A nurse-manager relationship plays a key role in a nurse’s practice environment. A nurse’s trust in one’s manager is the foundation for a supportive nurse-manager relationship and has crucial bearing upon the professional and personal lives of the nurse. However due to health care restructuring, nurses expressed little trust towards their leaders. To develop and implement strategies to help build healthy nurse-manager relationships, research is needed to more fully understand the factors that establish and enhance a nurse’s trust in one’s manager. This study tested a theoretical model that examined potential individual, managerial, relational and environmental attributes that impact a nurse’s degree of managerial trust. Employing a cross-sectional, descriptive design, a self-administered survey was completed by a random sample of 342 Registered Nurses employed in Ontario emergency departments. Structural equation modeling techniques tested and refined the hypothesized model. Final analysis showed adequate fit of data to theoretical model (χ 2 = 78.86, df = 20, SRMR = .02, CFI = .98, RMSEA = .09). In the final model, a manager’s perceived ability, benevolence, integrity and procedural justice had a strong, direct impact on managerial trust. Trust in one’s manager was indirectly influenced by procedural justice and ability as well as a manager’s facilitation of team work, communication accuracy, emotional availability and interaction frequency. Attributes of the individual RN, specifically job tenure and propensity to trust as well as self-determination, access to support and resources and span of control did not affect trust in one’s manager. Study findings suggest that creation and preservation of a nurse’s managerial trust is a complex process affected by manager’s competence and character as well as a fair decision-making process. Education programs that contribute to a manager’s ability, benevolence, integrity and procedural justice may help build and sustain nurses’ trust and healthy nurse-manager relationships.

A nurse-manager relationship plays a key role in a nurse’s practice environment. A nurse’s trust in one’s manager is the foundation for a supportive nurse-manager relationship and has crucial bearing upon the professional and personal lives of the nurse. However due to health care restructuring, nurses expressed little trust towards their leaders. To develop and implement strategies to help build healthy nurse-manager relationships, research is needed to more fully understand the factors that establish and enhance a nurse’s trust in one’s manager. This study tested a theoretical model that examined potential individual, managerial, relational and environmental attributes that impact a nurse’s degree of managerial trust. Employing a cross-sectional, descriptive design, a self-administered survey was completed by a random sample of 342 Registered Nurses employed in Ontario emergency departments. Structural equation modeling techniques tested and refined the hypothesized model. Final analysis showed adequate fit of data to theoretical model (χ 2 = 78.86, df = 20, SRMR = .02, CFI = .98, RMSEA = .09). In the final model, a manager’s perceived ability, benevolence, integrity and procedural justice had a strong, direct impact on managerial trust. Trust in one’s manager was indirectly influenced by procedural justice and ability as well as a manager’s facilitation of team work, communication accuracy, emotional availability and interaction frequency. Attributes of the individual RN, specifically job tenure and propensity to trust as well as self-determination, access to support and resources and span of control did not affect trust in one’s manager. Study findings suggest that creation and preservation of a nurse’s managerial trust is a complex process affected by manager’s competence and character as well as a fair decision-making process. Education programs that contribute to a manager’s ability, benevolence, integrity and procedural justice may help build and sustain nurses’ trust and healthy nurse-manager relationships.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

Quality of life and well-being of patients living in chronic care (CC) are determined to a considerable extent by the relationships these patients have with nursing personnel caring for them. Given the importance of these relationships, there is an absence of empirical research and measurement tools to assess these relationships from a patient’s perspective. The purpose of this study was to develop and test valid and reliable instruments to determine what qualities of the humanistic relationships between cognitively competent patients and nursing personnel in CC settings were most important to patients and what they experience most. A conceptual framework based on the Humanistic Nursing Theory by Paterson and Zderad (1976) served as a foundation to develop two scales; the Humanistic Relationship Importance Scale (HRIS) assessed what attributes of the relationship are most important, and the Humanistic Relationship Experience Scale (HRES) assessed what attributes of the relationship are experienced. Sixty-nine content relevant items based on six dimensions of the Paterson and Zderad theory were developed and tested for content validity resulting in the deletion of 20 items. Forty patients completed the now 49-item scales to establish their initial internal consistency reliability, test-retest reliability and construct validity. Another 25 items were deleted in the process. The 24-item scales were completed by 249 patients in five CC facilities and the results subjected to a iii principal axis analysis (PAA). An oblique rotation resulted in a five factor solution labeled: relational availability, promoting quality of daily life, recognizing and supporting choice, forming connections, and supporting human uniqueness. This was a simplification of the original six dimensions of the Paterson and Zderad theory. A PAA of the 24-item HRES resulted in a one factor solution labeled humanistic connection. Reliability testing of the factors resulted in the deletion of one more item and an HRIS with a Cronbach′s alpha of .87 indicating strong internal reliability and an HRES with a Cronbach′s alpha of .98 suggesting some redundancy of items. Relational availability was rated as the most important factor in the nurse-patient relationship although all factors were important to patients. The mean score of the HRES indicated that patients experience a moderate level of humanistic connection in terms of frequency and intensity with nurses who generally care for them. Findings of this study have contributed to a better understanding of the nurse-patient relationship, and support the care, research, and theoretical knowledge of nurses and patients in these environments.

The difficulties new nurses experience when first entering acute care work environments have been recognized since Kramer’s seminal work in the 1970s. Despite the implementation of interventions designed to help ease the transition, the literature continues to report that new graduates undergo stress when beginning their careers as nurses. The purpose of this study was to examine the effects of perceived demands, control, social support and self-efficacy on the job stress, job satisfaction and intention to leave of new nurses. The conceptual framework used in the study was Karasek’s (1979) Job Demands-Control-Support (JDC-S) model. This model posits that job demands increase employee stress, but that increasing control can alleviate the negative effects of high demands. Social support and self-efficacy were included in this study as potential moderators of the relationships between demands and control and the outcome variables. This was an exploratory study that utilized a cross-sectional survey was used to gather data. Surveys were mailed to the homes of new nurses working in acute care hospitals across Ontario, Canada. Data were received from 232 new nurses, a response rate of 23.8%. Nurses in the sample had an average of 18.2 months of experience. Data were analyzed using separate hierarchical regression models for each dependent variable. The results showed that the main effects of job demands, social support and self-efficacy provided partial support for the JDC-S model when examining job stress, job satisfaction and intention to leave the job. Only self-efficacy was significantly related to intention to leave the profession. There was no evidence of moderating effects of social support or self-efficacy. An understanding of factors in the work environment that influence new nurses may assist in supporting them during the transition. By exploring the effects of demands, control, social support and self-efficacy on new graduates’ job stress, job satisfaction and intention to leave, this study may provide direction to nursing leaders who are working new nurses in acute care.

Background: Ontario has the highest number of HIV positive test reports in Canada. Many of the HIV prevention interventions had a moderate effect on changing unsafe sexual behaviors within the young adult population. Participants’ preferences for such interventions could be a contributing factor to the moderate effect of the prevention interventions. Treatment preference is defined as a positive or negative attitude toward a particular treatment. To date few empirical studies examined preferences for educational and cognitive/behavioral interventions focusing on HIV prevention for young adults. Purpose: The purpose of this study is twofold: to examine participants’ preferences for different types of educational and cognitive/behavioral intervention components for HIV prevention and to explore socio-structural, psychological and intervention related factors that affect participants’ preferences for intervention. Design: The study used a cross-sectional mixed methods design. The data were collected using a face-to-face interview. Structured and open-ended questions were used to inquire about participants’ preferences for intervention. Sample: The sample consisted of 150 young adults ranging in age from 18 to 39 years, and able to speak and read English. The sample was recruited from the Greater Toronto Area. Measures: The measures included an adapted questionnaire to elicit participant preference for intervention, the multi-dimensional locus of control questionnaire, AIDS health locus of control questionnaire and standard demographic questions. Analysis: Descriptive statistics were used to examine preferences for intervention components. Regression analysis was done to explore the relationships between the selected factors and participants’ preferences for intervention. Findings: All 150 participants had a preference for an HIV prevention intervention. In terms of preference for treatment type, 64% preferred an intervention that incorporated a combination of educational and cognitive-behavioral components. Specifically, 23% preferred the intervention to incorporate all three components: educational information, communication skills and goal attainment. In addition, 49% of the participants’ preferred an intervention that incorporated an average of 1-4 sessions lasting 90 minutes in length. Of the socio-structural, psychological and intervention related factors hypothesized to be associated with participants’ preferences for intervention type, components and dose, intervention related factors were found to be the most significant factors related to participants’ preferences. Conclusions: Young adults preferred to have an HIV prevention intervention that encompassed a combination of education and cognitive-behavioral components when given the opportunity to choose their preferred interventions. Providing interventions that are consistent with participants’ preferences is posited as beneficial as it increases the participants’ sense of control, satisfaction with care, adherence to intervention protocol and achievement of desired outcomes.