The Nature of Leadership Style in Nursing Management - Research Paper Example

Qualitative Article Critique The Nature of Leadership Style in Nursing Management. Substantive Aspect The research article ‘The Nature of Leadership style in Nursing Management’ by John Azaare and Janet Gross (2011) addresses the problem of leadership among the nurse managers, and how their leadership styles affect nurses and general operations of the health facility setting. The authors have adequately defined the problem as addressed in the research paper. Therefore, the purpose of the study is adequately stated and defined as identifying the style of leadership adopted by nurse leaders, the effectiveness of such leadership styles, and evaluating how different nurses react to such leadership styles in healthcare settings, are taken into account. The study is significant to nursing; it highlights problems in administration of healthcare facilities, and sensitizes nurse managers to adopt effective leadership styles that are evidence-based, and avoid styles that may demoralize the staff leading to low productivity. The significance of the study is to identify the nurse leadership styles in most developing nations such as Ghana, and how it affects the operations of healthcare facilities. The paradigm in use in the study is the naturalistic paradigm. In a naturalistic paradigm, there are a number of realities involved, which can only be studied holistically; they cannot be controlled, though a good level of understanding regarding these issues can be achieved (Polit & Beck, 2008). Similarly, in this research there are a number of factors at paly in determining the leadership styles of a nurse manager. Though some factors may not be controlled, a good level of understanding may be achieved making such managers to adopt better management techniques. The paradigm in use will thus offer the required answers to the research question. Research framework The authors employed a conceptual framework in the above study. This involves an overview of ideas and practices that shape how nurses and nurse managers relate in a health care facility, and the effects of such relationships in operations of such facilities. A conceptual framework attempts to connect all the aspects of an inquiry, in outlining possible causes of an action, or a preferred approach to an idea in question. This approach increases the value of the study in that by connecting all the aspects of an inquiry in determining nurse managers’ leadership styles, and the effectiveness of such leadership in nursing, the researchers indirectly bring out a certain preferred approach to the idea of nurse leadership. Such preferred approach would be a managerial style that increases nurse motivation while promoting cooperation between the nurse and nurse manager. The theoretical framework which involves citing of previous researches is well integrated throughout the research. Using such a framework in the qualitative research allows the researchers to have some grounds through which they critically examine similar issues regarding nurse managers in different locations. Ethical Aspects The research adequately observed all the ethical requirements, and exhausted the necessary approval and permission from authorities before carrying out the research. Such included obtaining permission from the relevant hospital authorities before carrying out the research, requesting the nurse to participate in the research willingly, well informed, and by not revealing the names of the respondents and the hospitals in which the research was carried out. However, the author did not take due diligence in protecting the nurses from harm. The research portrays the nurse leaders as harsh and people who use authority to suppress their subordinates. The nurses participating in the above research were outsourced from nursing units and wards in the two hospitals. All the respondents were directly under a nurse manager in these hospitals. Consequently, there were chances of such nurse being victimized by the nurse managers for portraying them in bad light; the nurses were well known, and no attempt to conceal their identity from such managers was evident from the research. Consequently, the nurses were prone to psychological discomfort, which may result from manager’s bullying. The researchers made no attempt to prevent this from happening. However, coercion was not used as a tool to ensure participation in this research. All nurses were sent letters and then explained verbally regarding their roles in the enter research, implying they were adequately informed regarding the research to make an informed choice pertaining such participation. The participants were also informed of their rights to withdraw from the research if they wished to. There was no coercion to participate in this study. The study procedures involved obtaining permission from supervisors before the interview, and then informing the nurses of their roles and rights to participate in the study, while the details remained anonymous. Literature Review The researchers provided a brief literature review with only a few previous studies used to elaborate on the research problem. However, the few studies employed in the literature review are in line with the research problem. For example, the authors use a study by Bondas (2006) who noted that not much has been invested in developing nursing leadership in Africa, particularly Ghana, which implies presence of leadership problems as the study illustrates. The authors use a study by Kane and Urrabazo (2006), which explains that leadership is done through effective role modeling and communication at all levels. This implies that with lack of effective leadership, service delivery would not be effective. All the same, the authors categorically state that there lacks clear studies on nurse leadership in Ghana to understand the research problem; though the researchers explain that nurse leadership in Ghana has been a problem for a long time. However, the authors do not cite any opposing study in laying out their literature review, but only focused on a few studies that further supplement the research problem regarding lack of effective nurse managers in Ghana. The research focuses on a few current research studies; Glasser & Strauss (1967) may be considered as a classical study as it lays down the principle behind data collection to reach a saturation point where no more valuable information may be added by the data collected (Azaare & Gross, 2011). Apart from this, the authors used three current studies on leadership in nursing, which include Kane–Urrabazo (2006), Bondas (2006) and Sellgren et al. (2006), all of which are related to leadership and the resulting impact of such leadership to employees. The authors in the entire paper use primary research findings only. However, the authors did not provide a brief summary at the end of the literature review. Methodological aspects The authors effectively outlined the research design employed in the research study. The research design utilized was a qualitative, explorative, and descriptive design, which was enhanced with flexibility so that new ideas could be considered as data was collected in the research process. The use of ethnography in the research, which refers to a study of social interactions, perceptions, and behaviors, occurring between groups, teams, or organized communities was used as the main qualitative approach in the research design (Reeves, Kuper & Hodges, 2008). Such an approach is articulate of the research question in that the research problem involves examining the leadership styles of nurse managers, how they interact with nurses and the perceptions that nurses have on such leaders, in addition to the effects of these perceptions on their daily operations. In this research paper, the authors were systematic in setting up and carrying out the study. The authors did indicate the structure in which all the events were carried out. These stages include designing the research, research setting, sampling, instrumentation and data collection and analysis. The steps were well organized and easy to follow. In selecting the participants, two hospitals were identified. The first was in the Eastern Ghana region with 64 nurses under a nurse manager, and the other one in central Ghana with 193 nurses under a manager all working in different units within the hospitals, which were operating for 24 hours. The researchers used the quota method to identify 20 nurses who were to participate in the research, all participants having the same characteristics. A participant was required to be a nurse, should have been in service in the particular hospital for a year or more, should be at post and was required to be at duty at the time of the research study. This method of selecting such participants was appropriate as it was closely correlated to the main research questions under investigation. The sampling procedures applied were consistent with the research design. The sampling procedure in identifying only the nurses under a nurse manager, those in service and had been working in similar circumstance for the previous one year were therefore appropriate in understudying their relationship with managers and observing their reactions and motivations at work. However, the sample size used in the research was not adequate for critical description of relationships between nurses and nurse managers, and how their relationships affect service delivery at healthcare facilities across the country. The use of 20 nurses to represent the entire nurse population in Ghana, considering the different conditions of working at different locations might not offer a holistic picture of the relationships in question. This is because, the representative sample is small and only taken in two distinct location s and not randomly spread within the county in question. In data collection, the authors clearly defined the data collection methods used in the study. The data collection methods involved an open-ended questionnaire in the first part, and then a semi-structured questionnaire was prepared for a face-to-face interview with the respondents. The interview reviewed and restricted elements from the questionnaire, which were used to form a semi-structured and open-ended questionnaire for a face-to-face interview. The use of ethnography to describe nurse –managers’ relationships involved use of data collections methods that facilitated the subjects to describe and bring out elements that define the problem in question, in addition to recording of observable elements during the interviewing stage. The data collection methods were therefore appropriate with the research question, and the research design. The only means of proving reliability and validity of the data collected was analyzing the data similarities to form themes, and carrying out a comparative analysis of the data to indicate the similarities and dissimilarities. Creating such themes was considered enough to portray reliability of data where several respondents indicated similar responses. Considering the research questions, and that an interview required 20 minutes per respondent, the interview duration was fair enough for the respondents to offer all the required answers to a good detail. In most cases, the quality of the responses and the interviewing questions are the main determinants of effective answers to a research question, and not the time taken to answer such questions. Interpretive Aspect Data analysis involved a process of thematic analysis in hermeneutics, a process defined by Leornard (1994). After processing the field work data, the data was categorized into themes. Statements were coded and categorized under each theme for analysis. In total, the researchers used four themes describing the nurse manager’s leadership approach, which ranged from non –consultative leadership to a “knee-jerk” type of leadership. The themes were then tabulated to enhance clarity. Ethnography was defined as a study of social interactions, behaviors, and p-perceptions that may occur within groups or teams. Therefore, using specific themes to define nurse manager’s leadership styles as stated by the nurse respondents was consistent with research design in ethnography that aims at establishing relationships among such working teams. Consequently, the findings adequately answered the research question and the research purpose. In other words, the study indicated that there were poor leadership approaches from nurse managers; they were harsh and authoritative and led to demotivation of the nurses, which in turn affected the effectiveness of such nurses in healthcare settings leading to low productivity. The nurse respondents as indicated under each theme in the data analysis provided sentiments that indicated poor managerial skills and approaches by nurse managers. Therefore, the research design was well structured to confirm to the research questions. The above findings were also reviewed in relation to previous studies. For example, a study by Morrison et al. (1997) reported that nurses preferred leaders to undertake more active leadership, and the study by Lindholm et al. (2000), which reported the use of transactional leadership in such healthcare facilities rather than the use of transformational leadership that would improve operations. Such authoritative leadership as the study indicates is due to the hierarchical management structures employed by these healthcare facilities. The findings that emerged from the data analysis were much similar to results reported by previous research studies. The main limitation in this study is that the results are only applicable to healthcare facilities without clearly defined roles of the nurse manager. In other words, in such institutions the choice of managers is not based on education and training, but on promotion, long service, or seniority. This means the managers may not have the required qualifications to occupy managerial positions in healthcare facilities. These limitations were effectively discussed. All the same, the researchers made a number of recommendations. These include that nurse managers have to be transformative leaders and not transactional leaders for them to have an important role in improving nursing. The researchers recommended further research to be carried out the same research questions to identify the level of job satisfaction experienced by nurses and its relationship to the quality of healthcare offered to patients. In addition, the authors recommended the nursing training institutions to develop curriculum specifically targeting nursing administrators, to equip them with effective and transformative managerial ideas. Therefore, considering all the sections of this research study, it was well written and organized to portray a detailed analysis of the different elements of a research study and determine areas of weaknesses and strengths. As a practicing nurse, the study is important in highlighting the various challenges involved in managing healthcare facilities, and how such management impacts on the nursing profession. The researchers used a simple language that is easy to understand, and a good structure that facilitates effective follow up on issues affecting nursing profession related to management of healthcare facilities. The results obtained are reliable enough to provide a rationale through which the managerial problem may be approached in nursing facilities. The researchers have critically used previous studies to authenticate their findings, which makes the research findings reliable for decision making in the nursing profession. Conclusion Azaare and Gross (2011) in their work titled “The Nature of Leadership style in Nursing Management” critically examine the relationship between nurses and nurse managers, and how this relationship affects service delivery in healthcare facilities. The use of interviews and questionnaires is a reliable approach that leads the researchers to obtain credible responses, which are then processed and arranged into themes to define nurse managers’ managerial approaches. The use of ethnography clearly brings out factors that are pertinent in the nurse-nurse manager interaction, which impacts on performance in healthcare facilities. Therefore, the research is a masterpiece through which decisions may be made to improve managerial approaches in healthcare facilities, leading to a better nurse and nurse manager relationship. Such improved relationships would lead to improved performance and service delivery in healthcare facilities. References Azaare, J., & Gross, J., (2011). The Nature of leadership style in nursing Management. British Journal of Nursing, 20(11), 672-680 Polit D.F., & Beck T.C., (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice, PA: Lippincott Williams & Wilkins. Reeves S., Kuper A., & Hodges D. B., (2008). Qualitative research methodologies: Ethnography, Biomedical Journal, 337. Retrieved from http://dx.doi.org/10.1136/bmj.a1020 Read More