On 2015 Nov 13, University of Kansas School of Nursing Journal Club commented:

Reviewers: (Team 10) Sydney Jourdan, Lucy Bush, Elijah Penny, Cassidy Playter, Brittany Winter, Alex Noller, Parwana Noori (Senior Nursing Students – Class of 2016)

Background:

Many of our class discussions in our microsystem leadership course focused on methods currently available to accurately measure nurse job satisfaction and the elements needed to contribute to a healthy work environment, such as nursing leadership. Our selected article attests to how there is an increasingly high number of nursing turnover due to a lack of managerial leadership and support. This study found that nurse leaders who practiced authentic leadership created an environment of nurse empowerment regardless of their experience level - this ultimately promotes nurse health and retention. . We believe leadership training for nurse managers should be a requirement in today’s health-care organizations as it will aid in the development of an empowering work environment and attract and retain nurses (Laschinger, Wong & Grau, 2013). Laschinger, Wong, & Grau (2013), examined the impact of authentic leadership, autonomous practice and continuous support on the nursing work environment. Our group felt this article directly correlated to recent class discussions, further exemplifying the impact of authentic leadership on nurse job satisfaction, performance and safety.

Methods:

Our group located this article using the CINAHL database from the Dykes Library Resource Center. The literature was discovered using the search terms “authentic leadership” AND “healthy work environment.” The design of this study included a secondary analysis of data obtained via questionnaire of two study groups from Ontario in an acute care setting. The pattern of relationships regarding emotional exhaustion and cynicism versus authentic leadership and structural empowerment were examined in a group of 342 new graduate nurses with less than two years of nursing experience and in another group of 273 nurses with over two years of work experience (Laschinger et al., 2013). This study targeted both new graduate nurses and experienced nurses in order to examine how each group was affected by a work environment in the acute care setting containing structural empowerment and authentic leadership and how such practices related to group cynicism and burnout.. The acute care patient population has a lower socioeconomic status and higher rate of drug addiction and drug seeking than other healthcare settings, rendering a higher rate of cynicism and burnout amongst its nurses. Not only does this study impact acute care nurses, but their patients as well - the empowered and contented nurse will provide better patient-centered care. Data was obtained via questionnaire. 907 questionnaire packages were sent out to a sample population with a follow-up questionnaire sent three weeks later. Of the 907 questionnaires sent, 342 responded and met the criteria of less than two years nursing experience. 280 responded for the “experienced” portion of the study however, seven cases were removed from the later analysis as these respondents did not have over two years of nursing experience, leaving a sample size of 273 experienced nurse subjects (Laschinger et al., 2013). The questionnaires utilized included the Conditions of Work Effectiveness Questionnaire-II, which examines the four components of structural empowerment and has been previously discussed in our class, the Authentic Leadership Questionnaire, which measures the four components of nurses’ perceptions of their managers’ authentic leadership qualities and the Maslach Burnout Inventory-General Survey, which measures the emotional exhaustion and cynicism of nursing burnout (Laschinger et al., 2013).

Findings:

The results of this study supported a model linking authentic leadership and structural empowerment to nursing burnout (Laschinger et al., 2013). This study is the first to investigate the relationship between authentic leadership and structural empowerment to nursing burnout and cynicism and concluded authentic leadership had both direct and indirect effects on cynicism, a phenomena that is found to be linked to emotional exhaustion related to poor work environments (Laschinger, et al., 2013). Self-awareness and balanced processing are two characteristics of authentic leadership found to be critical to the creation of an empowered work environment. Leaders who were perceived to support employees and provide both positive and negative feedback rendered nurses who reportedly felt empowered to perform quality patient care in a meaningful way. The results of this study support the validity of both structural empowerment and the authentic leadership theory. This contributes to knowledge leaders can utilize to make positive changes in nursing work environments and promote nurses’ health and retention (Laschinger et al., 2013). Health care work environments are extremely stressful - however, the results of this study show relationship-driven leadership strategies have the ability to transform current nursing environments positively and ensure all nurses are empowered to provide optimal patient-centered care. This study is important because it examines methods such as structural empowerment and authentic leadership and how these practices may lead to less emotional strain, turnover and burnout for the acute care nurse. The study also explores how a healthy work environment may render less cynicism amongst nurses - leading to happier patients, effective communication and better health outcomes.

Implications:

This article is important to nursing practice because it examines how healthy work environments are essential to effective and optimal patient-centered care. Nursing burnout and emotional strain is a very real dilemma the acute care setting faces and leads to job dissatisfaction, poorer health outcomes and turnover. In a field already facing vast nursing shortages, studies such as this one are pertinent to finding the best practice environment. This study provides evidence to implement across the healthcare setting in order to promote happier, healthier and safer work environments. As medicine and technology advance, leadership tactics and qualities must also in order to compete with a constantly evolving environment. This article resonated personally with group members who work and/or aspire to work in the acute care setting and have witnessed the reality of nurse burnout and cynicism. The nurse is already given the difficult task of treating and caring for the patient’s mind, body and spirit. Having to provide such care in a strained and/or unsupportive environment sets the nurse up for failure. As our class faces graduation, we want to feel confidently that all of our study and practice efforts will be rewarded in an environment that promotes support, empowerment and authenticity. As a result of reading and discussing this article, our group has learned preventing emotional exhaustion is key to preventing advanced burnout and can be accomplished through structural empowerment and authentic leadership practices (Laschinger et al., 2013). Moving forward as professional nurses, we will aim to act authentically, seek support when needed and ensure our work environments are those that promote empowerment in order to prevent emotional exhaustion and provide the best patient care possible.

Reference:

Laschinger, Heather K. Spence, Carol A. Wong, and Ashley L. Grau. Authentic leadership, empowerment and burnout: A comparison in new graduates and experienced nurses. Journal of Nursing Management 21, no. 3 (April 2013): 541–52 12p. doi:10.1111/j.1365-2834.2012.01375.x.

On 2015 Nov 13, University of Kansas School of Nursing Journal Club commented:

Reviewers: (Team 10) Sydney Jourdan, Lucy Bush, Elijah Penny, Cassidy Playter, Brittany Winter, Alex Noller, Parwana Noori (Senior Nursing Students – Class of 2016)

Background:

Many of our class discussions in our microsystem leadership course focused on methods currently available to accurately measure nurse job satisfaction and the elements needed to contribute to a healthy work environment, such as nursing leadership. Our selected article attests to how there is an increasingly high number of nursing turnover due to a lack of managerial leadership and support. This study found that nurse leaders who practiced authentic leadership created an environment of nurse empowerment regardless of their experience level - this ultimately promotes nurse health and retention. . We believe leadership training for nurse managers should be a requirement in today’s health-care organizations as it will aid in the development of an empowering work environment and attract and retain nurses (Laschinger, Wong & Grau, 2013). Laschinger, Wong, & Grau (2013), examined the impact of authentic leadership, autonomous practice and continuous support on the nursing work environment. Our group felt this article directly correlated to recent class discussions, further exemplifying the impact of authentic leadership on nurse job satisfaction, performance and safety.

Methods:

Our group located this article using the CINAHL database from the Dykes Library Resource Center. The literature was discovered using the search terms “authentic leadership” AND “healthy work environment.” The design of this study included a secondary analysis of data obtained via questionnaire of two study groups from Ontario in an acute care setting. The pattern of relationships regarding emotional exhaustion and cynicism versus authentic leadership and structural empowerment were examined in a group of 342 new graduate nurses with less than two years of nursing experience and in another group of 273 nurses with over two years of work experience (Laschinger et al., 2013). This study targeted both new graduate nurses and experienced nurses in order to examine how each group was affected by a work environment in the acute care setting containing structural empowerment and authentic leadership and how such practices related to group cynicism and burnout.. The acute care patient population has a lower socioeconomic status and higher rate of drug addiction and drug seeking than other healthcare settings, rendering a higher rate of cynicism and burnout amongst its nurses. Not only does this study impact acute care nurses, but their patients as well - the empowered and contented nurse will provide better patient-centered care. Data was obtained via questionnaire. 907 questionnaire packages were sent out to a sample population with a follow-up questionnaire sent three weeks later. Of the 907 questionnaires sent, 342 responded and met the criteria of less than two years nursing experience. 280 responded for the “experienced” portion of the study however, seven cases were removed from the later analysis as these respondents did not have over two years of nursing experience, leaving a sample size of 273 experienced nurse subjects (Laschinger et al., 2013). The questionnaires utilized included the Conditions of Work Effectiveness Questionnaire-II, which examines the four components of structural empowerment and has been previously discussed in our class, the Authentic Leadership Questionnaire, which measures the four components of nurses’ perceptions of their managers’ authentic leadership qualities and the Maslach Burnout Inventory-General Survey, which measures the emotional exhaustion and cynicism of nursing burnout (Laschinger et al., 2013).

Findings:

The results of this study supported a model linking authentic leadership and structural empowerment to nursing burnout (Laschinger et al., 2013). This study is the first to investigate the relationship between authentic leadership and structural empowerment to nursing burnout and cynicism and concluded authentic leadership had both direct and indirect effects on cynicism, a phenomena that is found to be linked to emotional exhaustion related to poor work environments (Laschinger, et al., 2013). Self-awareness and balanced processing are two characteristics of authentic leadership found to be critical to the creation of an empowered work environment. Leaders who were perceived to support employees and provide both positive and negative feedback rendered nurses who reportedly felt empowered to perform quality patient care in a meaningful way. The results of this study support the validity of both structural empowerment and the authentic leadership theory. This contributes to knowledge leaders can utilize to make positive changes in nursing work environments and promote nurses’ health and retention (Laschinger et al., 2013). Health care work environments are extremely stressful - however, the results of this study show relationship-driven leadership strategies have the ability to transform current nursing environments positively and ensure all nurses are empowered to provide optimal patient-centered care. This study is important because it examines methods such as structural empowerment and authentic leadership and how these practices may lead to less emotional strain, turnover and burnout for the acute care nurse. The study also explores how a healthy work environment may render less cynicism amongst nurses - leading to happier patients, effective communication and better health outcomes.

Implications:

This article is important to nursing practice because it examines how healthy work environments are essential to effective and optimal patient-centered care. Nursing burnout and emotional strain is a very real dilemma the acute care setting faces and leads to job dissatisfaction, poorer health outcomes and turnover. In a field already facing vast nursing shortages, studies such as this one are pertinent to finding the best practice environment. This study provides evidence to implement across the healthcare setting in order to promote happier, healthier and safer work environments. As medicine and technology advance, leadership tactics and qualities must also in order to compete with a constantly evolving environment. This article resonated personally with group members who work and/or aspire to work in the acute care setting and have witnessed the reality of nurse burnout and cynicism. The nurse is already given the difficult task of treating and caring for the patient’s mind, body and spirit. Having to provide such care in a strained and/or unsupportive environment sets the nurse up for failure. As our class faces graduation, we want to feel confidently that all of our study and practice efforts will be rewarded in an environment that promotes support, empowerment and authenticity. As a result of reading and discussing this article, our group has learned preventing emotional exhaustion is key to preventing advanced burnout and can be accomplished through structural empowerment and authentic leadership practices (Laschinger et al., 2013). Moving forward as professional nurses, we will aim to act authentically, seek support when needed and ensure our work environments are those that promote empowerment in order to prevent emotional exhaustion and provide the best patient care possible.

Reference:

Laschinger, Heather K. Spence, Carol A. Wong, and Ashley L. Grau. Authentic leadership, empowerment and burnout: A comparison in new graduates and experienced nurses. Journal of Nursing Management 21, no. 3 (April 2013): 541–52 12p. doi:10.1111/j.1365-2834.2012.01375.x.