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Nurses' views of shared leadership in ICU: A case study
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
2010 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 26, no 4, 226-233 p.Article in journal (Refereed) Published
Abstract [en]

New management models develop; one of them is shared leadership where two nurse managers share tasks and responsibility for a unit. The overall aim of this study was to describe  staff’s views about shared leadership at an ICU in Sweden, and to study if there were any differences in perceptions between staff groups. This unit had changed the management organization from single leadership (one nurse manager) to shared leadership (two nurse managers). Sixty four (79%) registered nurses and assistant nurses responded to a 72 item questionnaire measuring social and organizational factors at work, especially leadership and shared leadership.

The results showed that staff reported positive views in relation to the dimensions ‘Organizational culture’, ‘Social interactions’, ‘Work satisfaction’, ‘Leadership’, ‘Shared leadership’ and ‘Work motives’. Registered nurses reported more positive views than assistant nurses in relation to the dimensions: ‘Organizational culture’, ‘Social interactions’, ‘Work satisfaction’ and ‘Leadership’. Further, females had more positive views than males on the dimension ‘Social interactions’. Staff described that shared leadership positively influenced the work in terms of confidence. In conclusion, staff reported positive views of work and the model shared leadership in the investigated ICU. One implication is that nurse managers have to be conscious of different health professionals in the unit and it is important to offer a good working environment for all staff. However, more research is needed within the area of shared leadership. A future research project could be to add a qualitative research question about how work and shared leadership affects different health professionals in the day to day practice both at the managerial as well as the team level to improve health care.

Place, publisher, year, edition, pages
2010. Vol. 26, no 4, 226-233 p.
Keyword [en]
Staff views, Quantitative method, Nursing leadership, Shared leadership
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-14022DOI: 10.1016/j.iccn.2010.06.001PubMedID: 20599383OAI: oai:DiVA.org:hj-14022DiVA: diva2:380626
Available from: 2010-12-21 Created: 2010-12-21 Last updated: 2012-04-04Bibliographically approved
In thesis
1. En hälso- och sjukvårdsorganisation i förändring: Från distanserat till delat ledarskap
Open this publication in new window or tab >>En hälso- och sjukvårdsorganisation i förändring: Från distanserat till delat ledarskap
2008 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis is to follow up, describe and generate a tentative theory on ongoing processes of change in health care. This will be done at a macro level, through the study of hospital mergers as well as a micro level through studies of shared leadership.

Method: ”Hospital Mergers” is based on a qualitative approach; Grounded Theory, with interviews of health professionals (I, II). ”Shared leadership” considered a change of the leadership model with interviews (III-IV) and questionnaires (V) as methods for data collection. Health professionals’ conceptions of leadership were described by a phenomenographical approach (III). In addition, two nurse managers’ experiences of working together as equal partners within a shared leadership model have also been presented by Grounded Theory (IV). In the last paper (V), a quantitative method has been used by means of a questionnaire. Some of these questions are included in the QPSNordic focusing on health professionals’ approach to work, leadership and shared leadership.

Results: Participation and balancing involvement in a change process was emphasised by the health professionals. Leadership was highlighted as an important factor for healthcare organisations in change. Nurse leadership was seen as an ideal image by the health professionals and emphasised the importance for being present and available in order to provide support and feedback to improve practice. Supportive ”two-getherness” in a shared leadership are described as a relationship based on trust and confidence. Shared leadership made it possible to share responsibilities and tasks, which gave nurse managers a good working environment. Health professionals believe that shared leadership contributes to increased availability of committed nurse managers in day-to-day work. Conclusion: Two empirical models; committed leadership and supporting ”two-getherness” were developed. Committed leadership is built on participation through support in a caring culture. Supporting ”two-getherness” uses concepts such as common value and confident relationship. Moreover, the theory of Caritative Leadership was further developed from another perspective which is that of the relationship between managers. This relationship is known as supporting ”two-getherness”.

Abstract [sv]

Syfte: Avhandlingen syftar till att följa upp, beskriva samt generera tentativ teori om pågående förändringsprocesser inom hälso- och sjukvården på såväl makronivå genom studier av sjukhusfusioner som mikronivå genom studier av delat ledarskap.

Metod: ”Sjukhusfusioner” beskriver två genomförda sjukhussammanslagningar utifrån en kvalitativ ansats, Grounded Theory med intervjuer av vårdpersonal (I, II). ”Delat ledarskap” utgår från en förändrad ledarskapsmodell på en intensivvårdsavdelning med intervjuer (III-IV) samt frågeformulär (V) som datainsamlingsmetod. Vårdpersonalens uppfattningar av ledarskap redovisas genom en fenomenografisk ansats (III). Vidare beskrivs två avdelningschefers upplevelser av att ha arbetat i ett delat ledarskap genom Grounded Theory (IV). I den sista delstudien (V) används en kvantitativ metod i form av ett frågeformulär. En del av dessa frågor ingår i instrumentet QPSNordic som belyser vårdpersonalens åsikter om arbete, ledarskap och delat ledarskap.

Resultat: Vårdpersonalen uttryckte behov av delaktighet och balans mellan olika behov och krav i ett förändringsarbete. Ledarskapets betydelse lyftes fram som en framgångsfaktor för att utveckla hälso- och sjukvårdsorganisationer i förändring. Vårdpersonalens idealbild av sjuksköterskans ledarskap utgjordes av en chef som var närvarande och tillgänglig i den dagliga verksamheten. Begreppet stödjande tvåsamhet lyftes fram som kärnan i delat ledarskap. Stödjande tvåsamhet, en tillitsfull relation mellan avdelningscheferna, bidrog till en god arbetsmiljö då ansvar och befogenheter delades av aktuellt ledarpar. Vårdpersonalen hade en positiv syn på sitt arbete och ledarskapet. De ansåg att det delade ledarskapet ökade avdelningschefernas möjligheter att vara engagerade och tillgängliga i det dagliga arbetet.

Konklusion: Resultatet har bildat underlag för två empiriskt grundade modeller; engagerat ledarskap och stödjande tvåsamhet. Engagerat ledarskap utgår från begreppen delaktighet och stöd i en vårdande kultur. Stödjande tvåsamhet bygger på en gemensam värdegrund och olikheter i kompetens hos ledarparet som ligger till grund för utveckling av en tillitsfull relation. Vidare har teorin om det caritativa ledarskapet vidareutvecklats genom begreppet stödjande tvåsamhet som belyser relationen chef till chef i en vårdande kultur.

Place, publisher, year, edition, pages
Jönköping: Hälsohögskolan, 2008. 84 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 5
Keyword
change, healthcare, Caritative leadership, mixed methods, committed leadership, shared leadership, supportive ‘two-getherness’, healthcare development, Förändringsarbete, Hälso- och sjukvårdsorganisation, Caritativt ledarskap, Mixade metoder, Engagerat ledarskap, Delat ledarskap, Stödjande tvåsamhet, Vårdutveckling
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-7329 (URN)978-91-85835-04-1 (ISBN)
Public defence
2009-01-30, Forum Humanum, Hälsohögskolan i Jönköping, Jönköping, 12:00 (Swedish)
Opponent
Supervisors
Available from: 2009-01-12 Created: 2009-01-10 Last updated: 2012-04-04Bibliographically approved

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