Core competencies and challenges among nurses transitioning into positions of leadership ­ a Caribbean perspective

Purpose ­ Nurses are a significant part of the professional workforce, but leaders may be promoted without the requisite competencies. This study aims to explore the perspectives of nurse managers about the core competencies necessary for promotion as leaders in health. Design/methodology/approach ­ This was a mixed-methods study that targeted nurses (N= 126) who were promoted in four Caribbean countries over the past five years. A 30-item questionnaire was used for quantitative data collection and analyzed using SPSS version 25. Interviews yielded the qualitative data, which were analyzed using open coding and thematic analysis. Ethical approvals were received from ethics committees at the university and country level. Findings ­ Most participants were female (n= 112), had 15 or more years' experience (n= 71) and an associate degree/diploma in nursing (n= 62). Leadership was the most important competency required of nurse leaders in spite of their position within the organization, followed by team building and motivation. Challenges to the transitioning into leadership positions included the prevailing culture and a lack of a systematic approach to building capacity in leadership. There was also between-group statistical significance, as determined by oneway ANOVA for delegation, motivation and leadership as core competencies based on occupations roles.

Nurses' preparation for transitioning into positions of leadership­A Caribbean perspective

Aim: To explore perspectives of nurse managers about their preparation for transitioning into positions of leadership. Background: There have been serious concerns about the level of preparation as well as availability of support systems for transitioning of nurses into positions of authority. Methods: This was a quantitative study conducted in four Caribbean countries targeting nurses promoted to leadership positions within the last 5 years. Data were collected using a 30-item questionnaire. Ethical approvals were received from the University of the West Indies and the participating countries. Results: Most participants were female, had 15 or more years' experience and an associate degree/diploma in nursing. They felt prepared through training and acting opportunities although many were not preceptored/mentored into the position. Preparation by training was positively correlated to acting opportunities, preceptorship programme and having a preceptor. Conclusion: Transitioning into positions of leadership requires readiness from a personal as well as an organisational perspective. There must be investment in the development opportunities to support nurses' transition into leadership positions. Implications for Nursing Management: Organisational continuity and effectiveness will be dependent on a balance between investing in experienced nursing personnel while encouraging personal development of less-experienced nurses. Peer mentorship must be utilized to facilitate nurse transition.

ET/WOC nursing ­ leadership lessons learned from the COVID-19 pandemic: an opinion

The coronavirus disease 2019 (COVID-19) pandemic has brought uncertainty and opportunity to nurses and healthcare. As part of the nursing profession, enterostomal therapy (ET) / wound, ostomy, continence (WOC) nurses offer specialised care that is critical to the health of persons with wounds, ostomies and continence. ET/WOC nurses' knowledge and practice have positioned these nurses as integral partners in leadership and the delivery of care during these challenging times. The aim of this paper is to highlight five leadership themes for ET/WOC nurses that have evolved during the pandemic, namely interprofessional practice, emotional intelligence, ethical practice, advocacy, and self-care.

Management/leadership of health systems of Small Island Developing States of the English-speaking Caribbean

OBJECTIVE: To discover experiences, challenges and competencies of senior managers/leaders in health systems of Small Island Developing States (SIDS). DESIGN AND METHODS: Grounded theory was utilized to collect and analyze data on experiences and perceptions of 21senior managers/leaders from seven SIDS from the English-Speaking Caribbean. Semi-structured, in-depth interviews using open-ended questions were used. Data analysis comprised open, focused and theoretical coding. RESULTS: The model of health care management that senior managers/leaders used was intuitive decision-making driven by organizational conditions in the health system which were in turn influenced by wider societal/political and global circumstances. Amidst rising uncertainty, senior managers/leaders bring to bear the use of anecdotal information, and their experiences, skills and insights. CONCLUSION: The implication of this research is its roadmap for improvement in the management/leadership of SIDS' health systems. It points to the need for policy-oriented evidenced-based decision making that includes the input of stakeholders across the health landscape. Looking forward, it further recommends that unless there are requisite changes at the domestic, regional and global governance levels, attempts at adjustments or reform of the management/leadership of health systems would simply be futile.

Community participation for health - an assessment of a community's response [abstract]

OBJECTIVE: To evaluate factors influencing community participation in promoting community health. METHODS: This operational research project was carried out in the urban community of Air Pipe and Chambers Lanes, St.Andrew. Household heads of 50 percent of the 70 families were interviewed about their health needs, values, resources, cultural beliefs and desire to improve their health status. Community participation in ensuing interventions was observed. RESULTS: Poor water supply reported by 63 percent of family heads interviewed; indiscriminate dumping of refuse and its attendant insect, rodent and odour nuisances and low levels of health literacy were the priority problems identified by the community. Community participation in the process, including relevant solutions, was influenced by a willingness among field personnel to meet with residents at their convenience. Cleaning up of the community, an intervention undertaken, had participation of 75 percent of families subsequent to an agreement that the clean-up would exclude a gully which provided Christmas work for them. Fifty percent of the families signed up for a scheme to bring water supply into their homes. This effort failed due to lack of trust, the presence of laggards in paying the required contributions and, primarily, the withdrawal of outside leadership for sustained efforts at community empowerment. CONCLUSION: Organizing this community for participation in health was facilitated by the social influence of the organizers and respect for community values. The need for sustained efforts at attaining empowerment seems relevant and vital. (AU)

Human resources in nursing: determining requirements and skills

Beset with feeble economies and debt servicing obligations, many countries have no recourse but to impose stringent structural adjustment policies, particular in the nonproductive social sectors such as health and education. Below, a look at the effects of these restraints on the health services and on nursing and some recommendations on how nurses respond, particularly in planning human resources. (AU)