of the nursing management field. We identified ways of implementing changes to enhance the nursing care quality in practice. The head nurses stated, that nurses accept these changes after a presentation of professional arguments, and that the head nurses are led and supported during the introduction of the changes by top management. The head nurses, interviewed by us, believe that the adoption of changes to enhance the nursing care quality will help to increase the prestige of nursing and support the independence of this field. Based on the evaluation results of the survey we have identified the reluctance of nurses to learn new things as the most common problem in the implementation of changes.
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Changes of the attitude of a nurse towards the nursing care after his/her ranging to a higher position.
PROCHÁZKOVÁ, Marie
The Thesis deals with a change of an approach of a nurse to nursing care provision after her promotion to a managerial position. A nurse appointed to the position of charge or head nurse has different responsibilities, she becomes a manager, her colleagues have suddenly become her subordinates, whose work she has to organize, lead and control. A wide range of new responsibilities might change her approach to provision of nursing care. The aim of the Thesis was to discover whether and how the approach of a nurse to nursing care changes when she is appointed to a managerial position and how a nurse promoted to a managerial position achieves authority among her subordinates. The following hypotheses were chosen in relation to the aims of the Thesis. Hypothesis 1: The approach of a nurse to nursing care changes after being promoted to a managerial position. Hypothesis 2: A nurse promoted to a managerial position requires provision of nursing care in line with nursing standards. Hypothesis 3: A nurse promoted to a managerial position is responsible for nursing care quality. Further research questions were put: 1. Is it difficult for a nurse promoted to a managerial position to achieve authority among senior nurses? 2. Is it difficult for a nurse promoted to a managerial position to control nursing care provided by shift nurses? 3. Is it easier for a nurse promoted to a managerial position to organize work for shift nurses she did not work with before? Quantitative research in the form of questionnaires was applied to confirmation or refutation of the hypotheses. The research sample consisted of head and charge nurses from South Bohemian hospitals and from hospitals in Příbram and Pelhřimov. Qualitative research was organized in the form of unstructured interviews with head nurses from Hospital České Budějovice. After evaluation of the results all the three hypotheses showed confirmed. The research results confirm that an approach of a nurse changes after their promotion to a managerial position. They are much more responsible for quality work among her subordinates. The results of the work will be presented at all-house seminars and conferences and published in a specialized journal. The results will also be provided to the hospital management {--} to the Nursing Care Manager {--} and finally to the respondents involved in the research.
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Contribution of sisters and ward sisters to the nursing care quality
NEKLOVÁ, Lenka
This degree work concerns the role of sisters and ward sisters and their share in the nursing care quality. The theoretical part of the work is divided into three sections. Section one presents sisters and ward sisters as active members of the nursing management. Section two deals with the managements functions of the sister staff and their impact on the nursing care quality. Section three reviews the basic issues of the nursing care quality. The purpose of section one was to review the scope of activities of sisters and ward sisters with respect to the nursing care quality. The purpose of section two was to identify the key difficulties preventing sisters and wards sisters from increasing the nursing care quality. The purpose of section three was to analyse the working relationships between sisters and ward sisters with respect to the nursing care quality. While mapping out the situation in the selected hospital (the Faculty Hospital in Plzeň), we asked the following six research questions: 1. What are the areas where the hospital sisters may affect the nursing care quality? 2. What obstacles the sisters can see preventing them from taking part in continuous improvements in the nursing care quality? 3. How do the hospital sisters co-operate with the respective ward sisters concerning the nursing care quality? 4. What are the areas where the ward sisters may affect the nursing care quality? 5. Are there any obstacles preventing the ward sisters from taking part in continuous improvements in the nursing care quality? 5. How do the ward sisters co-operate with the respective sisters concerning the nursing care quality? The questions were asked during informal discussions with ten sisters and ten wards sisters at the Faculty Hospital in Plzeň. The information and data collected were processed using the framework analysis method whereby the answers to the research questions were derived. The research identified the following main problems preventing the hospital sisters and ward sisters from increasing the nursing care quality: inefficient time management on the side of ward sisters, insufficient competencies of ward sisters regarding staff remuneration, insufficient application of the existing nursing-care quality improvement tools by both sisters and ward sisters, limited engagement of the hospital sisters and ward sisters in creation of internal standard procedures, and reluctant attitudes of the hospital staff to changes. Based on the shortcomings identified through our research we have worked out proposals on practical improvements.
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