Date of Award

Spring 3-4-2014

Degree Type

Dissertation

Degree Name

PhD Nursing

Department

Nursing

Advisor

Mary Ann McDermott, Ph.D

Committee Member

Dr. Marie Foley

Committee Member

Dr. Roseanne Mirabelle

Keywords

Self-Care Agency, Nurse Manager, Structural Empowerment, Psychological Empowerment

Abstract

Background: In today’s dramatically changing healthcare environment, the nurse manager’s role in an acute care hospital is critical to meet the increasing patient care demands and the goals of the organization. The literature provides consensus that optimal nurse manager role behaviors are essential to facilitate a successful unit based organizational structure that can sustain workplace success. These behaviors can be theoretically described as the result of a nurse manager’s ability as self-care agent to activate his or her power of self-care agency in order to engage in optimal role behaviors that will ultimately ensure that the goals of the organization are met (Orem, 1995). Little effort has been made to examine the innate self-care abilities of current nurse managers who must fulfill important managerial role behaviors. In addition, examination of relationships between nurse manager role behaviors and empowered workplace environments such as an organization with Magnet designation is very limited in nursing or healthcare literature.

Purpose: The purpose of this study was to examine the relationships between and among the power of self-care agency, perceived structural empowerment and psychological empowerment in nurse managers in acute care hospitals with Magnet designation.

Methods: This descriptive correlational study examined the relationships between and among self-care agency, perceived structural empowerment and psychological empowerment in nurse managers who work in an acute care hospital with Magnet designation. Ninety-seven volunteers nurse managers responded to four measurement tools including the Exercise of Self-Care Agency scale, the Conditions of Work Effectiveness-II tool, the Psychological Empowerment Instrument and a Demographic Information form.

Results: The Spearman rank correlation between self-care agency and perceived structural empowerment showed a moderate, positive correlation. The Spearman rank correlation between self-care agency and psychological empowerment showed a positive, but weak correlation. While there was a small, positive Spearman rank correlation between perceived structural empowerment and psychological empowerment, the result of a multiple regression to examine the relationship between self-care agency and the interaction between structural empowerment and psychological empowerment was not significant.

Conclusions: Findings support correlational relationships between self-care agency and structural empowerment and between structural empowerment and psychological empowerment. The findings provide some evidence that in an environment with structural support which optimizes nurse manager’s self-care agency, these relationships may potentially play an important role in alleviating the impending shortage of nurse managers by increasing the likelihood of retaining current nurse managers. Implementing and maintaining strategies that will enhance and strengthen positive structural environmental resources in current acute care hospital systems may increase retention current managers and by extension, attract the most capable and motivated nurse managers from among the ranks of bedside nurses who aspire to fill nurse manager positions in the future. The relationship between self-care agency and psychological empowerment was very weak and may be a spurious relationship.

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