First-line Nurse Managers' Preconditions for Practise : The Important Interplay between Person and Organization

The aim was to study personal and organizational conditions for first-line nurse managers and to identify and assess the skills and abilities important for leadership and management. Interviews were conducted with 5 first-line nurse managers, 5 registered nurses, 5 assistant nurses and one head of department delineating their perceptions of current and ideal roles of first-line nurse managers. Factor analysis was conducted to estimate validity and reliability of the Leadership and Management Inventory, developed in the context of this thesis, in one sample of 149 registered nurses and one sample of 197 health care personnel. Interviews and questionnaires to study expectations, experiences and outcomes of two different development programmes for 13 first-line nurse managers in a Training Programme, 14 in a Leadership Development Programme and 14 in a Comparison group were conducted. Letters and questionnaires from 32 former first-line nurse managers were analysed to describe their reasons for leaving their posts. First-line nurse managers, registered nurses and assistant nurses’ descriptions of the first-line nurse manager’s role were corresponding; the main focus was on service on the ward. The head of department described the first-line nurse manager’s responsibility towards the staff with focus on development and co-operation. Analysis of the Leadership and Management Inventory resulted in three factors: “interpersonal skills and group management”, “achievement orientation” and “overall organizational view and political savvy”. Validity and reliability were considered acceptable. Expectations concerning the development programmes were generally met; improvements corresponding to the content of the programmes were reported. Reasons to leave were personal, organizational and linked to the relationship with the head of department. Conclusion: The first-line nurse managers’ individual experiences, skills, abilities and ambitions are important, but so are the conditions in which she/he practices her/his leadership and management. It is important that the interplay between person and organization functions well.