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

Reviewer (Team 2): Jennifer Patton, Jessica Reed, Kendal Miller, Brittanny Nedblake, Christena Beer, Melissa Zanski-Loughlin, & Haydee Fewell (Senior Nursing Students Class of 2016)

Background and Introduction:

        Healthcare is currently going through a major reform due to multiple factors, including a change in government funding and a decline in the economy. As this is reforming, work environments in the health professions are becoming more stressful. Studies have shown that empowered healthcare providers have more of an effect on improving work environments, and effective leadership helps empower the workplace. The purpose of this article was “to test a model linking authentic leadership of manager with nurses’ perceptions of structural empowerment, self-rated performance, and job satisfaction” (Wong & Laschinger, 2012, p. 948). Leadership styles of nurse managers contribute immensely to a healthy work environment and researchers want to test the effectiveness of the authentic leadership style, since it is relatively new. Our team chose this article because we feel that it proved how well authentic leadership could positively affect the nursing work environment and how it can be applied to a wide range of settings.

Methods:

Our group used Google scholar to find research articles related to what we have been discussing in class. We searched the phrase “authentic leadership” and made sure parameters were set to articles that were published in the last five years and found an article that encompassed many of the topics we have discussed in class this year including: authentic leadership, healthy work environments, structural empowerment, and job satisfaction. The study first started out by gathering data from a random sample of 600 registered nurses (excluding manager, charge, or educator positions). They were sent questionnaires that evaluated their current work environments. The Authentic Leadership Questionnaire measured nurses’ perception of how their manager’s leadership style matched up to be an authentic leader. The Conditions of Work Effectiveness Questionnaire II was used to measure their working environment’s empowerment. The Global Job Satisfaction Survey was used to measure job satisfaction, and overall job performance was measured using the General Performance scale (Wong et al., 2012). Due to a 48% response rate, a final sample of 280 participants was utilized for the study. The data received from these surveys was analyzed using SPSS version 19.0 for Windows and the hypothesized model (authentic leadership’s direct affects on structural empowerment which then indirectly impacts job satisfaction and performance) was examined with the AMOS 19.0 version. The target population in this study was registered nurses, because they were the ones that were being affected the most by the leadership styles and empowerment of the nurse manager. The problem of stressful work environments impacts both nurses and patients. Stressful working environments lead to nurses who don’t give as good of care to the patients as they would if they were more content with their job. Restoring a healthier work environment would improve patient safety and better patient health outcomes.

Findings:

        The average age of nurses in the sample used for the research study was 43.4 years and these nurses had about 19 years of experience in the nursing field, working on medical-surgical units or ICU’s. Another important demographic to note is the education level. The majority of nurses represented were diploma prepared. Nurses’ described moderate job satisfaction and performance, which is indicated with a mean of 3.65 and 3.72, and standard deviation of 1.01 and 0.49, respectively. After analyzing the data collected through the different surveys, the researchers found some inconsistencies between the hypothetical model and covariance data that would suggest a direct, instead of indirect, relationship between authentic leadership and nurses’ job satisfaction (Wong et al., 2012). The final model proved to be statistically significant. According to the evidence, “structural empowerment mediated the relationship between authentic leadership and job satisfaction and performance”  (Wong et al., 2012, p. 953). It was also determined that “authentic leadership had a statistically significant positive direct and indirect effect on job satisfaction through empowerment” (Wong et al., 2012, p. 954).  Because this study is one of the first to observe how authentic leadership affects structural empowerment, which in turn impacts nurses’ job satisfaction and performance, further studies of this kind need to be done in order to provide higher external validity and make it transferable to other populations.  Another limitation of this study was that it used self-report measures; so common method variance could potentially be a factor. The authors also note that other studies should be done in order to explore other possible mediators between authentic leadership and job satisfaction and performance (Wong et al., 2012). This study was done in Ontario, Canada, so its important to be aware of the differences between possible studies performed here in the U.S. The demographics in the U.S. may be slightly different, altering the data results. As compared to Canada, nurses working in the U.S. are mainly ADN or BSN prepared nurses.  This education level can impact the degree of job satisfaction and performance as described in the surveys.

Implications:

        This article is one of many that play a key role in nursing practice, because it offers insight on how certain leadership styles can positively influence nursing work environments. When nurse managers empower their employees, they create an atmosphere where nurses are more satisfied and perform their tasks more efficiently. This ultimately increases patient outcomes and leads to higher, quality nursing care. Components of an authentic leader include “transparency, balanced processing, self-awareness, and high ethical standards” (Wong et al., 2012, p. 955). By understanding the qualities that are needed for effective leadership, nurses can further the movement to creating healthy work environments. As future nurses, we believe that this study provides certain criteria that are critical as we begin to search for jobs. We see the value in leadership styles and how that impacts the overall work environment. In addition, according to Kanter’s theory of structural empowerment by having access to opportunity, resources, support and information, nurses feel more autonomous in their jobs and report more meaningful work environments (Laschinger, Gilbert, Smith & Leslie, 2010). All these components are interrelated and strongly impact the microsystem. Our role as healthcare providers is to offer our patients the highest, quality care that results in better patient outcomes. In order to accomplish this, we must establish relationships with our coworkers that are respectful, open and encouraging so that we then feel empowered to practice to the fullest extent of our nursing education. This will transform the nursing profession and the care provided to our patients. 

References

Wong, C.A. & Laschinger H.K.S (2012). Authentic leadership, performance and job satisfaction: the mediating role of empowerment. Journal of Advanced Nursing 69(4). 947-959.

Laschinger, H.K.S., Gilbert, S., Smith, L.M., & Leslie, K. (2010). Towards a comprehensive theory of nurse/patient empowerment: Applying Kanter’s empowerment theory of patient care. Journal of Nursing Management. DOI: 10.1111/j.1365-2834.2009.01046.x

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

Reviewer (Team 2): Jennifer Patton, Jessica Reed, Kendal Miller, Brittanny Nedblake, Christena Beer, Melissa Zanski-Loughlin, & Haydee Fewell (Senior Nursing Students Class of 2016)

Background and Introduction:

        Healthcare is currently going through a major reform due to multiple factors, including a change in government funding and a decline in the economy. As this is reforming, work environments in the health professions are becoming more stressful. Studies have shown that empowered healthcare providers have more of an effect on improving work environments, and effective leadership helps empower the workplace. The purpose of this article was “to test a model linking authentic leadership of manager with nurses’ perceptions of structural empowerment, self-rated performance, and job satisfaction” (Wong & Laschinger, 2012, p. 948). Leadership styles of nurse managers contribute immensely to a healthy work environment and researchers want to test the effectiveness of the authentic leadership style, since it is relatively new. Our team chose this article because we feel that it proved how well authentic leadership could positively affect the nursing work environment and how it can be applied to a wide range of settings.

Methods:

Our group used Google scholar to find research articles related to what we have been discussing in class. We searched the phrase “authentic leadership” and made sure parameters were set to articles that were published in the last five years and found an article that encompassed many of the topics we have discussed in class this year including: authentic leadership, healthy work environments, structural empowerment, and job satisfaction. The study first started out by gathering data from a random sample of 600 registered nurses (excluding manager, charge, or educator positions). They were sent questionnaires that evaluated their current work environments. The Authentic Leadership Questionnaire measured nurses’ perception of how their manager’s leadership style matched up to be an authentic leader. The Conditions of Work Effectiveness Questionnaire II was used to measure their working environment’s empowerment. The Global Job Satisfaction Survey was used to measure job satisfaction, and overall job performance was measured using the General Performance scale (Wong et al., 2012). Due to a 48% response rate, a final sample of 280 participants was utilized for the study. The data received from these surveys was analyzed using SPSS version 19.0 for Windows and the hypothesized model (authentic leadership’s direct affects on structural empowerment which then indirectly impacts job satisfaction and performance) was examined with the AMOS 19.0 version. The target population in this study was registered nurses, because they were the ones that were being affected the most by the leadership styles and empowerment of the nurse manager. The problem of stressful work environments impacts both nurses and patients. Stressful working environments lead to nurses who don’t give as good of care to the patients as they would if they were more content with their job. Restoring a healthier work environment would improve patient safety and better patient health outcomes.

Findings:

        The average age of nurses in the sample used for the research study was 43.4 years and these nurses had about 19 years of experience in the nursing field, working on medical-surgical units or ICU’s. Another important demographic to note is the education level. The majority of nurses represented were diploma prepared. Nurses’ described moderate job satisfaction and performance, which is indicated with a mean of 3.65 and 3.72, and standard deviation of 1.01 and 0.49, respectively. After analyzing the data collected through the different surveys, the researchers found some inconsistencies between the hypothetical model and covariance data that would suggest a direct, instead of indirect, relationship between authentic leadership and nurses’ job satisfaction (Wong et al., 2012). The final model proved to be statistically significant. According to the evidence, “structural empowerment mediated the relationship between authentic leadership and job satisfaction and performance”  (Wong et al., 2012, p. 953). It was also determined that “authentic leadership had a statistically significant positive direct and indirect effect on job satisfaction through empowerment” (Wong et al., 2012, p. 954).  Because this study is one of the first to observe how authentic leadership affects structural empowerment, which in turn impacts nurses’ job satisfaction and performance, further studies of this kind need to be done in order to provide higher external validity and make it transferable to other populations.  Another limitation of this study was that it used self-report measures; so common method variance could potentially be a factor. The authors also note that other studies should be done in order to explore other possible mediators between authentic leadership and job satisfaction and performance (Wong et al., 2012). This study was done in Ontario, Canada, so its important to be aware of the differences between possible studies performed here in the U.S. The demographics in the U.S. may be slightly different, altering the data results. As compared to Canada, nurses working in the U.S. are mainly ADN or BSN prepared nurses.  This education level can impact the degree of job satisfaction and performance as described in the surveys.

Implications:

        This article is one of many that play a key role in nursing practice, because it offers insight on how certain leadership styles can positively influence nursing work environments. When nurse managers empower their employees, they create an atmosphere where nurses are more satisfied and perform their tasks more efficiently. This ultimately increases patient outcomes and leads to higher, quality nursing care. Components of an authentic leader include “transparency, balanced processing, self-awareness, and high ethical standards” (Wong et al., 2012, p. 955). By understanding the qualities that are needed for effective leadership, nurses can further the movement to creating healthy work environments. As future nurses, we believe that this study provides certain criteria that are critical as we begin to search for jobs. We see the value in leadership styles and how that impacts the overall work environment. In addition, according to Kanter’s theory of structural empowerment by having access to opportunity, resources, support and information, nurses feel more autonomous in their jobs and report more meaningful work environments (Laschinger, Gilbert, Smith & Leslie, 2010). All these components are interrelated and strongly impact the microsystem. Our role as healthcare providers is to offer our patients the highest, quality care that results in better patient outcomes. In order to accomplish this, we must establish relationships with our coworkers that are respectful, open and encouraging so that we then feel empowered to practice to the fullest extent of our nursing education. This will transform the nursing profession and the care provided to our patients. 

References

Wong, C.A. & Laschinger H.K.S (2012). Authentic leadership, performance and job satisfaction: the mediating role of empowerment. Journal of Advanced Nursing 69(4). 947-959.

Laschinger, H.K.S., Gilbert, S., Smith, L.M., & Leslie, K. (2010). Towards a comprehensive theory of nurse/patient empowerment: Applying Kanter’s empowerment theory of patient care. Journal of Nursing Management. DOI: 10.1111/j.1365-2834.2009.01046.x