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Head nurses' perceptions of their roles Baxter, Elaine Marilyn


The purpose of this study was to explore head nurses' perceptions of their roles. The head nurse is in a crucial position of management in a nursing department, acting as a link between upper management and the work group. It is the head nurse who sets the standards and directions for nursing practice on a nursing unit and who manages the staff delivering care. Owing to the decentralization of managerial decisions in many nursing organizations and the change from functional to primary nursing in the care delivery systems, the head nurse's role has changed considerably. Despite this, research into the work of head nurses has been limited and based largely on the perception of others such as staff nurses and directors of nursing. An exploratory, descriptive research design was used to collect and to analyze data. Data collection was based on semi-structured interviews using Mintzberg's framework of ten managerial roles. The procedure of content analysis was used to analyze the data. The findings showed that the head nurses were able to describe their work within the context of each of the 10 managerial roles described by Mintzberg. Roles which were more familiar to them were those of monitor, disseminator, entrepreneur, disturbance handler, resource allocator, leader, and liaison. Roles that were less familiar were those of spokesman, negotiator, and figurehead. Mintzberg's framework was useful as a basis for describing the head nurse position and identifying areas of future development for head nurses. Several general themes were identified from the findings of the study. First, many of the activities of the head nurse in the manager position are unstructured and informal but nonetheless effective. Second, there is a variation in emphasis among roles depending upon the skill of the manager and the situational requirements. Third, the ability of the head nurse to see the whole organization from a systems perspective may require development in future. Finally, head nurses favour a highly participative management perspective, encouraging staff involvement in many ways. The two roles that were particularly significant for head nurses were those of leader and resource allocator. The leader role enabled the head nurse to set directions for the nursing" unit and create an environment in which staff were motivated. The resource allocator role was one which focussed the head nurses' attention on the staff, equipment, and supplies available to the nursing unit. The importance of the resource allocator role may have increased over the past few years, since scarce financial resources have become the boundary for many decisions on nursing units. The knowledge about the behaviours described by the subjects in this study may provide information to improve the educational preparation necessary for the head nurse position. As well, increased understanding about the managerial roles should enable head nurses to facilitate the provision of high quality patient care.

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