In this thesis I am concerned to examine the management behaviours and predilections of managers across the two settings of health and theatre considered to be divergent. To do this I explore and map methods, similarities and differences managers employ to ???manage??? workers across the industries. I also deconstruct creativity and its manifestations in both managerial behaviours and environmental contexts and map the complexity issues that managers face in different settings. Further, I explore the extent to which management activity is contextual to the identity of participant organisational aims and processes and examine the level of calculated chaos experienced by managers across the settings. Central to this approach is the utilisation of multi-method design incorporating interview, micro-ethnography, auto-ethnography and a RAND expert panel to assist with interpretation of the results. Core findings include high degrees of similarity in the roles and functions and support systems utilised by managers across the settings despite substantial differences in environmental contexts and organisational aims and processes. Differences were identified in the areas of: levels of chaos, interactions, purposes, and environmental characteristics. To account for these differences I apprehended seven metafactors grounded in the data sets. These seven metafactors can be found in each setting but emerge in different ways. The metafactors that I apprehend are order versus disorder; creativity; experimentation and change; risk; reflection; trust and respect; and time and pressure. While I discuss these seven metafactors as separate factors in reality they are fundamentally inter-related. Suggestions for future research are included.

The aim of this study was to investigate the role of the ward manager in creating a conducive clinical learning environment for nursing students. An explorative descriptive research method was employed. Findings reveal that the ward managers are generally satisfied with the way in which they handled the important role they play in facilitating teaching and learning for nursing students. They feel strongly, however, that the nursing students themselves need to be active in the learning process. While acknowledging the efforts of the ward managers in creating and maintaining the learning environment, nursing students were dissatisfied about several aspects that appeared to be lacking in the clinical environment, such as good interpersonal relations, support, exposure to practice administrative skills (for example, problem-solving and decision-making) and lack of feedback about their performance. There appears to be a need to develop more effective support structures within the learning environment so that nursing students can obtain sufficient exposure to learning opportunities. / Health Studies / M.A. (Advanced Nursing Sciences)

The objective of this study is to evaluate the impact of the Diabetes Nurse Care Manager on an at-risk diabetic population using a Primary Group Visit Model in Outlying Medical Offices within the Kaiser-Permanente Health Care System upon the process and outcome of care in this population.

Indiana University-Purdue University Indianapolis (IUPUI) / Objective: This study provided a qualitative description of stress and coping as perceived by today's nurse manager incumbents. Background: The healthcare work environment as a source of overwork and stress has been implicated in today's nursing shortage. Nurse managers play a pivotal role in creating work environments for staff nurses, but little is known about the nature of nurse manager work. Methods: This qualitative descriptive study determined what situations contribute to nurse manager stress, what coping strategies they utilize, what health outcomes they report, and what decision-making processes they follow to address stressful situations in their roles. A purposive sample of 21 nurse managers employed at three U.S. acute care hospitals participated in the study. Participants completed a demographic questionnaire and a 14-question interview incorporating components of the Critical Decision Method. Content analysis was completed and themes identified. Results: Difficult situations reported included feeling pressure to perform, interpersonal conflicts associated with organizational communication deficits, and issues of human resources and staffing. Nurse managers utilized a combination of emotion-focused and problem-focused coping strategies. When comparing novice nurse managers (3 years or less in role) with experienced nurse managers (greater than 3 years in role), the novices used predominantly emotion-focused coping strategies, a narrow repertoire of self-care strategies, and experienced negative psychological, physiological, and functional outcomes related to their coping efforts. Experienced nurse managers working as co-managers demonstrated mostly problem-focused coping strategies, a broad repertoire of self-care strategies, and reported no negative health outcomes. The study produced a cognitive model in the form of 10 questions that guide nurse manager decision-making related to stressful situations. The study generated four themes amenable to intervention. Conclusions: Performance expectations for nurse managers in acute care hospitals have increased since the 1990's making the role requirements unrealistic. Rising expectations increase nurse manager stress perceptions, making coping more difficult, and potentially harming nurse manager and work environment well-being. Findings from this study suggest that to address stress, coping, and complexity in the nurse manager role requires a combination of strategies that address individual factors as well as organizational culture, supportive structures, and systems that facilitate the role.

Thesis (MCur)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: The traditional management practice of the unit manager has changed dramatically in the past decade. She is responsible to supply nursing services in an environment which is characterized by smaller operational budgets, rapid developments and changes in every sphere. The researcher has identified deficiencies in the management process of the unit manager. This led to the evaluation of the management activities of the unit manager in a selected group of hospitals. A quantitative, non-experimental, descriptive approach was followed with a questionnaire survey as research design. Standards were set and the management activities were evaluated against these standards. The main findings were: • The unit manager was not 100% involved in her comprehensive management task • The unit manager did not have the necessary training to empower her to manage effectively. The researcher recommends that the unit manager should be empowered by inservice education programmes but should also follow the formal management programmes at a recognized tertiary education institution. Keywords: Unit management / Standard formulation / AFRIKAANSE OPSOMMING: Die tradisionele bestuurspraktyk van die eenheidsbestuurder het oor die afgelope dekade dramaties verander. Sy is verantwoordelik vir die verskaffing van verpleegdienste in 'n omgewing wat gekenmerk word deur kleiner operasionele begrotings, vinnige vooruitgang en veranderinge op alle gebiede, Die navorser het leemtes in die bestuursproses van die eenheidsbestuurder geïdentifiseer. Dit het gelei tot die evaluering van die bestuursaktiwiteite van die eenheidsbestuurder in 'n geselekteerde groep hospitale. 'n Kwantitatiewe, nie-eksperimentele beskrywende navorsingsbenadering is gebruik met 'n vraelysopname as navorsingsontwerp. Standaarde is gestel waarteen die bestuursaktiwiteite geëvalueer is. Die belangrikste bevindinge was dat: • Die eenheidsbestuurder nie 100% betrokke was by haar omvangryke bestuurstaak nie • Die eenheidsbestuurder nie oor die nodige opleiding beskik wat haar bemagtig om hierdie bestuurstaak effektief te verrig nie. Die navorser beveel aan dat die eenheidsbestuurder bemagtig moet word deur middel van indiensopleidingsprogramme maar ook deur formele bestuursopleiding aan 'n erkende tersiêre opvoedkundige intansie moet te volg. Sleutelwoorde: Eenheidsbestuur/standaard formulering

M.Cur. (Nursing Management) / Transformational leadership involves the creation of a motivating climate that enhances growth, development, commitment, goal achievement and enjoyment which encourages behaviour based on a set of shared values (Price, 2006:124). In this study transformational leadership referred to concepts of motivation, and change management with regard to the implementation of the Cervical Cancer Screening Programme in a PRe setting. During support visits in Ekurhuleni Health District, the researcher observed a lack of transformational leadership among facility managers in Primary Health Care Clinics to transform the Cervical Cancer Screening Program in line with relevant health care legislation. It was apparent that the problems in implementing the Cervical Cancer Screening Programme were related to poor motivation and lack of implementation of change management principles in the PHC clinics. From the problem statement the following research questions emerged: To what extent is the facility manager perceived as a transformational leader to implement the Cervical Cancer Screening Programme in a PHC clinic? Which actions should the facility manager take to implement the Cervical Cancer Screening Programme in PHe? From the findings guidelines for the facility managers were described to enable them to implement a Cervical Cancer Screening Programme in a Primary Health Care clinic within legal requirements...

Background: The government of South Africa has focused on Primary Health Care and implementation of the National Health Insurance (NHI) as part of the plan to reform the South African health care system. This is based on the principle of the right to healthcare and the right to access health care facilities. Aim: The aim of this study was to analyse the Nurse Managers’ interpretation of the National Health Insurance Policy and, its implications for implementation on their roles and responsibilities in health care facilities. Methodology: The sequential mixed method approach was conducted. There was direct interaction (semi structured interviews) with the Nurse Managers as well as a survey (questionnaires) for both qualitative and quantitative phases. Qualitative data was collected and analysed first, and an instrument was developed based on the analysed data from the qualitative phase to collect quantitative data. Setting: EThekwini district comprising of two district hospitals, three Community Health Centres (CHC) and four Private healthcare facilities were selected. Participants: Nurse Managers in the public Primary Health Care facilities and private hospitals in the EThekwini district. These were Nurse Managers (top middle and lower levels) from the public healthcare facilities (district hospitals, Community Health Centres, primary health clinics) middle and lower levels in the private facilities. Data Analysis: A thematic analysis was used in the qualitative phase. Descriptive statistic was used in the quantitative phase to describe and synthesize data (Polit and Beck 2004) as well as inferential numeric analysis (Creswell 2009). Findings: The findings in both the qualitative and quantitative data revealed that the participants demonstrated a general impression on the NHI rather than specific understanding; hence the researcher believes that there was more general than specific knowledge and interpretation of the NHI policy. The participants’ display of lack of knowledge and understanding of the concept NHI and the implementation process was an indication that there was lack of personal development in relation to expectations from the nurse managers concerning NHI though there is a lot of publicity in this respect from the government and media. There are national policies and guidelines for all citizens to access. Recommendations: The recommendations were made for sharing with the policy makers and seniors in the healthcare facilities in order to improve nursing management, nursing education and nursing research. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2012.

INTRODUCTION: Providing sufficient quality nurses in resource strapped countries is a human resource management challenge which nurse managers’ experience on a daily basis. THE PURPOSE of this study was to analyse and to determine the issues which affect the the human resources management of nurse managers in selected hospitals in the eThekwini District of the Province of KwaZulu-Natal, South Africa, and to formulate draft guidelines to assist nurse managers with human resource management. METHODOLOGY: A constructionist, reflexive ethnographic approach was used. The ethnographer spent two years in the field collecting data from informants, who were nurse managers, in four (4) selected district hospitals. Data was collected using unstructured informant interviews, non-participant observation and confirmatory document analysis. Data analysis led to eliciting codes from the data, searching for semantic relationships, performing componential analyses and discovering the themes for discussion within the final ethnographic report. A nominal group process was used to develop the draft guidelines. FINDINGS: The findings showed that the human resources management around sick nurses is a complex task. The themes of nurse managers’ experiences were a “burden” of maintaining confidentiality, as well as an emotional burden. Administratively, they experience the burden of absenteeism and the burden of policy compliance. The final theme is the burden of the deaths of HIV and Tuberculosis affected/infected nurses. CONCLUSION AND RECOMMENDATIONS: Organizations should create a non-judgmental work environment where non- disclosure by employees is respected in order to promote disclosure. They should have an awareness of the emotional effect on nurse managers and provide them with support. Emphasis needs to be placed on an HIV and AIDS policy and programme, incapacity leave workplace strategies and return to work policies. It is also recommended that contingency plans be provided when the death or prolonged absence of an employee impacts the staffing of the organization; consideration to be given to piloting and refining the draft guidelines; the management of employees on prolonged sick leave be included in the Nursing Administration Curricula taught to future nurse managers; and further research be conducted to assess employee reluctance to report needle stick injuries (sharps injuries) as well as the related phenomenon of stigmatization. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2014.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 4 uppsatser.

M.Cur. / The overall purpose of this study is to describe empowerment strategies for the nurse unit manager to create a climate conducive to clinical learning at the nursing college in the North-West Province. In view of the South African Nursing Council report (1990), it clearly indicates that the nurse unit managers do not apply their theoretical knowledge to clinical practice, and that the student learning in the clinical nursing units are not up to the expected standard, hence the quality of clinical nursing education is questionable. The current education system in South Africa focuses on the provision of quality assurance in order to be in line with international standards. In accordance with the South African Qualifications Authority, the Constitution, South African Nursing Council, Batho-Pele principles, National Plan for Higher Education and outcomes-based education, there is a need to create a climate that is conducive to learning in the nursing units in order to develop the students' abilities regarding analytical, critical, evaluative and creative thinking. The nurse unit manager is experiencing problems with regard to clinical nursing education and the nursing students are also complaining that the clinical learning areas are not conducive to their learning. Therefore, the products that are produced by such an environment lack knowledge, skills, values and attitudes inherent in the nursing profession. Hence this study strives to describe empowerment strategies for the nurse unit manager to create a climate conducive to learning, based on their expert knowledge and experiences. The research questions arising from this problem are: What are the expectations and perceptions of the nursing students about the role of the nurse unit manager in creating a climate conducive to learning at the nursing college in the North-West Province? How can the nurse unit manager be empowered to create a climate conducive to clinical learning? The objectives are: Phase One: Stage one: To explore and describe the expectations of the nursing students regarding the role of the nurse unit manager in creating a climate conducive to learning. Stage two: To explore and describe the expectations and perceptions of the nurse unit manager regarding their role in creating a climate conducive to learning. Phase Two: To describe a conceptual framework. Phase Three: To describe empowerment strategies for the nurse unit manager to create a climate conducive to learning. The research design in this study was qualitative, descriptive, explorative and contextual in nature. In stage one of phase one, descriptive naïve sketches were used as a method of data gathering (Giorgi in Ornery, 1983:52) whereby 22 nursing students from the nursing college were selected for the research study. The following open-ended questions were written on the chalkboard, namely: "What are your expectations about the role of the nurse unit manager in creating the clinical nursing units as a climate conducive to learning?" The data was analysed according to Tesch's descriptive method (in Creswell, 1994:155). An independent coder who was purposively selected was used in the categorisation of data. The researcher held meetings with the independent coder for consensus discussions reached independently. Trustworthiness was ensured as described by Lincoln and Guba's (1985:290-326) model of trustworthiness. In order to ensure the credibility of the study, five nursing students who participated in the study were selected to participate in individual interviews to validate the categories and subcategories. In stage two of phase one, focus group interviews were conducted as a method of data gathering whereby 13 nurse unit managers from the clinical learning areas where the nursing students are placed for their clinical learning experiences were selected by the quota sampling technique. The interview was conducted by a nurse educator with a Master's degree, who is also a psychiatric nurse with expertise and experience in interviewing skills. A tape recorder was utilised with the nurse unit manager's permission to collect data. A follow-up interview with five nurse unit managers was conducted to validate the data gathered during the focus group interview. The following open-ended questions was used to obtain data from the nurse unit manager: "What are your perceptions regarding your role in creating an environment conducive to clinical learning?" "How can you be empowered as part of your role, to create clinical nursing units as climates conducive for clinical teaching and learning for nursing students?" Data was analysed according to Tesch's descriptive method (in Creswell, 1994:155). An independent coder was purposively selected in the categorisation ( iv ) of data. Categories were defined and arranged in table form for both participants in order to arrive at final categories. Trustworthiness was ensured as described by Lincoln and Guba's (1985:290-326) model of trustworthiness. Findings were conceptualised and conclusive statements made through logical deductive, inductive reasoning and inferences. A conceptual framework was developed within Muller's (1998) management process and the legal and professional frameworks. The integrated empowering process was adapted from Muller's management process, Vogt & Murrel's (1990) & Hokanson-Hawks' (1999) empowerment methods. This process comprises planning, organising (providing and structuring), directing (education, leading, mentoring and supporting), and control (actualising). Empowerment strategies for the nurse unit manager were described to create a climate conducive to learning, based on the results of phase one and phase two. Evaluation of the study was done, limitations, recommendations and conclusions were described with regard to nursing education, practice and nursing research.