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Experience of health care managers with motivation, team leadership and build-up of the professional competence of their employees
MAREČKOVÁ, Tereza
Current state: The motivation of nursing staff is an integral part of the activities of nurse managers. Most of the time, work in the healthcare sector is very mentally and physically demanding for all medical staff, and especially for nursing staff, who are in closest contact with patients. Nurse managers should therefore be aware of the importance of staff motivation. All health workers have the obligation of lifelong learning, and therefore the head nurses should pay attention to the educational activities of the staff. The objective of the qualitative research was to describe the work motivation of nurses, in particular, the experience nurse managers have with team building activities and to map their role in the field of increasing the professional competence of their employees. The aim of the quantitative part of the study was to evaluate nurse satisfaction with the motivational program of the organization in which they work. Another goal was to find out if nurses are interested in team building activities. The final goal of the quantitative research was to evaluate nurse satisfaction with the employer's offer of lifelong learning. Methodology: A mixed qualitative and quantitative design was chosen for the research. The data collection for the qualitative research was carried out through semi-structured interviews with first and middle line nurse managers. The data intended for the quantitative research study were obtained using the technique of a non-standardized self-constructed questionnaire intended for shift nurses. The research group of the qualitative part of the research survey was made up of 11 head nurses, and the research group of the quantitative part of the research survey was made up of 179 shift nurses. The research took place in two hospitals of the faculty and regional type in the period July-September 2022. Results: Nurse managers considered employee motivation to be an important and integral part of their work. Adequate financial remuneration of nurses was stated by the majority of nurse managers as the strongest motivating factor. Four fifths of the interviewed nurses were satisfied with their salary (81%). More than four-fifths of nurses were satisfied with the hospital incentive program (82.7%), and nurse satisfaction with the incentive program did not vary statistically significantly with their age (p=0.724). The head nurses had no experience with team building activities. More than a third of nurses (40.8%) were interested in participating in team building activities. Nurse willingness to participate in team building activities decreased with age (p <0.030). The head nurses stated that they try to motivate and support the nurses for further education. Among the obstacles preventing further education of nurses, they included fatigue associated with a lack of staff, as well as lack of time and lack of interest of nurses in further education. More than three quarters of nurses (76%) were satisfied with the offer of lifelong learning offered by the employer. Nurse satisfaction with the employer's offer of lifelong learning increased significantly with the applicability of newly acquired knowledge in clinical practice (p <0.001). Conclusion: The level of relationships at the workplace is related to the satisfaction and motivation of the staff, and the associated effective communication in the team. Nurse managers should therefore pay attention to the development of positive relationships at the workplace and the cooperation of individual team members. One of the possibilities of working with teams can be, for example, team building. If we want educated nursing staff in hospitals who are continuously educated, it is necessary for them to be supported in further education by senior staff and the organization.
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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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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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Application of the Nursing Care Research Results into Practice {--} the Role of Head Nurses
NETOLICKÁ, Jana
One of the key factors influencing the quality of nursing care practice is the research applied within nursing processes. Therefore it is vital for theory to be closely linked with practice. To perform research and apply its results in practice is one of the conditions which lead to the development of evidence-based practice. Research applied in nursing care is a key strategy resulting into the unification of the human educational and scientific aspects of nursing care. This thesis focuses on the nursing care research and its application in practice together with the role of senior nurses within this process. The aim was to investigate whether and how the nurses are actually involved in nursing care research plus to examine whether ordinary nurses are willing to accept any changes associated with the introduction of the results of nursing care research into nursing practice. Besides this, also to determine whether nurses are encouraged to implement the results of nursing research into nursing practice, to observe nursing care deputies and leading nurses experience in respect to the implementation of the nursing care research results into practice in different types of hospitals plus to determine whether and how nurses introduce the results of nursing care research into practice. The final objective of this thesis was to determine whether the head nurses manage to introduce the results of the nursing care research into their nursing practice. In quantitative survey performed, the research sample consisted of nurses who work in inpatient departments at clinics and regional hospitals - public limited companies of the Central, South, West Bohemia, and Prague. 350 questionnaires were distributed. The research involved 186 questionnaires. Qualitative research data collection involved 12 respondents, out of which there were 3 head sisters employed at clinics and 3 nursing care deputies plus 3 head nurses from regional hospitals - public limited companies. All interviews were entirely anonymous. According to the survey findings, most of the nurses replied that they are not actively involved in the nursing care research. Nurses generally follow published results of nursing care research, but on the other hand, it is obvious, that they follow nursing care research outcomes randomly and without particular focus. Nurses not only that they refuse any changes, but they do not see any benefits of the implementation of research findings into the nursing care practice. The qualitative survey performed met objectives and all questions were answered. Any of the responses can serve for further quantitative research, especially when the results of the implementation of the nursing care research into practice at clinics and regional hospitals are compared.
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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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Requirements for changes in nursing care on the part of top management
PŘIBYLOVÁ, Kateřina
Requirements for changes in nursing care on the part of top management Abstract At present, nursing care has been experiencing a great progress. Implementation of the nursing process as a working method has been striven for. The educational system for non-medical workers has been changing. Nurses holding top managerial posts should have competence to lead and manage people effectively in the ever changing nursing environment. To acquire information necessary for achievement of the set goals, a quantitative research was employed. Within the framework of the quantitative research, the questioning method using a questionnaire was selected. The questionnaires concerned were sent to top managers among nurses and doctors working in medical centres all over the Czech Republic. The thesis had three objectives defined. First, to discover what prerequisites top managers miss to be able to implement the changes concerned in the area of nursing care. Second, to discover top managers´ opinions on the system of nursing care provision. Third, to identify differences between requirements for the nursing process method on the part of top managers {--} nurses and top managers {--} doctors. Based on these objectives, four hypotheses were formulated. The hypothesis no. I: The current situation does not allow top managers operating in health service to implement changes in nursing care in practice. This hypothesis has been confirmed. The hypothesis no. 2: Top managers do not require group nursing care as a prerequisite for the implementation of nursing care changes. This hypothesis has not been confirmed. The hypothesis no. III: Representatives of nurses in managerial posts promote the nursing process application as a prerequisite for changes concerning nursing care. This hypothesis has been confirmed. The hypothesis no. IV: Representatives of medicine doctors in managerial posts do not promote the nursing process application as a method of nurses´ work. This hypothesis has not been confirmed. As far as the results of this diploma thesis are concerned, we were trying to outline possible solutions of the issues concerning changes in nursing care. Top managers are recommended to stimulate critical thinking in their employees in the course of work in the nursing process. It is beneficial to improve communication on the managerial level in hospitals, and in addition, to obtain feedback from subordinates with respect to continuing education, to identify effectiveness and needs relating to education on the part of employees and to enable them to participate in the process of the respective changes implementation. To train function nurses in such changes management. To implement a programme aiming at continual quality improvement.
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