On 2015 Nov 16, University of Kansas School of Nursing Journal Club commented:

"Voice behaviour" in this article is synonymous with "speaking up" and getting nurses involved in a meaningful conversation, addressing safety issues on the unit which our students have been exposed to through their TeamSTEPPS training in school.

On 2015 Nov 13, Lydia Maniatis commented:

I would like to note that the title of this article is rather unclear ("nurses' voice behaviour...?).

On 2015 Nov 12, University of Kansas School of Nursing Journal Club commented:

Reviewers (Team 11): Caitlin Colston, April Urie, Bethany Macchi, Lauren Meyers, Madison Steele, Elizabeth Diaz, & Huntre Graham (Senior Nursing Students - Class of 2016)

Background Introduction:

Throughout Section 2 in our Microsystem Leadership course, several of the lectures have touched on how crucial it is to have effective leadership in healthcare in order to maintain a trusting and healthy work environment not only for the patients, but for the staff as well. One topic that was recently discussed in class was about authentic leadership and how it can be utilized as an impactful leadership method. The article Authentic Leadership and Nurses' Voice Behaviour and Perceptions of Care Quality further discusses this topic by describing how personal and social identification, trust in the manager, and work engagement are all impacted by an authentic leadership style. The objective of this article is to examine how the authentic leadership style influences the level of trust staff nurses have in their managers, their voice (or speaking up) behavior, and how they perceive the quality of care given on their units (Wong, Laschinger, & Cummings, 2010, p.890). As a group we found that this article helped to clarify at a deeper level how authentic leadership makes a difference in the work environment and should be considered when we participate in future leadership roles.

Methods:

        “Authentic leadership” and “nursing” were the keywords used when searching the PubMed database for relevant articles. Using this method, our group located several articles to choose from that referred to the topic of authentic leadership in the healthcare setting. After reviewing the relevant articles, we found the article by Wong, Laschinger, and Cummings to be better suited to our topic and research requirements.
       In this study a non-experimental, predictive survey design was used to try to link authentic leadership with staff nurses’ use of voice behavior and their perceptions of the quality of care given (Wong, Laschinger, & Cummings, 2010, p. 892). For the study, the survey was broken down into sections to better ensure accurate depictions of the participant’s thoughts about their work environments. In total there were 6 sections that reviewed authentic leadership, trust in manager, personal and social identification, work engagement, voice behavior, and perceptions of unit care quality. A numerical scale was provided for the participant to rate their answers for each topic. With ethical approval from the University of Western Ontario Ethics Review Board for Health Sciences Research, a sample of 600 registered nurses working in acute care teaching and community hospitals throughout Ontario were randomly selected from the College of Nurses registry list and asked to participate in the study (Wong, Laschinger, & Cummings, 2010, p.892). In order to ensure proper data collection, multiple steps were utilized. The first step of the data collection was to mail the surveys to these nurses with a letter of information describing the study, a stamped return envelope, and a $2.00 ‘thank you’ coffee voucher. A reminder letter was then sent out two weeks after the initial survey mailing and if by three weeks there was no response, a final reminder letter and replacement questionnaire was sent out. Of the 600 requests mailed, there was a 48% response rate resulting in 280 useable surveys received from both full-time and part-time registered nurses for the study. For this study to be successful, it was crucial to ask staff nurses since they are directly impacted by various leadership styles. By gathering this information, the researchers had the potential to not only determine how effective authentic leadership is in the healthcare setting, but they were also able to provide an opportunity for the staff nurses to give voice to their opinions.

Findings:

The results of the study indicated that staff nurses found their managers to be moderately authentic in the working environment. When describing voice behavior and perceptions of the quality of care given on their units, staff nurses provided a moderately high rating. The participants also reported a moderate rating when discussing trust in their managers and work engagement. Upon review of the overall resulting data, Wong, Laschinger, & Cummings (2010) concluded that, “Authentic leadership significantly and positively influenced staff nurses’ trust in their managers and work engagement which in turn predicted voice behavior and perceived unit care quality” (p. 899). One of the limitations of this study, however, was the use of a cross-sectional design instead of a longitudinal design, which could have offered new information on how managerial use of authentic leadership impacts the work environment of the staff nurses. Another limitation was incorporating the Authentic Leadership Questionaire (ALQ) when discussing authentic leadership in the survey. At the time of the study, the ALQ was not used in nursing samples for other studies, which resulted in the researchers having to compare the some of their data to studies in other fields. Conducting the study in Ontario, Canada could also be considered a limitation as well because though the United States neighbors Canada in close proximity, there was still be a chance of cultural differences affecting the perceptions of the qualitative research provided.

Implications:

This article is important to nursing and nursing practice because it provides a foundation of evidence for nursing managers to build their leadership style. When using the authentic leadership style, nurse leaders are able to create a trustworthy environment with the staff nurses, which will then enable the staff to implement safe nursing practices such as voice (or speaking up) behavior. As students of KU School of Nursing, we are consistently told that we all have the potential to become leaders in the future, yet many of us are intimidated by this idea. By reviewing this piece of literature we can begin to visualize ourselves as effective leaders utilizing the most appropriate leadership styles; it is only in this way that we can meaningfully impact the healthcare setting by building positive relationships with our supervisors, peers, and staff.

References

Wong, C. A., Laschinger, H. K., & Cummings, G. G. (2010). Authentic leadership and nurses' voice behaviour and perceptions of care quality. Journal of Nursing Management, 18(8), 889-900.

On 2015 Nov 12, University of Kansas School of Nursing Journal Club commented:

Reviewers (Team 11): Caitlin Colston, April Urie, Bethany Macchi, Lauren Meyers, Madison Steele, Elizabeth Diaz, & Huntre Graham (Senior Nursing Students - Class of 2016)

Background Introduction:

Throughout Section 2 in our Microsystem Leadership course, several of the lectures have touched on how crucial it is to have effective leadership in healthcare in order to maintain a trusting and healthy work environment not only for the patients, but for the staff as well. One topic that was recently discussed in class was about authentic leadership and how it can be utilized as an impactful leadership method. The article Authentic Leadership and Nurses' Voice Behaviour and Perceptions of Care Quality further discusses this topic by describing how personal and social identification, trust in the manager, and work engagement are all impacted by an authentic leadership style. The objective of this article is to examine how the authentic leadership style influences the level of trust staff nurses have in their managers, their voice (or speaking up) behavior, and how they perceive the quality of care given on their units (Wong, Laschinger, & Cummings, 2010, p.890). As a group we found that this article helped to clarify at a deeper level how authentic leadership makes a difference in the work environment and should be considered when we participate in future leadership roles.

Methods:

        “Authentic leadership” and “nursing” were the keywords used when searching the PubMed database for relevant articles. Using this method, our group located several articles to choose from that referred to the topic of authentic leadership in the healthcare setting. After reviewing the relevant articles, we found the article by Wong, Laschinger, and Cummings to be better suited to our topic and research requirements.
       In this study a non-experimental, predictive survey design was used to try to link authentic leadership with staff nurses’ use of voice behavior and their perceptions of the quality of care given (Wong, Laschinger, & Cummings, 2010, p. 892). For the study, the survey was broken down into sections to better ensure accurate depictions of the participant’s thoughts about their work environments. In total there were 6 sections that reviewed authentic leadership, trust in manager, personal and social identification, work engagement, voice behavior, and perceptions of unit care quality. A numerical scale was provided for the participant to rate their answers for each topic. With ethical approval from the University of Western Ontario Ethics Review Board for Health Sciences Research, a sample of 600 registered nurses working in acute care teaching and community hospitals throughout Ontario were randomly selected from the College of Nurses registry list and asked to participate in the study (Wong, Laschinger, & Cummings, 2010, p.892). In order to ensure proper data collection, multiple steps were utilized. The first step of the data collection was to mail the surveys to these nurses with a letter of information describing the study, a stamped return envelope, and a $2.00 ‘thank you’ coffee voucher. A reminder letter was then sent out two weeks after the initial survey mailing and if by three weeks there was no response, a final reminder letter and replacement questionnaire was sent out. Of the 600 requests mailed, there was a 48% response rate resulting in 280 useable surveys received from both full-time and part-time registered nurses for the study. For this study to be successful, it was crucial to ask staff nurses since they are directly impacted by various leadership styles. By gathering this information, the researchers had the potential to not only determine how effective authentic leadership is in the healthcare setting, but they were also able to provide an opportunity for the staff nurses to give voice to their opinions.

Findings:

The results of the study indicated that staff nurses found their managers to be moderately authentic in the working environment. When describing voice behavior and perceptions of the quality of care given on their units, staff nurses provided a moderately high rating. The participants also reported a moderate rating when discussing trust in their managers and work engagement. Upon review of the overall resulting data, Wong, Laschinger, & Cummings (2010) concluded that, “Authentic leadership significantly and positively influenced staff nurses’ trust in their managers and work engagement which in turn predicted voice behavior and perceived unit care quality” (p. 899). One of the limitations of this study, however, was the use of a cross-sectional design instead of a longitudinal design, which could have offered new information on how managerial use of authentic leadership impacts the work environment of the staff nurses. Another limitation was incorporating the Authentic Leadership Questionaire (ALQ) when discussing authentic leadership in the survey. At the time of the study, the ALQ was not used in nursing samples for other studies, which resulted in the researchers having to compare the some of their data to studies in other fields. Conducting the study in Ontario, Canada could also be considered a limitation as well because though the United States neighbors Canada in close proximity, there was still be a chance of cultural differences affecting the perceptions of the qualitative research provided.

Implications:

This article is important to nursing and nursing practice because it provides a foundation of evidence for nursing managers to build their leadership style. When using the authentic leadership style, nurse leaders are able to create a trustworthy environment with the staff nurses, which will then enable the staff to implement safe nursing practices such as voice (or speaking up) behavior. As students of KU School of Nursing, we are consistently told that we all have the potential to become leaders in the future, yet many of us are intimidated by this idea. By reviewing this piece of literature we can begin to visualize ourselves as effective leaders utilizing the most appropriate leadership styles; it is only in this way that we can meaningfully impact the healthcare setting by building positive relationships with our supervisors, peers, and staff.

References

Wong, C. A., Laschinger, H. K., & Cummings, G. G. (2010). Authentic leadership and nurses' voice behaviour and perceptions of care quality. Journal of Nursing Management, 18(8), 889-900.

On 2015 Nov 13, Lydia Maniatis commented:

I would like to note that the title of this article is rather unclear ("nurses' voice behaviour...?).

On 2015 Nov 16, University of Kansas School of Nursing Journal Club commented:

"Voice behaviour" in this article is synonymous with "speaking up" and getting nurses involved in a meaningful conversation, addressing safety issues on the unit which our students have been exposed to through their TeamSTEPPS training in school.