Master's Theses

Date of Award

Summer 1996

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Advisor

Mary R. Hassett

Abstract

Empowerment of staff and directors in the health care environment is key to success in providing quality care and services to health care clients. An empowered work force influences the standards that control the nature and flow of care delivery, the working environment, and organizational productivity. Employee empowerment through the process of work redesign promotes collaborative “group thinking” regarding information, supplies, resources, and support needs necessary for quality patient care and outcomes. In the ever changing health care delivery system, nursing executives should provide an infrastructure that supports decision making at the level of those providing the care. High costs prevent multi structures of management in organizations. Empowered staff, armed with information, resources, support, and opportunity, can provide the positive fiscal and quality outcomes necessary for survival of sound health care systems. This study utilized a nonexperimental descriptive design to partially replicate an investigation that evaluated Kanter’s Structural Theory of Organizational Behavior (1977) by exploring the relationship between job-related empowerment concepts and the self-efficacy of directors in leadership competencies based on Quinn’s Competing Values Model of Management Competencies. Erickson, Tomlin, and Swain (1991) nursing theory of modeling/role-modeling was revised to apply to leadership methodology included in Quinn’s’ theory (1988) to explore director’s approach in facilitating and mentoring staff. A sampling frame was obtained from two similar Midwestern acute care medical centers. A convenience sample of two intact groups of nursing directors (N=14) and nursing staff (N=303) was included in this study. Each hospital was evaluated separately and compared by the following surveys: The Revised Conditions for Work Effectiveness Questionnaire, Organizational Relationship Scale, Organizational Descriptive Opinionnaire, A&B, and the directors also completed a Managerial Self-Efficacy Scale. Results indicated a higher overall score in empowerment for directors at both hospitals over staff nurse empowerment scores. Directors scored higher than staff in levels of informal power and in involvement of power structures in the hospitals. Director scores for empowerment directly correlated to their scores of self-efficacy. Director scores in the roles Facilitator and Mentor were high in both hospitals. Staff nurses demonstrated lower empowerment scores than directors on all tests. Staff nurse perception of the level of their immediate directors’ power was related to the perceptions of their own job-related power. Empirical evidence for the hypothesized relationships between managerial self-efficacy and perceived empowerment of directors supported the link proposed between organizational structure and high levels of performance utilizing Quinn’s (1988) differing managerial roles. The concepts of modeling and role-modeling theory were applied to the directors in evaluation of their scores in the Facilitator and Mentor roles. These roles demonstrated a positive relationship with the director’s total empowerment scores. An empowered director is able to apply the concepts of modeling and role-modeling theory to their staff. Directors scored high in all eight leadership roles at both hospitals. This study supported the findings of the study it replicated (Laschinger & Shamian, 1994). It was noted that possible recent merger activities at both organizations may have affected the staff scores in empowerment, informal power, and involvement in power structures in each organization. Future research is necessary to analyze the effect of hospital mergers and acquisitions on staff and director total empowerment scores, informal power scores, and involvement in power structures.

Rights

Copyright 1996 Linda K. Goodwin

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