Factors Influencing New RNs’ Supervisory Performance in Long-Term Care Facilities

Abstract

In long-term care facilities (LTCF), registered nurses (RNs) perform both clinical and supervisory roles as part of a team aiming to provide high-quality care to residents. The residents have several co-morbidities and complex care needs. Unfortunately, new RNs receive minimal preparation in gerontology and supervisory experience during their program, leading to low retention rates and affecting resident outcomes. This qualitative study explored factors that influence supervisory performance of new RNs in LTCF from the perspective of 24 participants from Ontario, Canada. Data were collected through individual interviews, followed by a directed content analysis. Three levels of influences were identified: personal influences, organizational influences, and external influences. Each level presented with sub-elements, further describing the factors that impact the supervisory performance of the new RN. To retain new RNs in LTC, organizations must provide additional gerontological education and mentoring for new RNs to flourish in their supervisory roles.

Unpacking the multiple dimensions and levels of responsibility of the charge nurse role in long‐term care facilities

“…In contrast to previous studies focusing on the RNs' supervisory skills and the difficulties they experienced as supervisors (McGilton et al, ; Prentice et al, ), findings from this study revealed the multiple additional responsibilities RNs hold as charge nurses in LTCFs. The role of the charge nurse in LTCFs is essential to patient safety, workforce organisation and regulatory compliance.…”

“…There should be an acknowledgement that a certain level of experience is required to meet the demands placed upon charge nurses by the multiple dimensions and responsibilities of this role. We may be setting charge nurses up for failure and jeopardising their health by recruiting new graduates for this role, which may lead to deleterious effects on resident outcomes (Prentice et al, ), the work environment and staff outcomes (Escrig‐Pinol et al, ).…”

“…All project data were collected in 2015, including the subset of data used for this study (i.e., interviews with RNs). Further details on the project's background and methodology are included in recent publications (Escrig‐Pinol, Corazzini, Blodgett, Chu, & McGilton, ; Prentice et al, ).…”

“…In Canada, Registered Nurses (RNs) in LTCFs act as supervisors who oversee the health care team, consisting of personal support workers (PSWs) and registered practical nurses (RPNs), and are commonly referred to as charge nurses (Chu et al, ). The charge nurse in LTCFs typically conducts resident assessments; is involved in resident care planning, medication administration and provision of care, supervises the health care team and communicates with residents and their families (Prentice et al, ). As team leads, charge nurses are also integral to setting the tone for the work culture of the LTCF (Chu et al, ; Corazzini et al, ).…”

“…In acute care, charge nurses often focus on clinical leadership (Sherman et al, ) and are not promoted into the charge nurse role until excellence in clinical practice has been established. In LTCFs, new RN graduates are often placed in charge nurse positions once they are hired (Prentice et al, ). In long‐term care (LTC), delegation by the charge nurse is the mechanism by which the RPNs and PSWs provide a majority of the direct care to residents, in contrast to RNs in acute care (Corazzini et al, ).…”