Description of an effective manager in nursing: A systematic review

Abstract

Objective

The study was to describe and previous analysis study with an effective manager in nursing.

Method

This manuscript uses systematic review design. The database is obtained from online database EBSCO, Science-Direct, JSTOR, BMC, ProQuest, Sage-Journal, and Springer=Link from 2012 to 2017. The selections are based on inclusion criteria that have been foreordained.

Results

A total of 11,917 studies was found from six databases. From, the number of these direct search, systematic review identifies conformity based on the title, so that it obtained 23 studies with a title that suitable for the selected discussion. The number of resources that had been studied was as many as 9 kinds of literature by classifying 4 factors that exemplify effective managers in nursing in terms of communication skills, leadership, work duration as well as experience and education.

Conclusion

The nursing manager can be portrayed as effective if they possess adequate. Effective communication skills with all level of organizations, positive leadership, ethics awareness. An effective manager must be supported by continuous skills through professional working experience and education. These factors need to be developed as an effective of management. The implications for nursing management must create effective managers who produce quality nursing services to patients.

Introduction

Competent managers are highly essential in building an organization to be developed, especially in facing global challenge. This is important because managers will affect many norms to increase the quality of service.¹ Effective nursing manager's role impact on the quality of services for patients, the assurance and prolongation of organizations.^2,3 One of the abilities of competent managers is their ability to lead, unite activities so that every aspect of organizations can run effectively.^4,5

Nursing managers bare duties to establish responsibility from a small group of people to a large group of people carrying complex problems.⁶ Nursing managers must have capabilities, skillfulness to oversee many things efficiently and systematically.² Ideal managers profile in nursing is judged by their leadership. Managers in nursing will affect the nurses’ performance, create strategies in many sectors, and establish a conducive working environment in order to benefit the organizations.⁷

Managers role in nursing involves many units with other multidiscipline, that preoccupy personal or interpersonal and group factors. The guise of a manager in nursing must be able to delegate and provide influence in many sectors in the organizations.²

Nursing managers will withstand many complex demands every day, in terms of controlling labor, taking work risks, providing working innovations, collaborating with other multidiscipline, formulating recruitments to developing staffs.^1,3,8 The quality of services for patients and numbers of turnover will impact the effectiveness of a nursing manager.^9,10

There are many types of research regarding managers in nursing. However, there is no research that determines the description of an effective manager in nursing. Therefore, inquiries are needed for comprehending the description of effective managers in nursing. This paper will investigate many portrayals of effective managers in nursing.

Method

This systematic review obtained a date from online database Ebsco, Science Direct, BMC, Jstor, ProQuest, Sage Journal, and SpringerLink. Journals examinations, articles, and literature review using the keywords: nurse executive, nurse manager, and effective manager. Data were obtained from 2012 to 2017. Discovery journals, articles, and literature with such keywords from the source were as many as 11,917. The selection process was done based on the predetermined inclusion criteria.

Paper of study result was identified based on criteria which set using the framework the PICos: P = participants, I = interest, Co = Context, and S = types of studies (Table 1). Studies selection adapted PRISMA flow model. The selection process went through 3 steps. First, the search in 9 databases obtained 11,917 studies. Next, the first step is to identify the title, which appropriates with the keyword and discussion, then eliminating 11,816 studies, which left 101 studies with appropriate titles. The second step is based on the abstract (n = 23), and the third selection is the content of studies as a whole based on inclusion criteria (n = 9) (Fig. 1). Furthermore, analyzing of effective of the nursing manager.

Table 1.

Factors that describe an effective manager in nursing (n = 9).

Factor	N	%
Work duration and experience	2, 6, 8, 3	33
Education	6, 8	22
Communication capability	4, 8, 13	33
Leadership	4, 8, 10, 13, 14	56

Figure 1.

Papers selection process.

Inclusion criteria are (1) title, and the abstract article focuses on nursing manager, (2) articles published in English, (3) articles that have nurses’ samples in the hospital in managerial level, and (4) research uses literature review methods, cross-sectional, experimental, quantitative or qualitative. Exclusion criteria in this systematic review include managerial articles in general. Steps of research done can be seen in Fig. 1, and after obtaining 9 papers, it will ease the analysis process, done systematically (Table 2).

Table 2.

Papers serial numbers.

No	Penulis
1	Baddar et al., 2016
2	Cui et al., 2014
3	Westphal, J., 2012
4	Rouse, R., 2014
5	Knies et al., 2014
6	Viimikainen et al., 2015
7	Thomson, S., 2017
8	Mcneese-Smith et al., 2017
9	Austin, 2017

Results

In many results of studies involving the finished selection process based on inclusion criteria, there is as many as 9 kinds of literature that become study materials in this systematic review. Factors that portray effective managers in nursing are categorized by the author into four parts, communication skills, education, work duration as well as work experience, and leadership. Categories of the portrayal of effective managers can be seen in Table 2, and research results classifications based on study design can be seen in Table 3.

Table 3.

Papers classifications based on study design (n = 9).

Factor	Review	Cross-sectional	Eksperimental	Kualitatif	Total paper
Work duration and experience				2	2
Education	1				1
Leadership	2	2			4
Communication capability			1	1	2

Communication skills. Communication becomes essential for all circles of people, especially for managers in nursing. Managers must be able to communicate effectively in any condition. This is because communication is the mentorship fundamental for other staffs, coordinating multidiscipline, easing problem-solving, creating confidence, overcoming conflicts, building interpersonal attachments, and describing criticalthinking.^6,11,12,13

Leadership. Leadership is a process that needs to be developed. The leadership of managers will affect their numbers of turnover, working environment, work performance and quality of service for patients.^3,6,9 Nursing management that possesses effective leadership will be able to constitute good teamwork, provide motivations, elucidate conflicts, mediate strategic decisions and maximize staff work satisfaction.^14,15

Education. Unfaltering education is imperative for managers because they will become the source of information and mentor.^3,8 The informational post cannot be separated from managers as the information provider for their staffs, whether it is delegating or executing functions with other multidiscipline which will be more effective.⁸

Work duration and work experience. Work duration is a period that had been succeeded in the history of work in nursing professions. Work duration includes work experience where in time will hone their skills as well as nursing skills. A process that will be done will ascend nurses to managerial levels. Managerial positions in nursing tend to be achieved by nurses who have expert work duration and skills.^3,8 Longer work duration for managers in nursing will become a process for building confidence, gaining wider connections and cooperative, assigning duties and executing delegation functions as well as collaboration.²

Discussion

It was shown in our systematic review that four factors. Those factors are categorized into four parts and become competencies that have to be possessed for becoming managers in effective nursing. Effective nurses’ managers are interpreted by their leadership skills. Leaders will influence a group of people to reach the same goal in organizations.⁹

In order to prompt a group of people, leaders need to establish effective communications, and the author opinionates, effective communication becomes fundamental in contriving leadership in a person. Nursing manager's leadership will also affect the number of turnovers of nurses in the hospital which will ascend the quality of nursery for patients.^2,6,16

Occasionally there are managers who are authoritarians in executing their duties, where their leadership nursing managers should have been more open to dialogs and make decisions with their staffs.^4,12,17 The previous research results stated that transformational leadership styles create a more positive influence for establishing conducive environment, compared to Laissez-faire leadership styles that tend to concoct blameculture.¹⁸ The research suggested that managers in nursing should apply transformational leadership because this leadership style is perceived to be more effective in supporting better staffs work performance.¹⁴

Every leadership has advantages and disadvantages. Therefore, more discussions are needed to pursue the value of effective leadership style for nursing managers and continuous leadership developments for a manager in nursing to establish effective managers.

Other factors that describe effective manager in nursing is based on education. The author recognizes that education shall be followed by work experience because it will hone skills, increase knowledge, boost confidence in playing the role and functions of managerial and staffs. That skillfulness will be supported by the number of nurses’ interactions during their professions and experience in caring for the patients. They are different from the staffs who just finished their studies and become managers, in terms of their confidence and skill in nursing executions.^3,8

Managers in nursing can be said to be more effective if they possess adequate communication skills with all level of organizations, positive leadership styles supported by the skills that are honed through professional working experience and unceasing education.

Factors for creating effective nursing managers do not show up instantly, it needs some underlying and continuing process of learning for effective managers in nursing to exist. Nursing management plays important parts in shaping the nurses’ working culture and creating service quality to patients, this comprises knowledge development planning, skillfulness, and other interpersonal capabilities. Specialized leaders in the managerial position in nursing need expert skills and competencies to create conducive working culture, decrease burnout and increase service quality for patients.

Conflict of interests

The authors declare no conflict of interest.

Acknowledgements

This work is supported by Hibah PITTA 2018 funded by Directorate of Research and Community Services Universitas Indonesia No. 1853/UN2.R3.1/HKP.05.00/2018.