Nurses’ Experiences of Managing and Management in a Critical Care Unit

Abstract

In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem.

Understanding how nurse managers see their role in supporting ICU nurse well‐being—A case study

“…Although NMs in this study mentioned strategies to support nurse well‐being, many felt powerless and unable to make changes. Similar to the findings in this current study, other studies have described how NMs see themselves in an inferior position, lacking the influence, autonomy and confidence to participate in strategic planning (Labrague, McEnroe‐Petitte, Leocadio, Van Bogaert, & Cummings, ; Ogle & Glass, ; Paliadelis, ). Lack of autonomy may be linked to NMs poor academic qualifications, upper management's unclear understanding of the NM role or a lack of trust in NMs ability to make decisions (Brown, Fraser, Wong, Muise, & Cummings, ; Hewko, Brown, Fraser, Wong, & Cummings, ; Roche, Duffield, Dimitrelis, & Frew, ).…”

“…The quality of NMs' leadership behaviours has shown to influence nurses' levels of satisfaction (Lu, Zhao, & While, ; Press Ganey, ) and intentions to remain in their position (Cowden, Cummings, & Profetto‐Mcgrath, ; Roche, Duffield, Dimitrelis, & Frew, ; Sawatzky et al, ). It is, therefore, concerning when nurses do not feel supported by their NM (Johnson & Rea, ; Moloney, Boxall, Parsons, & Sheridan, ; Morsiani, Bagnasco, & Sasso, ; Ogle & Glass, ; Rouse, ). Although recent research suggests progress in the perceptions of NMs' competencies related to communication, collaboration, recognition and leadership skills (Ulrich et al, ), there is still much room for improvement in this area.…”

Nurses’ professional dignity in private health care: a descriptive phenomenological study

“…Nurses’ autonomous practice is not negotiable because it represents their dignity and professional standing (Sabatino et al 2014). Without that, they become inferior and subservient to other health team members (Ogle et al 2014), unable to care for patients to their full potential as dignified and professional persons.…”

Competências gerenciais de coordenadoras de cursos de graduação em enfermagem

“…To meet the demands of a globalized world, institutions (1)(2) require a professional profile that is in constant development, able to keep up with technological innovations, being resolutive, proactive and easy for negotiation. Healthcare organizations, specifically, have experienced an economic crisis that demands efficient management, in general, under the responsibility of nurses.…”

“…Thus, professional competence are at the management level that will enable individuals to play roles within the institutions, generating results, recognized and legitimized by themselves and by other social actors with which their work takes place (15) . In addition to these facts, we may cite other facts found in the literature related to nursing professional, such as modelling the workforce (2) , well-being and job satisfaction (16)(17)(18) , occupational stress (2,(20)(21)(22)(23) , Burnout Syndrome (2,(16)(17)19,21) , occupational fatigue (22) and violence at work (2) . Besides these, there are other complex issues and which occur during daily work as managing other professional categories within the health area and other categories (2,24) as well as the fact that other professionals are being managed by a nurse (2) .…”