Weaving Diversity, Equity, Inclusion, and Belonging for Organizational Sustainability.

Within the intricate tapestry of healthcare, the threads of diversity, equity, inclusion, and belonging (DEIB) are paramount. These elements enrich the fabric and strengthen its resilience, ensuring it stands the test of time. This article describes the origins of the American Organization for Nursing Leadership (AONL) DEIB Toolkit, its DEIB Guiding Principles, its significance in nursing leadership, and the broader implications for the evolution of nursing practice. AONL aims to transform healthcare throughout various levels of nursing practice, ensuring diverse, equitable, inclusive, and belonging-centric care environments.

Supporting the Role Transition of Interim Nurse Managers: Development of an Evidence-Based eManual.

Executive nurse leaders may rely on interim nurse managers (INMs) to fill vacated nurse manager positions open for an extended time. To optimize the INM role for future leadership succession planning, ongoing professional development for this role is critical. The authors describe the use of evidence in the creation of onboarding leadership resources to support the role transition of INMs within a healthcare environment over a 100-day period.

The Relationship Between Social Media Use, Nurse Characteristics, and Job Decision-Making.

OBJECTIVE: To describe nurses' use of social media and examine the relationship between social media use, nurse characteristics, and job decision-making. BACKGROUND: Social media shares information, connects, and influences thought. A gap remains in understanding how nurses use social media for professional purposes. METHODS: A national survey of RNs and advanced practice RNs included demographics, questions about which social media platforms respondents use personally and professionally, and engagement activities on each platform. Data analysis included descriptive statistics, Cramér's V test, and binomial logistic regression. RESULTS: Eight hundred twelve nurses participated. Platforms and activities used by nurses varied significantly by age, job title, and employment. The majority (61%) of respondents were satisfied or highly satisfied with their job, yet about one-third intended to leave their position or organization within 1 to 12 months. CONCLUSIONS: Nurse leaders should adopt a strategic, data-informed approach to leverage social media in attracting and retaining a diverse nursing workforce.

Role-Related Value Conflicts: A Qualitative Study of the Experiences of Perianesthesia Nurse Managers.

PURPOSE: Value conflicts with the potential to elicit moral distress are among the factors that contribute to burnout and threaten nurse manager retention. Little is known about the value conflicts faced by nurse managers working in the perianesthesia environment. Using the process model of managerial dissonance and responsibility attribution as a framework of inquiry, this study explored the types of value conflicts experienced by perianesthesia nurse managers and how they worked to reduce the accompanying distress. DESIGN: Qualitative, descriptive design. METHODS: Data were collected by means of semi-structured interviews from 14 participants meeting inclusion criteria. Thematic analysis was used to analyze data. FINDINGS: Eleven subthemes were identified and mapped onto the four phases of process model of managerial dissonance: Phase 1 Harm Doing Event: (1) Operational management strategies, (2) Patient care management strategies, (3) Standardized organizational practices; Phase 2 Dissonance: (4) Questioning my leadership, (5) Altered well-being, (6) Just do something; Phase 3 Attribution, (7) Consider organizational viewpoint, (8) Consider role and responsibilities, and Phase 4 Outcomes, (9) Commit to act, (10) Value the organization, and (11) Forgotten by leadership. CONCLUSIONS: Perianesthesia nurse managers experience similar types of value conflicts as inpatient nurse managers; however, some aspects of their experiences reflect the uniqueness of their practice environment. The process model of managerial dissonance and responsibility attribution serves as a useful framework for understanding the psychological difficulties and processes by which nurse managers seek to resolve the distress associated with mandated actions likely to induce harm in employees. Executive leaders must act to implement strategies to mitigate the associated psychological difficulties and prevent the increased potential in nurse managers for work-role disengagement and potential exit from the organization.

The Impact of Generation on Nurse Manager Job Satisfaction.

OBJECTIVE: The aim of this study was to determine the effects of generational membership on nurse managers' (NMs') perception of their practice environment and job satisfaction using the Nurse Manager Practice Environment Scale (NMPES). BACKGROUND: Boomers, Generation Xers, and millennials make up the NM workforce. Each has specific perceptions and expectations for their practice environment and job satisfaction. Little is known about these differences. METHODS: A secondary analysis of NM survey data was conducted using descriptive statistics and multiple regression to identify the impact of generation on NMs' perception of their practice environment and satisfaction. RESULTS: Generational membership did not significantly impact NMPES or job satisfaction scores, but the practice environment was a strong predictor of these outcomes. CONCLUSION: Generational membership did not impact NMs' satisfaction for this sample, but the practice environment did. Further research is needed to examine additional factors that influence NM satisfaction and retention.

Building the Science to Guide Nursing Administration and Leadership Decision Making.

OBJECTIVE: The aim of this study was to identify the challenges, barriers, and solutions for conducting nursing administration and leadership science (NALS) research. BACKGROUND: Evidence from leadership science should be at the forefront of nurse leaders' decision making. Yet, challenges remain in building the evidence and moving it into nursing administration and leadership practice. METHODS: This study used a Delphi technique with open-ended questions and direct content analysis to evaluate survey responses of members of the Association for Leadership Science in Nursing and American Organization for Nursing Leadership. RESULTS: Open-ended responses were coded to yield super categories and supportive codes for areas with limited evidence to guide leadership practice and the challenges for conducting NALS research. CONCLUSIONS: These findings provide future directions for continuously driving NALS research and for building and leveraging leadership science to support nursing administration decision making.

Frame of reference training for content analysis with structured teams (FORT-CAST): A framework for content analysis of open-ended survey questions using multidisciplinary coders.

In the context of a global pandemic, the need for reliable analysis of qualitative data in healthcare has never been more pressing. Open-ended questions are a feasible way for both researchers and organizational stakeholders to gain deeper insight into complex situations when timely research is needed. However, the interpretation of brief, textual responses can prove problematic. Both manual and automated/semiautomated methods of coding qualitative data have been associated with errors and costly temporal delays. Data obtained from the qualitative analysis of open-ended questions have been questioned for lacking robust insights. The present article introduces an innovative, manual, team-based method of analyzing responses to open-ended survey questions. This method was developed and implemented at the outset of the COVID-19 pandemic to understand the needs of nurses and their perceptions of organizational strategies that were implemented to address pandemic-related challenges. This framework utilizes a dedicated project management structure, general purpose software for data collection and analysis, frame-of-reference training designed for an interdisciplinary team of coders, and data analysis procedures that align with qualitative content analysis procedures. In concert, these techniques empower researchd team members with varying backgrounds and disparate levels of experience to provide unique human insights to data analysis procedures, refine the coding process, and support the abstraction of meaningful themes that were used to prioritize organizational strategies and further support nurses as the pandemic progressed.

Setting the Research Agenda for Nursing Administration and Leadership Science: A Delphi Study.

OBJECTIVE: The aim of this study was to identify and prioritize research topics for nursing administration and leadership science. BACKGROUND: Nursing administration and leadership research priorities should provide a framework for building the science needed to inform practice. METHODS: The Association for Leadership Science in Nursing (ALSN) and American Organization for Nursing Leadership (AONL) Foundation (AONL-F) for Nursing Leadership and Education collaborated on a Delphi study. Initial input on research priority items were received from ALSN and AONL members. National experts participated in a 3-round Delphi study. RESULTS: Top-ranked priorities included: 1) nurses' health, well-being, resiliency, and safety in the workplace; 2) developing and managing a nursing workforce to meet current and future healthcare needs; 3) healthy work/practice environments for direct care nurses; 4) healthy work/ practice environments for nurse leaders; 5) quantification of nursing's value across the healthcare delivery system; and 6) nurse leader development and essential competencies. CONCLUSIONS: Researchers and funders should use these priorities to guide future studies.

Factors that influence nurse manager job satisfaction: An integrated literature review.

AIMS AND OBJECTIVES: To understand factors that influence nurse manager job satisfaction. BACKGROUND: Nurse managers influence patient care, staff retention and health care initiatives, yet poor retention and recruiting outcomes threaten the supply of managers. Research regarding staff nurse job satisfaction and retention is substantial, but far less is known about these same areas for nurse managers. EVALUATIONS: Electronic databases were systematically searched to find studies regarding nurse manager job satisfaction. Articles were selected using professional guidelines and set criteria. Fourteen peer-reviewed publications were included in this review. Major themes were extracted and synthesized. KEY ISSUES: Findings from this review indicate that nurse manager job satisfaction is influenced by workloads, organisational support, nurse manager-supervisor relationships and the quality of their training and competency. CONCLUSIONS: This review found overwhelming workloads, inadequate resources, poor supervisor relationships and insufficient training to be commonplace for nurse managers. To improve satisfaction and retention, institutions must cultivate practice environments that promote healthy workloads, strong interorganisational relationships, professional growth and success of their nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT: Findings from this study reveal areas for improvement that health care institutions and senior nursing leadership can use to transform practice environments, increase nurse managers' job satisfaction and entice them to stay.

Sustaining Exemplary Practice: Leading Through the Lens of Organizational Learning.

Nurse leaders must be proficient at fostering organizational learning within their teams and throughout their companies. Organizational learning can be achieved by creating a culture conducive to learning, integrating learning practices into the team's routines, and leveraging the impact of learning by cultivating a strong, vibrant institutional memory. Authors describe the concept of organizational learning, provide strategies for fostering a culture where organizational learning thrives, and underscore the nurse leaders' role in leading organizations to achieve and sustain exemplary practice.

Magnet® and Pathway to Excellence®: Focusing on Research and Evidence-Based Practice.

Healthcare organizations seeking to achieve or maintain Magnet or Pathway to Excellence designation are increasingly challenged to demonstrate how nurses are leading or are engaged in research and evidence-based practice. This article describes common barriers to and effective strategies for developing a culture of research and evidence-based practice, with recommendations for Magnet- and Pathway-seeking organizations.

Clinical Nurses: Leading Through the Complexity of Human Trafficking.

The global crime of human trafficking, has nursing leaders urgently assessing, developing, and implementing various strategies to ensure the safety and well-being of human trafficked victims and their teams. The complex elements of human trafficking and the impact of associated consequences on victims and teams, coupled with needed resources to serve trafficked victims, could overwhelm any health care organization and community agencies. As the call for action surrounding this victimization grows, nurses are well-positioned to lead through the complexity. This article describes an improvement project led by clinical nurses and a nurse leader that involved interdisciplinary groups, the local nonprofit community, and state agencies. The ensuing partnership created a system-wide trauma-informed human trafficking program that identified and holistically addressed the health care needs of trafficked victims throughout the risk continuum.

The Incidence of Workplace Bullying and Related Environmental Factors Among Nurse Managers.

OBJECTIVE: The purpose of the study was to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States. BACKGROUND: Consequences of workplace bullying are linked to intent to leave, turnover, and harmful emotional and physical effects. METHODS: An explorative, descriptive, cross-sectional design using an online survey was utilized. RESULTS: Thirty-five percent of nurse managers reported being a target of workplace bullying with severity levels ranging from occasional to severe. Executive nurse leaders were identified as the primary perpetrator with the downward direction recognized as most prominent. CONCLUSIONS: Nurse managers are recipients of workplace bullying emanating from executive nurse leaders, clinical nurses, and their nurse manager peers.

Critical Appraisal of Electronic Surveys: An Integrated Literature Review.

Background and Purpose: Electronic surveys are an essential data collection method in survey research but there are pros and cons. The purpose of this literature review was to understand the advantages and disadvantages of electronic surveys in research. Methods: An integrated literature review was performed. Results: Twenty publications met the criteria and were analyzed. The advantages of electronic surveys include speed, cost, convenience, flexibility, ease of analyses, global reach, reduced errors, and question diversity. The disadvantages of electronic surveys are response outcomes (nonresponse, item-nonresponse/poor completion rates, and careless responding errors) and digital literacy requirements. Conclusions: The advantages of electronic surveys outweigh their disadvantages, but researchers must understand the problems associated with electronic surveys and avoid them.

Filling the Knowledge Gap for Nurse Leaders: Next Steps Following COVID-19.

The purpose of this article is to share gaps in knowledge and research related to pandemic management identified by nurse leaders during the COVID-19 pandemic. As part of a larger Delphi study, nurse leaders responded to an open-ended question about gaps in research they saw as important following the pandemic. Responses were analyzed using directed content analysis. Results are presented as 4 supercategories: Organizational leadership preparedness, adaptive leadership in crisis, innovations in care delivery, and health, well-being, and resilience.