Liberating the Voice of Nurse Leaders: Improving Nurse Manager Satisfaction
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Achievement of strategic priorities in one rural health system is predicated on a foundational goal—creating an ideal work environment. As such, sustaining a work environment that supports team cohesion and staff empowerment is an organizational imperative and a primary responsibility for leaders at all levels. In a biennial employee partnership assessment, nurse manager survey scores experienced double digit declines for three questions related to communication and professional influence over work. Low satisfaction and engagement of nurse managers affect role performance, the unit culture and practice environment. Lack of role power and influence inhibits goal attainment and further erodes organizational commitment. Nurse managers exhibiting behaviors of marginalization and disempowerment requested organizational support to address powerlessness and low self-esteem. Innovative strategies and nurse manager support are required to manage an increasingly complex workload and mitigate stress. Improvements are needed in nurse managers’ perception of organizational support and self-empowerment. Each nurse manager needs from his or her superior what subordinates need from nurse managers—visible commitment and tangible support. Research related to nurse leader work life and satisfaction demonstrates that in addition to senior leader support, engagement of those affected by change is an important requirement for success. These findings support this capstone project, offering strategies consistent with overcoming oppression using a group intervention model. A facilitated group process was implemented to improve nurse manager self-awareness and empowerment, including introduction of appreciative inquiry as a paradigm shift from the traditional problem-oriented perspective, compelling leaders to envision transformation of what is to what may be possible (Cooperrider & Srivastva, 1987). Reframing negativity associated with constructive feedback and change into positive dream and design processes aligns with current organizational culture imperatives. While statistically significant change was not demonstrated in pre- and post-assessment scores, participant nurse managers actively engaged in group intervention as evidenced by attendance and successful completion of a self-directed action plan. Post-intervention evaluation included the recommendation to share the appreciative inquiry model with leadership team and continue group sessions, including all nurse managers in continued supportive environment of self-awareness and advocacy. When nurse managers find their voice, they are able to transform the work environment.