Leadership and job satisfaction in the Mobile Emergency Care Service context.

OBJECTIVE: to evaluate the correlation between the practice of Coaching Leadership performed by nursing coordinators and job satisfaction, in the self-perception of coordinators and the perception of nursing technicians of the Mobile Emergency Care Service. METHOD: a descriptive, correlational study that used the Questionnaire on Self-Perception of the Nurse in the Exercise of Leadership to measure the self-perception of leadership of the eleven nursing coordinators and the Questionnaire on Nursing Technician Perception in the Exercise of Leadership to verify the perception of 155 nurse technicians. The Job Satisfaction Questionnaire assessed job satisfaction in both categories. Correlations among instrument domains were determined using the Spearman test (p<0.05) and the association was analyzed. RESULTS: the Coaching Leadership exercise correlated with job satisfaction (p-value=0.001), both in the self-perception of nursing coordinators, with high correlation (Spearman coefficient - (0.835), and in the perception of nursing technicians, with moderate association (Spearman coefficient - 0.678). CONCLUSION: coaching Leadership showed a positive correlation with job satisfaction, marked by mutual trust, continuous interaction between nurse and nursing technicians, and the pursuit of professional and personal development.

Perception of nurse managers about the functionally-readapted worker.

OBJECTIVE: To understand the perception of nurse managers about the functionally-readapted worker. METHODS: Descriptive study with qualitative approach, whose data were collected in from November 2016 to April 2017, through interviews with 14 nurse managers of a university hospital. The content analysis analysis was applied to interpret the speeches. RESULTS: The reports converged into three categories, which revealed the impact on the management of the nursing staff, the management of the limitations of the readapted worker, and the regular follow-up planning for him. FINAL CONSIDERATIONS: Nurse managers are clear that readapted workers need special attention, so that their potentialities mat be maximized, respecting the workers' limitations. Readapted workers must be encouraged to resume their self-esteem, identity, autonomy, and feel socially included.

Perception of nurse managers about the functionally-readapted worker / La percepción de enfermeros gerentes sobre el trabajador reasignado funcionalmente / Percepção de enfermeiros gerentes sobre o trabalhador readequado funcionalmente

ABSTRACT Objective: To understand the perception of nurse managers about the functionally-readapted worker. Methods: Descriptive study with qualitative approach, whose data were collected in from November 2016 to April 2017, through interviews with 14 nurse managers of a university hospital. The content analysis analysis was applied to interpret the speeches. Results: The reports converged into three categories, which revealed the impact on the management of the nursing staff, the management of the limitations of the readapted worker, and the regular follow-up planning for him. Final considerations: Nurse managers are clear that readapted workers need special attention, so that their potentialities mat be maximized, respecting the workers' limitations. Readapted workers must be encouraged to resume their self-esteem, identity, autonomy, and feel socially included.

RESUMEN Objetivo: Conocer la percepción de enfermeros gerentes sobre el trabajador reasignado funcionalmente. Métodos: Estudio descriptivo de abordaje cualitativo, en que se recolectaron los datos en el período de noviembre de 2016 a abril de 2017, por medio de entrevistas con 14 enfermeros gerentes de un hospital universitario. En la interpretación de los discursos se utilizó la técnica de análisis de contenido. Resultados: Las declaraciones convergieron en tres categorías, que revelaron el impacto en la gestión del personal de enfermería, la gestión de las limitaciones de ese trabajador reasignado y la planificación de un seguimiento regular para él. Consideraciones finales: Los gerentes entienden que los trabajadores reasignados necesitan una atención especial, para que se maximicen sus potencialidades, respetando sus limitaciones. Es necesario estimularlos para que retomen su autoestima, identidad, autonomía y se sientan incluidos socialmente.

RESUMO Objetivo: Conhecer a percepção de enfermeiros gerentes sobre o trabalhador readequado funcionalmente. Métodos: Estudo descritivo com abordagem qualitativa, cujos dados foram coletados no período de novembro de 2016 a abril de 2017, por meio de entrevistas com 14 enfermeiros gerentes de um hospital universitário. Para interpretar os discursos utilizou-se a técnica de análise de conteúdo. Resultados: Os depoimentos convergiram em três categorias, que revelaram o impacto no gerenciamento da equipe de enfermagem, o gerenciamento das limitações desse trabalhador readequado e o planejamento de um acompanhamento regular para ele. Considerações finais: Os gerentes apresentam clareza de que os trabalhadores readequados precisam de atenção especial, para que suas potencialidades sejam maximizadas, respeitando suas limitações. Faz-se necessário estimulá-los para que retomem sua autoestima, identidade, autonomia e sintam-se incluídos socialmente.

Critical incidents connected to nurses' leadership in Intensive Care Units.

OBJECTIVE:: The goal of this study is to analyze nurses' leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. METHOD:: Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. RESULTS:: Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses' behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses' activities; people management; and the setting of high quality care targets. FINAL CONSIDERATIONS:: Researchers identified a mixed leadership model, leading them to the conclusion that nurses' knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization's results. OBJETIVO:: Analisar a liderança do enfermeiro em Centros de Terapia Intensiva de hospitais localizados no interior do estado de São Paulo, diante de incidentes críticos positivos e negativos. MÉTODO:: Estudo exploratório, descritivo, realizado com 24 enfermeiros, que utilizou a Técnica do Incidente Crítico como referencial metodológico. RESULTADOS:: Os resultados foram agrupados em 61 incidentes críticos distribuídos em categorias. Identificou-se que situações relacionadas à liderança interferem no comportamento do enfermeiro de Terapia Intensiva, dentre elas: dificuldade no processo de comunicação, conflitos existentes no dia a dia do exercício profissional, gerenciamento de pessoas e estabelecimento de metas para o alcance da assistência qualificada. CONSIDERAÇÕES FINAIS:: Encontrou-se um modelo misto de liderança, o que permite concluir que o conhecimento e a prática dos enfermeiros acerca de teorias/estilos contemporâneos de liderança tornam-se fundamentais, pois facilitam o processo de comunicação, focando nos aspectos comportamentais e crenças, e valorizam a flexibilidade, impactando positivamente os resultados da organização.

Critical incidents connected to nurses' leadership in Intensive Care Units / Incidentes críticos relativos al liderazgo del enfermero en Centros de Terapia Intensiva / Incidentes críticos relacionados à liderança do enfermeiro em Centros de Terapia Intensiva

ABSTRACT Objective: The goal of this study is to analyze nurses' leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Method: Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results: Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses' behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses' activities; people management; and the setting of high quality care targets. Final considerations: Researchers identified a mixed leadership model, leading them to the conclusion that nurses' knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization's results.

RESUMEN Objetivo: Analizar el liderazgo del enfermero en Centros de Terapia Intensiva de hospitales del interior del estado de São Paulo, ante incidentes críticos positivos y negativos. Método: Estudio exploratorio, descriptivo, realizado con 24 enfermeros, utilizando la Técnica del Incidente Crítico como referencial metodológico. Resultados: Los resultados fueron agrupados en 61 incidentes críticos, distribuidos en categorías. Se identificó que situaciones relativas al liderazgo interfieren en la conducta del enfermero de Terapia Intensiva, entre ellas: dificultades del proceso de comunicación, conflictos diarios del ejercicio profesional, gestión de personas y establecimiento de metas para alcanzar la atención calificada. Consideraciones finales: Se encontró un modelo mixto de liderazgo, que permite concluir en que conocimiento y práctica de los enfermeros acerca de teorías/estilos contemporáneos de liderazgo resultan fundamentales, pues facilitan el proceso de comunicación, enfocándose en los aspectos conductuales y en creencias, y valoran la flexibilidad, impactando positivamente en los resultados de la organización.

RESUMO Objetivo: Analisar a liderança do enfermeiro em Centros de Terapia Intensiva de hospitais localizados no interior do estado de São Paulo, diante de incidentes críticos positivos e negativos. Método: Estudo exploratório, descritivo, realizado com 24 enfermeiros, que utilizou a Técnica do Incidente Crítico como referencial metodológico. Resultados: Os resultados foram agrupados em 61 incidentes críticos distribuídos em categorias. Identificou-se que situações relacionadas à liderança interferem no comportamento do enfermeiro de Terapia Intensiva, dentre elas: dificuldade no processo de comunicação, conflitos existentes no dia a dia do exercício profissional, gerenciamento de pessoas e estabelecimento de metas para o alcance da assistência qualificada. Considerações finais: Encontrou-se um modelo misto de liderança, o que permite concluir que o conhecimento e a prática dos enfermeiros acerca de teorias/estilos contemporâneos de liderança tornam-se fundamentais, pois facilitam o processo de comunicação, focando nos aspectos comportamentais e crenças, e valorizam a flexibilidade, impactando positivamente os resultados da organização.

The meaning of evidence-based management to Brazilian senior nurse leaders.

PURPOSE: The study objective was to understand the meaning of evidence-based management for senior nurse leaders in accredited, public hospitals in the State of Sao Paulo, Brazil. DESIGN AND METHOD: A phenomenological approach was used to analyze interviews conducted with 10 senior nurse leaders between August 2011 and March 2012. The analytic method was developed by the Brazilian phenomenologist, Martins. FINDINGS: Senior nurse leaders described how they critically appraise many sources of evidence when making managerial decisions. They emphasized the importance of working with their teams to locally adapt and evaluate best evidence associated with managerial decision making and organizational innovations. Their statements also demonstrated how they use evidence-based management to support the adoption of evidence-based practices. They did not, however, provide specific strategies for seeking out and obtaining evidence. Notable challenges were traditional cultures and rigid bureaucracies, while major facilitators included accreditation, teamwork, and shared decision making. CONCLUSIONS: Evidence-based management necessitates a continuous process of locating, implementing, and evaluating evidence. In this study leaders provided multiple, concrete examples of all these processes except seeking out and locating evidence. They also gave examples of other leadership skills associated with successful adoption of evidence-based practice and management, particularly interdisciplinary teamwork and shared decision making. CLINICAL RELEVANCE: This study demonstrates senior nurse leaders' awareness and utilization of evidence-based management. The study also suggests what aspects of evidence-based management need further development, such as more active identification of potential, new organizational innovations.

The nurse executive in the public sector. Responsibilities, activities, and characteristics.

Most published research on the role of the nurse executive has occurred in the private sector. The authors expand our knowledge by reporting nurse executive practice in the public sector, specifically the Department of Veterans Affairs.