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Nurses’ Experiences Transitioning from Staff Nurse to Management in a Community

Section 1: The Problem Introduction Management in healthcare is a career option for many registered nurses (RNs), and an important role in nursing leadership is that of the nurse manager. Nurse managers contribute to accomplishing daily goals for their respective units (Kath, Stichler, & Ehrhart, 2012). The Institute of Medicine ([IOM], 2011) noted the importance for all professional nurses to be leaders within their environment, focusing on change that will enhance patient outcomes. However, many nurses are leaving their manager role to resume a staff nurse position or to withdraw from the nursing profession completely, which has a critical impact on patient outcomes (Sankelo & Åkerblad, 2008). With the nursing shortage predicted to continue, the number of nurses choosing to enter management may decline (Wong et al., 2013). The Problem Remaining in the management role is a challenge for nurses due to the ambiguity of the position’s functions and high stress levels associated with unrealistic expectations related to meeting goals and ensuring outcomes. In spite of the IOM call for nurses to assume leadership positions, the Robert Wood Johnson Foundation ([RWJF], 2010) identified that average patients and healthcare professionals do not expect nurses to function as agents of change or to enter management roles. Perceptions that management roles are not influential in creating change and a lack of preparation for manager roles both hinder the transition of nurses to managerial roles (RWJF, 2010; Wong et al., 2013). The absence of nurse managers results in unsupported nursing staff and lack of valuable nursing staff input at administrative meetings focused on improving patient care. To address the problem of inadequate numbers of experienced nurse managers, it is crucial to gain insight into the experiences of present and former nurse managers who have exchanged or attempted to exchange staff nursing positions for management positions. Previously untapped information could prove valuable in changing the negative perception among nursing staff of the nurse manager role, thus possibly increasing the numbers of nurses who become career nurse managers. This section of the project study provides definitions of key terms and the rationale behind and evidence to support a project study for nurses who choose a career in management. The significance of the problem of nurse managers exiting their position is discussed in terms of its importance to the local and national situation of high turnover of nurse managers. Research questions are used to explain the focus for the study, identifying and addressing the gap in practice created by the failure to retain nurse managers. The literature review includes conceptual frameworks for the study and recent research articles to support and address the need to explore the problem. The implications section explores potential projects, as identified by the data analysis, that would address the problem of high turnover among nurse managers. Definition of the Problem During the period from 2009 to 2014, there was large turnover in nurse managers within one local community hospital, with some of the remaining managerno open nurse manager positions. However, there are two other hospitals within a 25- mile radius of this hospital, and one of them appears to have been experiencing the same problem of turnover in nurse managers; within the last two years they have had up to 23 open positions for nurse managers at various times. Constant turnover of nurse managers has a direct impact on staff performance and on the operations of nursing departments (Watrous, Huffman, & Pritchard, 2006). Nurse managers provide essential services by keeping the units operational by supporting nurses through appropriate resources, managing payroll, assisting with patient transition from admission to discharge, monitoring staffing, and participating at various meetings (Surakka, 2008). There are just over 3.25 million active female nurses versus, approximately 306,000 active male nurses employed in the United States (Kaiser Family Foundation, 2016). In 2020, almost 30% of the U.S. population will be 55 or older, and it is projected that there will be more women than men are in this age group (Toossi, 2012). The large population of female nurses and the larger population of women retiring, may contribute to the projected shortage of over 300,000 nurses by 2020 (Juraschek, Zhang, Ranganathan, & Lin, 2012), and ultimately the pool of potential nurse managers. Warshawsky and Havens (2014) conducted a study on nurse managers’ satisfaction with their position and their intention to leave. The researchers discovered that almost 75% (181) of the 243 nurse managers surveyed planned to leave within the coming five years. With the large number of potential nurse managers planning to retire within the next decade, there is an emphasis on focusing on organizational support for nurse managers (Zastocki & Holly, 2010). Zastocki and Holly (2010) identified that the increasings stating that they were considering leaving management in the near future. At present, the hospital has    


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