Nurse unit managers’ work and impacts on clinical leadership: A cross-sectional study

Problem/Background: Nurse unit managers are critical to clinical leadership and play an important role in the contemporary context of health care management. Lack of role satisfaction and reports of excessive workloads place this crucial role at risk; it is therefore essential to understand the workplace factors that influence the important work of nurse unit managers, and the stressors that impact their leadership practices. Aim: To capture and explore nurse unit managers’ perceptions of their work and leadership practices within a large, multi-facility tertiary healthcare organisation. Methods: A cross-sectional study with a convenience sample of nurse unit managers (n=34) in an Australian health service was undertaken. A multi-dimensional instrument included socio-demographics, validated scales (perceived organisational support, work engagement, intentions to stay), purposefully developed scales (administrative workload, clinical leadership profile), and an open-ended question (clinical leadership aspirations). Nurse unit managers’ demographics and scales were analysed descriptively; content analysis was used to code the qualitative data. Findings: Nurse unit managers were clinically experienced, had limited postgraduate education, worked excessive hours, had high administrative loads, and enacted multiple leadership categories. Work engagement was characterised by absorption and dedication, nurse unit managers were ambivalent in their perceptions of organisational support. Nurse unit managers expressed aspirations for clinical leadership and wished to retain their positions in the organisation. Discussion: Due to the critical role of nurse unit managers within health systems, it is vital that knowledge of nurse unit managers’ work and leadership practices are investigated. Nurse unit managers’ clinical leadership activities and aspirations require ongoing clarification. Relationships between perceived organisational support, work engagement, and nurse unit managers’ intentions to stay need further exploration. The level of post-registration qualification in the workforce needs to be raised. Conclusion: Increased awareness of leadership realities and workplace factors that influence nurse unit managers could be used for advancing clinical leadership and ongoing role development.