There are numerous factors that influence a nurse manager's job satisfaction and intention to remain in a job. The purpose of this project was to evaluate whether a formal mentorship program for nurse managers impacted job satisfaction and intention to remain in a job. A pilot program was developed and 15 nurse managers from 2 hospitals in the Pacific Northwest participated in a 6-month mentorship program. The program was guided by mentorship enactment theory and Kouzes and Posner's exemplary leadership framework. Using the Leadership Profile Inventory (LPI) and the Nurse Manager Practice Environment Scale (NMPES), job satisfaction, intention to stay in a job, and transformational leadership behaviors were measured before and after the program. Results were analyzed using a paired samples t test. There were statistically significant differences between the preprogram LPI scores (M= 212.27, SD=37.8) and postprogram scores (M=232.47, SD= 25.28); t (14) = -2.83, p =.013. There were also statistically significant differences between the preprogram NMPES Subscale 3: Culture of Generativity (M= 23.20, SD= 4.65) and postprogram scores (M= 26.20, SD= 4.74); t (14) = -2.40, p=.032. The results demonstrated a significant increase in job satisfaction, intention to stay, and transformational leadership behaviors. Implementation of this pilot program supported positive social change through reduced nurse manager turnover, resulting in a reduction of healthcare spending on replacement costs in addition to improved patient outcomes.

Purpose. This study was designed to determine the perceptions of the Oregon-certified nurse practitioners (NPs) with respect to their usage, competency, and preparation for selected functions. Clarification of what NP's perceive themselves doing and with what degree of competence could give structure and direction to their preparation. In Oregon, NPs provide specialized primary care in collaboration with physicians and other health care professions and agencies. The performance of an NP may vary according to the specialty, setting, and needs of the consumer. If some functions of the NP could be brought into clearer focus, then not only could benefits come to the health care consumer, but also health care professionals could work together more efficiently and productively. Furthermore, educators could build programs with a clearer sense of purpose and structure. Procedure. The data were obtained through a survey of 574 NPs certified in Oregon. A four-part questionnaire was adapted from instruments developed by researchers of NPs in North Carolina, Arkansas, and Colorado. The analysis of service diaries provided by Oregon nurse practitioners, additions by the Oregon State Board of Nursing, and pretesting in the field resulted in statements about selected characteristics and attitudes, practice settings, and clinical and community functions of Oregon nurse practitioners. Questionnaires were mailed, and 386 were analyzed. Summary of Findings and Conclusions. Three research hypotheses were formed and tested by chi-square. The following findings and conclusions were identified: (a) Some relationships did exist between NP functions and specialty groups with respect to competency, frequency of performance, and preferred preparation. (b) Most nurse practitioners serve a large number of consumers in low or very low economic circumstances through community or home health agencies. (c) Some functions of high competency and usage are needed in the preparation of all nurse practitioners at the baccalaureate and master's level. (d) Higher education is preferred for preparation of nurse practitioners in a sequence of baccalaureate in nursing followed by a master's degree which qualifies for certification in a nursing specialty. (e) For the functions of lower competency and usage, reduced emphasis or deletion from nurse practitioner preparation is desirable. (f) Some functions are suitable for major emphasis in continuing education programs with the standards of higher education.

Indiana University-Purdue University Indianapolis (IUPUI) / The implementation of evidence into practice is a complex process. Estimates indicate that it takes seventeen years on average for research to be translated into practice. Delay in implementation of evidence-based practice (EBP) results in poor patient outcomes and negative impacts to healthcare systems. While many factors contribute to delayed implementation of evidence, organizational characteristics of healthcare institutions have a significant impact on implementation. Leaders play a critical role by influencing these organizational characteristics to support evidence-based practice implementation. A key leadership role within acute care healthcare organizations is that of the front-line nurse manager (NM). Front-line nurse managers have responsibility for nursing unit operations and clinical nurses who deliver patient care under the nurse managers supervision. The relationship between NM leadership competencies and implementation of EBP is not well understood. Therefore, there is a critical need to identify how NM leadership behaviors influence the implementation of EBP. This dissertation examined the relationship between NM leadership behaviors and implementation of EBP. Results link the role of the NM to evidence-based clinical practice, and describe competencies and education needed for NM development. With an understanding of the NM leadership behaviors associated with implementation of EBP, healthcare leaders can develop education, processes, and interventions to increase competencies on NM leadership behaviors. Better implementation support by NMs will result in an improvement in use of EBPs. To examine the NM leadership behaviors that are associated with implementation of EBP, the following activities were completed: (1) an integrative review of the literature related to NM competencies associated with implementation, (2) identification and description of nurse manager competencies associated with EBP implementation using the Delphi method, and (3) examination of NM leadership behaviors associated with implementation of EBP during the COVID-19 pandemic response through a multi-site descriptive correlational survey of NMs and their nursing staff. Results of these studies demonstrate the importance of NM leadership characteristics and behaviors on EBP implementation.

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This dissertation investigated the reason nurses (RNs, LPNs) stayed at one job for 20 years or longer and compared their responses to nurses (RNs, CMAs) who changed jobs more than four times in 20 years. The study divided their responses into two categories, hygiene factors or motivation factors, based on Herzberg’s two factor theory. The dissertation topic was chosen to determine if increased pay has a significant impact on the long-term employment of nurses, although quantitative research in the field heavily promoted pay as a solution to turnover. Healthcare companies incur costly consequences of turnover and this qualitative study adds information to the field on potential interventions to address and decrease turnover. This dissertation examined the real reasons these participants stayed at their jobs long-term and why these short-term employees left jobs frequently, with the results showing that pay would not decrease turnover of short-term employees. The long-term people stayed for motivation factors and the short-term people left to seek hygiene factors. The quantitative research in the field, focused on interventions to decrease turnover, was not supported in this research.

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