This qualitative study was designed to explore the career development of Black female chief nurse executives. Although a small proportion of Black female nurses have achieved positions at the nurse executive level, there remains a paucity of Black female nurse executives in this crucial position which raised the question of what factors contributed to this lack of advancement, but, more important, what factors have contributed to the success of the few who have achieved such level of success in healthcare organizations. The purpose of the study was to explore the career paths of Black female chief nurse executives with a view of understanding the factors which both facilitate and hinder the career development of these leaders in healthcare organizations. The guiding research question was, How do Black female nurse executives in this sample describe their career development? The participants in this study were Black female chief nurse executives located throughout the United States who, for the most part, were raised in segregation with a strong family foundation. To collect data, semistructured telephone interviews were conducted with 10 Black female chief nurse executives throughout the United States. The transcripts from the interviews were transcribed, coded, and analyzed. Using Super’s (1990, 1996), and Gottfredson’s (1981, 1996, 2002, 2005) career development theories and critical race theory (Crenshaw, 1995; Delgado, 2000) as the theoretical framework, the researcher found that the participants’ career development was influenced by (a) strong support system, (b) guidance, (c) influence of diversity, and (d) servant leadership. The findings help us understand the factors that have contributed to their successes as Black chief nurse executives. With the increasingly diverse population and concurrent increasing diversity in nursing and concerns about healthcare disparities, it is imperative that organizations attract, hire, develop, retain, and advance qualified Black nurses. Future studies addressing not only the career development of Black nurses but nurses in general might be informed by the present study’s findings. Recommendations are offered for nursing practice, education, and organizational policy.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第18195号 / 人健博第12号 / 新制||人健||1(附属図書館) / 31053 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 任 和子, 教授 若村 智子, 教授 川村 孝 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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This thesis explores nurses' and patients' perceptions of caring relationships in a hospital context. An attempt is made to discover the meaning these caring relationships have for the nurses who provide care and for the patients who participate in this process. The nurses enter into the caring relationship as voluntary and professional participants. The patients come into hospital because of illness. The relationship entered into is claimed to be a caring relationship yet little is known about the personal experiences of the participants. In the first part of the study the repertory grid technique was used to structure interviews with 25 experienced nurses. Personal constructs were elicited and rated during the interviews. Six major themes emerged from a content analysis of the constructs. These were: personal qualities, clinical work style, interpersonal approach, level of motivation, concern for others, and use of time. The personal cost of caring for the nurses surfaced as a significant aspect of the caring relationship. In the second part of the study 10 nurses and 10 hospitalised patients were interviewed. These were analysed by means of a method grounded in interpretive phenomenology which focuses on the informants' lived experiences. Nine general themes emerged which captured the nurses' experiences of caring relationships. The themes were: patient dependency, patient circumstances, effectiveness, emotional involvement, stress, preparedness, ward constraints, role uncertainty, and personal benefits. The patients' experiences of being cared for were embodied in four general themes quite different from the nurses. The themes were: vulnerability, self-presentation, service evaluation, and other concerns. The thesis provides many details about the perceptions of caring relationships through the exploration of the lived experiences of nurses and patients in hospital. An extended picture of caring relationships in nursing has emerged. The need to take account of both the professional and consumer perspective is emphasised as it highlights important discrepancies between the views of carers and those they care for. Professional carers must be able to understand the patient in order to care in a personalised way and the approach used here demonstrates how this understanding can be achieved. Such an approach could also be used in nursing practice. The findings and methods used here should also be of interest to other helping professions and consumers of health care.

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