AONE Funded Research Study The Nursing Leadership Institute Building our Nursing Leadership Bench Strength: What will it take to interest Younger Nurses in Nursing Leadership Positions? AONE Funded Research Study The Nursing Leadership Institute Christine E. Lynn College of Nursing © December 2003

The Research Question What are the factors that influence the decisions of Younger Registered Nurses to consider or reject Nursing Leadership Positions?

Background of the Study “I really worry about who will take our nursing leadership positions when we retire – so few of my younger nurses are interested in Nursing Leadership” – Nurse Manager Interviewed in 2002 NLI Study Enrollments in Masters Programs designed to prepare Nursing Leaders have steadily declined over the past two decades. Most Current Nursing Leaders are Baby Boomers – literature suggests upcoming generations have different values and ideas in the workplace with no specific research on nursing leadership.

Study Methodology Designed as a qualitative study using a ConCensus ™ process approach to collecting the themes and factors of importance to participants. Nine Questions were asked – NLI Advisory Members participated in the design of the questions. Three Focus Groups were held between June and September of 2003 with 48 Registered Nurses not currently in formal leadership positions born after 1960 who volunteered to participate in the study and signed consents.

The ConCensus ™ Process All Participants have an opportunity to identify the factors in response to each question. The Process does not begin until all factors considered important by participants in answer to that question have been identified. Participants vote on the importance of each factor in relation to every other factor identified. Factors are prioritized in relation to one another after the voting has concluded.

Step Two – Factors are Compared against each Other

Step 3 – A Summary Matrix is Formed

Analysis of the Data The Findings on each question from the three focus groups were merged and sorted. Some Factors identified were the same between the three groups and others were similar but slightly different. The Investigator and the ConCensus ™ facilitators worked together to group the factors into thematic categories. Every Factor received a 1-10 weight based upon the ranking received by the group. Thematic categories were averaged and sorted from highest to lowest ranking.

Demographics of our Study Participants

Age of Our Participants Group # # Participants Median Age Average Age One 17 36 34 Two 21 31 33.1 Three 10 32 32.3  

Highest Level of Nursing Education of our Participants Group # ADN Diploma BSN MSN One 7 1 8 Two 10 Three 4 3

Years of Experience in Nursing Group Median Average One 8 7.1 Two 5 6.3 Three 7.5

Other Demographics 48 Participants – 4 Male, 44 Females Leadership as a Long Term Professional Career Goal – 6 Participants (12 ½ % of total Sample)

Clinical Areas of Employment Critical Care – 12 Cath Lab – 2 ER – 4 Oncology – 1 Telemetry – 6 NICU – 1 Med Surg –12 Public Health – 3 OR – 4 Maternal Child – 1 Rehab – 1 Wound Care - 1

Healthcare Agencies whose Staff Participated Bethesda Memorial Hospital Boca Raton Community Hospital Holy Cross Hospital Good Samaritan Hospital Jackson Memorial Hospital JFK Medical Center Jupiter Medical Center

Healthcare Agencies whose Staff Participated Martin Memorial Hospital Memorial Hospital – Pembroke Pines Palm Beach County Health Department Palm Beach Gardens Medical Center St Lucie Medical Center VA Medical Center West Boca Medical Center

What are the Major Role Responsibilities of Nursing Leaders Today? Providing a Safe Environment Staffing Supervisor as a Resource to Staff Motivation Delegation of Patient Care Responsibilities 6. Educator 7. Providing Mentorship 8. Organizing Unit 9. Outside Liaison 10. Managing Administrative Issues 11. Managing the Budget

What Feedback do you hear about Nursing Leadership Positions from Current Nursing Leaders? Stressful The Power of Administration Unrealistic Expectations Budget Constraints Lots of Responsibilities 6. Too Much Paperwork 7. Long Hours for not much Money 8. Time Consuming – Work –Life Balance 9. Lack of Support from Peers 10. Lack of Job Security

What Incentives would be there for You in a Nursing Leadership Position? Make a Difference Personal Growth Experience Money Being a Mentor Status Schedule

Nursing Leadership Advisory Board – December 4th. 2003

What would you fear most about taking a Nursing Leadership Position? Compensation Lack of Control Too much Responsibility Lack of Support Work-Life Stresses Pleasing Everybody Fear of Failure Job Security Loss of Clinical Skills

Nursing Leadership Advisory Board – December 4th. 2003

What would the Ideal Nursing Role Look Like? Cohesive Administrative Team Cohesive, Competent & Available Staff Better Nurse-Patient Ratios Ability to Serve as a Mentor to other Nurses True Power Delegated from Administration Budget Control Perks and Compensation Positive Staff Interactions & Attitudes Less Pressure

What Essential Values are needed to Ground the Practice of Nursing Leadership? Ethics Empathy Trust Professionalism Experience Patience Education Respect

What Contributions could you make in a Nursing Leadership Role? Provide Support for Staff Foster Cooperation Initiator of Ideas for Change Be a Good Role Model Self-Motivated Provide Vision Bring my Experience to the Role Charisma

Nursing Leadership Advisory Board – December 4th. 2003

What Type of Support would you need to move into a Nursing Leadership Position? Mentorship Administrative Support Education Self-Confidence Staff Support Family Support Eliminate the Barriers to Moving Up

What Qualities would you look for in a Mentor? Honesty Trust Organizational Skills/Competence Teaching Skills Supportive 6. Experience 7. Patience 8. Encouraging 9. Access to Resources 10. Education

Major Overall Themes Potential in the Role to make a Difference for Patients and Staff A Need for True Power in the Role Compensation and Perks are Important. Mentoring and Education are critical to a Successful Transition. Current Messages being sent about Nursing Leadership Positions are not positive.

Implications for Growing our Future Nursing Leaders Our Younger Nurses do see the potential power of Nursing Leaders to have impact on patient care and the work environments of staff. The Rewards of “Stepping up to the Plate” to Nursing Leadership Positions need to be revisited by organizations. The Decision Making Power and Control of Nursing Leaders in Organizations and how this is perceived by staff has impact on recruitment to leadership positions. Younger Nurses see Education & Mentorship as a critical part of a role transition to a Leadership Position.

Other Considerations for Nursing Leaders What Messages do we send in our everyday discussions with staff about the role of Nursing Leaders in our Organization? Different Generations have different values and these values impact career decisions.

Special Thanks To the American Organization of Nurse Executives for providing the Grant Funding. To the 48 Wonderful Registered Nurses who came (almost all on their own time) to participate in the groups and share their ideas. To the Chief Nursing Officers for Encouraging their Nursing Staff to Participate. To Bob and Cheryl Schwartz of ConCensus ™ for your facilitation, ideas and support throughout this study.

For More Information Rose Sherman, EdD, RN, CNAA The Nursing Leadership Institute Christine E. Lynn College of Nursing www.fau.edu/nli Phone (561) 297-0055 E-Mail rsherman@fau.edu The Nursing Leadership Institute – Christine E. Lynn College of Nursing © Copyright 2003