Effectiveness of first line nursing managers

Date of Completion

January 1990


Business Administration, Management|Health Sciences, Nursing|Health Sciences, Health Care Management




This study evaluated what managerial activities first line nursing managers (head nurses) in acute care hospitals were responsible for and assessed effectiveness in that role. The descriptive data obtained were compared with similar data presented in a previous study (Beamen, 1986). The purpose of the comparison was to identify modifications in the head nurse management role as a result of increased regulation in the health care system.^ The path analysis method was utilized to test a model of managerial effectiveness derived from existing theory related to contingency leadership and the first line management role. The path method distinguished between direct and indirect effects of the variables and their relative importance. The variables in the model included: motivation to manage, management development, years of management experience, educational preparation, burnout, and an index of interpersonal competence. The Healthcare Management Effectiveness Analysis (HMEA) designed by the Management Research Group (1985) measured the endogenous or dependent variable of interest.^ One hundred nineteen (119) first line nursing managers practicing in Connecticut acute care hospitals were included in the study. An increase in the number and complexity of managerial behaviors in the areas of hiring, orientation, budget, meetings and committees, and patient/physician rounds was noted. The majority of the sample expressed ambivalent feelings about the head nurse role, citing lack of support from higher levels of nursing administration as a dissatisfier.^ Three of the six variables in the model contributed to the explanation of managerial effectiveness. Interpersonal ability and years of management experience exerted direct effects, while motivation to manage had an indirect effect through interpersonal ability. The data are consistent with the theoretical model described. However, the low amount of variance explained (8%) suggests the existence of influential unspecified variables.^ The demonstrated effects of interpersonal ability and years of management experience should be considered in the development of appropriate curricula to prepare first line nursing managers for their complex and challenging role. The managerial effectiveness of head nurses must be enhanced if hospitals are to meet the goal of decreasing costs while delivering high quality patient care. ^