The highly complex role of the Chief Nursing Officer (CNO) requires the refinement of a multitude of competencies and leadership skills in this unprecedented time of healthcare reform. As the senior most patient advocate in our medical centers the CNO is responsible for translating research into practice, policy development and implementation creating value based patient-centric strategies to transform health care. The ability to sustain and thrive in this role is essential in repositioning nursing as a knowledgeable discipline actively contributing to the redesign of healthcare. This exploratory descriptive phenomenological study was designed to explore and describe the elements that contribute to the sustainment of CNOs in their practice of nurse executive leadership. Ray’s (1989) Theory of Bureaucratic Caring, Authentic Leadership Theory (Wong & Cummings, 2009), and Resiliency Theory (Earvolino- Ramirez (2007) provided the theoretical lens through which this study was grounded. Semi-structured telephonic interviews were conducted with twenty CNOs all with two consecutive years experience in their current role. Six themes emerged after thorough content analysis which describes the lived experience of sustainment. Each theme was supported by several subthemes. Themes emerged as: Loving the Profession, Having a Broader Impact Reflecting on One’s Own Work, Learning to Manage Conflict, Maintaining Work/Life Balance Working with Supportive Leaders. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

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.

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 purpose of this study was to establish if, and to what extent, management of nursing colleges enhanced personnel development with regard to the professional and personal development of nurse educators and clinical preceptors. From the literature survey, it was concluded that an effective personnel development programme that included all nursing personnel involved in the education and training of student nurses, was imperative for the rendering of continuous quality nursing education. The importance of co-operation between management of nursing colleges and nursing management of clinical facilities regarding the development of personnel involved in the education and training of student nurses, was emphasised. A programme for personnel development in nursing colleges was developed. The programme included suggestions for the educational development of both nurse educators and clinical preceptors/ registered nurses involved in the education and training of student nurses. It was suggested that nursing colleges should initiate the programme. Research consisted of an in-depth literature review about the management of personnel development in the educational milieu and a survey with regard to the management of the development of personnel involved in the education and training of student nurses. Principals of nursing schools, nursing educators, nursing directors of health services and clinical preceptors in clinical settings formed the population for the study. The theoretical framework used in this research with regard to personnel development in nursing schools, was Donabedian's theory on structural, process and outcomes standards as applied to quality improvement, as well as Alspach's theoretical foundation of nursing staff development. The focus of this study was to use data generated through research to develop a personnel development programme for all registered nurses involved in the education and training of student nurses. The most important conclusions of this research were as follows:  Personnel development was provided for nurse educators and clinical preceptors/ registered nurses involved in the education and training of student nurses in the clinical setting, but it did not necessarily meet the personal and professional developmental needs of these professionals.  The specific developmental needs of nurse educators and clinical preceptors/ registered nurses were related to educational skills, higher cognitive skill and skills related to research.  Available resources at nursing colleges did not facilitate and support the development of nurse educators and clinical preceptors involved in the education and training of student nurses. The main conclusion was that the establishment of a Department of Personnel Development at nursing colleges could provide for the educational needs of both nurse educators and clinical preceptors/ registered nurses, would benefit the personal and professional development of all learners involved and, ulitmately, would enhance the quality of patient care rendered by student nurses. / Advanced Nursing Sciences / D.Litt. et Phil. (Advanced Nursing Sciences)

M.Cur. (Professional Nursing) / Grievance procedures form an important instrument by means of which nursing staff can make their grievances known to management, thereby effecting a solution to the problem. Therefore, the way in which grievances are handled form an integral part of the staff duties of a nursing service manager. The effective handling of grievances directly influences the satisfaction of nursing staff, as well as the quality of nursing, and thus productivity. Effective handling of grievances depends on the nursing service manager's knowledge of and abiU ty to utilise grievance procedures. This implies that the nursing service manager should be willing and able to investigate all grievances that she becomes aware of, in a consistent manner. She can only fulfil this responsibility if there is an existing grievance procedure in the hospital, and if this procedure is known to all nursing staff. Utilisation of this procedure only is possible when all staff have access to it. This is ensured by training, which will equip them with knowledge and skills in the execution of grieval1ce procedures. The purpose of this study is to determine whether grievances are being handled effectively by nursing service managers in selected hospitals. A descriptive, exploratory study was done within this context by means of a historical analysis of available literature, including newspaper reports, as well as by case study analyses and interviews with nursing service managers in the selected hospitals. A self-training programme regarding the management of grievances will be developed. Analysis of the data indicates that nursing service managers in the selected hospitals do not handle grievance procedures effectively During interviews the nursing service managers indicated that grievance procedures do indeed exist at the hospitals in the Pretoria Witwatersrand area. However, a degree of uncertainty exist. about the difference between grievance procedures and disciplinary procedures.

M.Cur. / Following the democratic elections that took place in 1994, South Africa is undergoing transformation. This transformation was initiated by the external and internal driving forces, of which, the political forces are the most significant. This political transformation led to the promulgation of the Constitution of the country, which impacted on the transformation of the health system, to ensure accessibility and equity. The promulgation of the Constitution was followed by many legislative and policy changes, such as a new Higher Education Act. The South African transition from apartheid to democracy, necessitated that all the existing policies, institutions and practices should be transformed and revised, according to the demands of the new era. With the new political dispensation of the country, many regional, national and local policies have changed. These changes have had an inevitable impact on higher education, which in turn impacts on nursing education. The change in the higher education system required the restructuring and rationalisation of nursing colleges in all the provinces. The need for the transformation of nursing colleges is unavoidable because of the development of the new legislation to readdress the imbalances of the past. Following the new political dispensation, it was however necessary to transform these nursing colleges through rationalisation/integration. The focus of this study is on the transformation of nursing colleges in Gauteng, which poses many challenges to the directors in terms of the management of transformation. The transformation process impacts directly on the directors of nursing colleges. This study is based on the transformation management of selected nursing colleges in Gauteng. The study is conducted in two phases. Phase one explores and describes the experiences and perceptions of directors regarding the transformation of nursing colleges in Gauteng. Phase two describes the formulation of transformation management standards which consists of two phases of standards formulation, namely, the development phase and the quantifying phase.

M.Cur. / It is evident that the current political changes presently taking place in South Africa need to be accompanied by a dramatic transformation to accommodate the economic, social, technological and health changes amongst others. The nursing discipline is no exception. For a change to be felt by nursing staff and by health consumers, effective management strategies need to be developed to accommodate transformation guidelines as outlined by the Reconstruction and Development Programme, the National Health Plan and the Constitution which all emphasize the right to health, hence this study. This study focuses on a primary health care clinics. This is a qualitative, contextual, exploratory and descriptive study with the overall aim of exploring and describing a nursing service strategy for change in Soweto Primary Health clinics where the researcher is employed. To accomplish this aim, the following objectives were formulated: to explore and describe the expectations of the managers and the functional nurses concerning the required nursing service strategy for change within Soweto Primary Health Clinics; to explore and describe the expectations of health consumers concerning the required nursing service strategy for change in Soweto Primary Health Clinics; to describe the required nursing service strategy for Soweto Primary Health Clinics. Through purposive sampling, three focus groups were selected from the role players within Soweto who represent the nursing managers, the functional nurses' and the health consumers in order to infer the required change strategy for the nursing service. i. Data was collected through these focus groups interviews using semi-structured questions. Data management and data analysis was done using the methods of content analysis according to Kerlinger (1986: 480). An research expert, was utilised as a reliability measure to identify and categorise themes separately from the researcher. The categories that emerged were subsequently refined through consensus discussions between the researcher and the independent researcher. Woods and Catanzaro' s measures (1988: 136) to ensure validity and reliability were applied in this study.

MCur / Department of Advanced Nursing Science / Se the attached abstract below

Prior to 1994, the South African Health Department was characterised by a fragmented health care system, which was largely curative and hospital based, with services planned and managed without community involvement and participation. The government, through the establishment of a district health system, integrated the health services with the aim of overcoming the fragmentation, and providing integrated comprehensive health care services that are equitable, accessible, efficient and effective. The integration of health services in Gauteng, meant the devolution of primary health care services from the provincial health department to the local authority health department, because the local authority services are nearer and accountable to the community. The process of integration of health services also meant the closing down of provincial clinics and transferring of provincial authority nurses to the local authority clinics. The transfer process impacted negatively on staff morale and on the resources available for health care delivery to the communities. It is against this background that the researcher decided to investigate the integration process. The researcher then conducted focus group interviews with the local authority nurses, provincial authority nurses and the district management team as these nurses's immediate supervisors. The results revealed that the local and provincial authority nurses were integrated without proper consultation and as a result integration was rejected. The following themes emerged from the results as negative perceptions and obstacles towards integration: lack of consultation, disparities in conditions of service and resistance to change. Positive perceptions also emerged from the results as strategies to improve the integration, and these strategies were used to develop guidelines to operationalise the model. It is envisaged that the proposed model will serve as a theoretical framework for nurse managers from both spheres of government, local and provincial to improve the integration of nurses through proper consultation, and involvement of nurses in the process affecting them. It is further envisaged that the model will serve as guideline to introduce changes within the district health system with more understanding and acceptance by nurses affected. Health care managers will find the model useful to overcome disparities in conditions of service among nurses and, in turn this may boost the moral of nurses and lead to successful integration of provincial and local authority nurses. / Health Studies / D.Litt. et Phil (Health Studies)

Quantitative, descriptive research was conducted to determine which factors contribute to absenteeism among nurses. A structured self-administered questionnaire was administered to the entire population of nurses who worked at a district hospital in the Limpopo Province. Statistical data analysis, involving factor analysis, frequencies and Chi-squares was performed. The findings revealed that various factors related to the characteristics of the nurse, characteristics of the manager, characteristics of the work and characteristics of the organisation contribute to absenteeism. Professional nurses and sub-professional nurses, as well as nurses younger than 40 and nurses who are 40 years and older, appeared to disagree on the extent to which various factors contribute to absenteeism in the workplace. This study was aimed at assisting organisations and managers in reducing absenteeism in the workplace, and by doing so, improving the quality of care. / Health Studies / MA (HEALTH STUDIES)