Date of Award

Spring 5-22-2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Cecelia Catson Grindel, PhD, RN

Second Advisor

Joan Cranford, EdD, RN

Third Advisor

Robert Eisenberger, PhD

Abstract

ABSTRACT

THE EFFECTS OF HOSPITAL UNIT NURSE LEADERS’ PERCEIVED FOLLOWER SUPPORT ON NURSING STAFF PERFORMANCE OUTCOMES

by

JOY BAILEY

Hospital unit nurse leaders are increasingly expected to deliver high quality patient outcomes at less cost yet very little is known about how they accomplish these goals while meeting work force demands and the needs of the organization. Whereas the literature is replete with studies about the work environment of nurses in general, very little has been published that examines the work environment of unit nurse leaders even though, by virtue of their role, they are inextricably linked to both staff performance and patient outcomes and ultimately the success of hospital organizations.

The purpose of this study was to examine nursing support relationships (unit nurse leaders’ perceived follower support (PFS), nursing staff perception of leader supportive supervision (SS) and unit nurse leaders’ perceived organizational support), unit nurse leaders’ work stressors (role conflict, workload and span of control) and nursing staff outcomes of work team cohesion (WTC), job satisfaction, absenteeism and turnover intent on the acute care hospital nursing unit.

Thirty-two unit nurse leaders from nine urban hospitals, along with 397 of the staff they supervised were surveyed. Seventy-seven percent (n = 305) of the nursing

staff were registered nurses; the remaining 23% (n = 92) were nursing assistants and unit secretaries. The average nurse leader’s span of control was 41staff members (SD=43.5; range: 24-135). Most nurse leaders were affiliated with academic medical centers.

Results showed that leaders with higher levels of PFS were more likely to display higher levels of SS of their staff and that higher levels of SS were associated with greater WTC, higher staff job satisfaction and increased staff intent to remain with the organization. Supportive supervision mediated the relationship between PFS and staff work team cohesion, job satisfaction and turnover intent. Also the negative effects of nurse leader role conflict on SS weakened with higher PFS.

This preliminary study lays the ground work for more expansive studies on supportive interactions between unit nurse leaders and their staff, with potential to inform nurse administrators about the importance of the unit leader/staff relationship and its influence on nursing staff performance outcomes and ultimately patient outcomes.

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