Challenges in Developing Future
Nursing Leaders
Sally Dampier
CASN, 2009
Investigator Team
Patricia Sevean RN, MA (N)
Susan Pilatzke RN, MPH
Research Assistant
Christine Zozula MPH (c)
Geographical Location
Session Plan
 Background (RNAO BPG, 2006)
 Key literature
 Methods
 Findings
 Next Steps
Background
Without leadership
that fosters and
supports
transformational
change it is difficult
to create work
environments that
maximize patient,
nurse and system
outcomes.
(The Office of Nursing
Health Policy, 2006)
Purpose
To conduct an environmental scan of an in-patient
unit in a regional hospital based on Registered
Nurses Association of Ontario:
Healthy Work Environments Best Practice Guidelines:
Developing and Sustaining Nursing Leadership.
(RNAO, 2006)
Objectives
 Identify the organizational supports that enable nurses
to develop effective leadership skills
 Evaluate the current leadership style in context to the
‘Healthy Work Environments Best Practice Guidelines:
Developing and Sustaining Nursing Leadership’ (RNAO, 2006)
 Evaluate the educational supports for nurse leaders and
aspiring nurse leaders
Conceptual Model for Developing & Sustaining
Leadership (RNAO, 2006, pg. 22)
Contextual Factors
Move to a new unit, new manager, 3 month review
indicated:
 All staff were overwhelmed by the volume & acuity of




the unit
Sick time was increasing
Overtime was on the rise
Staff were very disgruntled &complaining of lack of
support and high patient numbers
Generalized discontent, negative feelings, feeding a
negative atmosphere……….
Nursing Experience
Number of Years Experience
Number of
RNs
%
20+ years
1
2.4%
15+ years
7
17.07%
10+ years
3
7.31%
5+ years
6
14.63%
1-5 years
*24
58.53%
* 4 years
2
8%
*3 years
8
33%
*0-1.5 years
14
58%
Of the 24 staff with < 5 years
experience
Methods
Phase I: Survey n=56
 Based on the RNAO Best
Practice Guidelines
 14 Likert-scaled questions
 4 open-ended questions
 Statistical software (SPSS)
to analyze data
 Thematic analysis of openended questions
Demographics
Age
100
50
80
40
60
30
Percent
Percent
Gender
40
20
20
10
0
Female
Male
Gender
0
18 to 24
25 to 34
35 to 49
Age
50 to 59
Survey Questions: Range (1-5)
Mean
Std
Deviation
Variance
1) Does your unit have a vision, objectives and action plans
for nursing practice?
2.9
1.181
1.394
2) Are the vision, objectives and action plans for nursing
practice implemented and evaluated?
2.58
1.180
1.391
3) Does the leadership provide opportunities for continuing
education for nurses?
3.63
.937
.878
4) Does the leadership create conditions for satisfaction and
growth?
3.28
.904
.818
2.98
.958
.918
6) Does the leadership expect yourself and others to pursue
excellence?
3.18
1.014
1.028
7) Does the leadership build partnerships with unions,
professional associations and other stakeholders to achieve
the unit goals?
2.63
1.113
1.238
5) Is the leadership on your unit effective?
Survey Questions: Range (1-5)
Mean
Std
Deviation
Variance
8) Does the leadership develop a supportive team by seeking
and sharing information?
2.84
.987
.975
9) Does the leadership develop a supportive team by pursing
joint problem-solving?
2.94
.925
.856
10) Does the leadership develop a supportive team by
encouraging new ideas?
2.9
.974
.949
11) Does the leadership inspire trust by establishing open and
candid relationships?
2.78
.986
.973
13) Does the leadership treat all individuals fairly and with
respect?
2.78
.907
.824
14) Does the leadership practice in accordance with the
standards and professional Codes of Conduct?
3.25
1.017
1.034
15) Does the leadership maintain high standards of integrity?
3.00
1.039
1.080
Thematic Analysis: Open-ended Question
1) What are the best things about the
leadership practices on your unit?
 Mentoring/Preceptorship for new nurses
 Visible, approachable leader
 Ongoing continuing education
 Support for evidence based practice
 Opportunities for professional growth
Thematic Analysis: Open-ended Question
2) Is there anything about the leadership practices
on your unit that you particularly do not like?
 Inconsistency, lack of equality
 Not enough sharing of information
 Unclear vision, objectives and action plan for nursing
practice
 Few opportunities to provide feedback on nursing
practice
 Lack of empowerment to support a culture that values
knowledge and builds trust
Thematic Analysis: Open-ended Question
3) If you could change one thing about the
leadership practices on your unit what would it
be?
 More effective team work
 Access to mentors, clinical experts
 Ongoing education opportunities to meet learning
needs
 Improved communication
 Ongoing feedback on new initiatives
Thematic Analysis: Open-ended Question
4) Is there anything you would like to share that we
have not asked?
 Improved access to resources
 More support for novice nurses
 Clearer lines of communication
“Leaders are those individuals in formal and informal
leadership roles who are recognized by their peers and
colleagues as experts in their practice, who consider
patient care and nursing excellence as their priorities,
who can be trusted and with whom it is easy to have an
conversation about one’s dreams and vision for one’s
career”
Gail J. Donner, RN, PhD. & Mary M. Wheeler, RN, Med, PCC., from Donner
G. J. & Wheeler, M. M. (2004). New Strategies for Developing Leadership.
Journal of Nursing Leadership, 17(2),27-28.
Next Steps: Challenges in Developing
Future Nurse Leaders
Phase 11 Interviews: (n=6)
Explored concepts related to transformational leadership
practices, focusing on:
 Building relationships & trust
 Creating an empowering work environment
 Creating a culture that supports knowledge development &
integration
 Leading & sustaining change
 Balancing competing values & priories
(RNAO,2006 p 22)
Nursing Leadership
Towards an Understanding…..
“At one level it is, I’d say, quite simple. We remind ourselves
what lies at the heart of our nursing practice. And then we
begin to reshape our health care systems to ensure that the
fundamental values and functions of nursing remain at their
centre. To do this we need strong leadership of nursing – at
all levels and in all sectors of the profession.”
Alison Kitson BSc PhD RN FRCN
Honorary Professor, Executive Director, Nursing,
Royal College of Nursing,
(2004).Drawing on Leadership.JAN. 48(3)pg211
Acknowledgments
Project sponsored by:
 Registered Association of
Ontario (RNAO)
 Nursing Leadership
Network of Ontario
(NLN.ON)
Contact Details
Sally Dampier
Faculty
Confederation College
Thunder Bay, Ontario
P7C 4W1
sdampier@confederationc.
on.ca
Questions
References
Donner G. J. & Wheeler, M. M. (2004).New Strategies for Developing Leadership.
Journal of Nursing Leadership, 17(2),27,28.
Kitson, A. (2004). Drawing on Leadership. Journal of Advanced Nursing. 48 (3) pg
211.
Registered Nurses’ Association of Ontario: Nursing Best Practice Guidelines
Program (June, 2006). Healthy Work Environments Best Practice Guidelines:
Developing and Sustaining Nursing Leadership, Toronto, Ontario.
http://www.rnao.org/projects/hwe.asp
The Office of Nursing Health Policy, 2006