Mitigating the Impact of Nurse Manager Large Spans of Control

Abstract

Nurse managers are instrumental in achievement of organizational and unit performance goals. Greater spans of control for managers are associated with decreased satisfaction and performance. An interprofessional team measured one organization's nurse manager span of control, providing administrative assistant support and transformational leadership development to nurse managers with the largest spans of control. Nurse manager satisfaction and transformational leadership competency significantly improved following the implementation of large span of control mitigation strategies.

Perceptions of the impact of introducing administrative support for nurse unit managers: A qualitative evaluation

“…Reports of two interventions from the UK (Locke et al, ) and the United States (Simpson et al, ) support the intent of the intervention reported in this paper. In a study evaluating the introduction of administrative assistants in the UK, ward managers reported a reduction in workload and greater job satisfaction (Locke et al, ).…”

“…Recommendations from the reviews included measures to reduce the bureaucratic administrative burden for the NUM role and the need for clinical leadership education and mentoring (Queensland Government, , ). The state‐wide review findings are not unique and are consistent nationally (Duffield et al, ; Gaskin, Ockerby, Smith, Russell, & O'Connell, ) and internationally (Gunawan et al, ; Loveridge, ; Simpson et al, ; Udod et al, ; Wong & Laschinger, ).…”

“…Nurse unit managers' accountabilities include quality patient care, staff satisfaction and retention, implementation of evidence-based practice, meeting budgetary requirements and execution of organisational change (ANMF, 2013; Gunawan & Aungsuroch, 2017;IOM, 2011). As the direct interface between health care executives and bedside nurses, NUMs play a pivotal role in supporting the achievement of positive health care and organisational outcomes (Gunawan, Aungsuroch, & Fisher, 2018;Simpson, Dearmon, & Graves, 2017;Wong, Cummings, & Ducharme, 2013). Due to health system reform and restructuring, technological advances, higher acuity and faster turnover of patients, budgetary restrictions and ageing populations, the health care environment has become more complex and demanding for nurse managers in the health care industry (Duffield, Kearin, Johnston, & Leonard, 2007;Udod, Cummings, Care, & Jenkins, 2017;Warshawsky, 2018).…”

“…Internationally, role stress and challenges faced by NUMs are reported in the United States (Jones, McLaughlin, Gebbens, & Terhorst, ; Loveridge, ; McCright, Pabico, & Roux, ; Nelson, ; Shirey, McDaniel, Ebright, Fisher, & Doebbeling, ; Simpson et al, ; Steege, Pinekenstein, Arsenault Knudsen, & Rainbow, ) and Canada (Brown, Fraser, Wong, Muise, & Cummings, ; Udod et al, ; Wong & Laschinger, ). This is further supported by studies from New Zealand (McCallin & Frankson, ), the UK (Locke et al, ; Rankin et al, ; Timmons, ) and wider Europe (Adriaenssens, Hamelink, & Van Bogaert, ; Tewes & Fischer, ).…”

“…In a study evaluating the introduction of administrative assistants in the UK, ward managers reported a reduction in workload and greater job satisfaction (Locke et al, ). Similarly, the introduction of administrative assistants for NUMs in the United States led to higher job satisfaction (Simpson et al, ). While the intervention reported in this paper was not informed by the work of Simpson et al () and Locke et al (), there are parallels in what they report as interventions and outcomes.…”