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The purpose of this paper is to compare the perceived transformational leadership practices of charge and staff nurses. Transformational leadership is effective in promoting change in organisations, with the leader guiding followers towards a common vision.

A quantitative, descriptive, comparative survey design was used. All charge nurses (N = 151) and staff nurses (N = 1,950) in six health entities in Malta were included. A mixed mode survey design was used. Data were collected using the Leadership Practices Inventory and analysed using ANOVA and the Kruskal–Wallis test.

An overall response rate of 15% (n = 315) was achieved. Both staff and charge nurses perceived transformational leadership to be practiced. Charge nurses scored consistently higher than staff nurses. In long-term care environments, charge nurses are more likely to “model the way”, while in acute settings, they were more likely to “enable others to act”.

Transformational leadership appears to be applied by charge nurses in Malta. The response rate achieved was low and may limit the generalisability of the results of the study.

Nurse managers need to adapt their transformational leadership style based on the context in which they work.

Regular feedback from nursing staff should be sought for charge nurses to be aware of the extent to which they are implementing transformational leadership.

The aim of this paper is to examine the leadership role of the ward sister/charge nurse in the English National Health Service and demonstrate that its influence in maintaining standards of care has been undermined.

This is achieved through a critical review of the relevant research and policy literature. Evidence relating to recent failures in the provision of nursing care is summarised to establish the nature of the problem. This is followed by an analysis of existing research concerned with the ward sister/manager role in the context of recent policy.

The evidence demonstrating that the ward sister/charge nurse is one of the key determinants of quality care has been overlooked in recent years and this in part accounts for the quality failures that have occurred in NHS hospitals of late.

Action is needed to place the ward sister/charge nurse at the heart of the hospital system. Systems of organisational and mutual support are needed to ensure that these ward-based leaders can reach their full potential as the guardians of care.

The perspective offered in this paper illustrates how a solution to pressing organisational problem can be found through accessing the appropriate literature. Although the recommended action may not be “new” it is novel in the sense that it is based on rediscovering a role that already exists and can be supported to bring about change, rather than seeking wholesale complex change.

This project was organised in response to nursing teams experiencing sustained pressure, reflected by increased staff sickness, escalating complaints and emerging themes in clinical incident reports. A framework was developed to provide a structure that would enable a team of senior nurses to review nursing practice in any clinical speciality within the acute Trust. The aim was to highlight and report on areas of good practice, identifying and making recommendations in areas for improvement. The review process involved gathering information that helped to form a triangle of evidence. Interviews were conducted with the multi‐disciplinary team in order to provide evidence. There has been evidence of improved morale at ward level that can be attributed to changes in practice and improved resource allocation. There is clear evidence of changes at service level enabling a more seamless system of care delivery. The framework and methodology developed for this review process can be adopted to make an initial assessment of nursing care within the clinical area.

This ethnographic revisit of a general hospital aims to critically explore and describe the mechanisms of corporate culture change and how institutional excellence is facilitated and constrained by everyday management practices between 1996/1997 and 2014/2015.

A five-month field study of day-to-day life in the hospital's nursing division was conducted by means of an ethnographic revisit, using participant-observation, semi-structured interviews, free conversations and documentary material.

Using labour process analysis with ethnographic data from a general hospital, the corporate culture is represented as faceted, complex and sophisticated, lending little support to the managerial claims that if corporate objectives are realised, they are achieved through some combination of shared values, beliefs and managerial practices. The findings tend to support the critical view in labour process writing that modern managerial initiatives lead to tightened corporate control, advanced employee subjection and extensive effort intensification. The findings demonstrate the way in which the nursing employees enthusiastically embrace many aspects of the managerial message and yet, at the same time, still remain suspicious and distance themselves from it through misbehaviour and adaptation, and, in some cases, use the rhetoric against management for their own ends.

What are the implications for clinical and managerial practitioners? The recommendations are to (1) develop managerial practitioners who are capable of managing change combined with the professional autonomy of clinical practitioners, (2) take care to practise what you preach in clinical and managerial reality, as commitment, consent, compliance and difference of opinion are signs of a healthy corporate culture and (3) consider the implications between social structures and human actions with different work behaviours on different levels involved.

This ethnographic revisit considers data from a labour process analysis of corporate culture change in a general hospital and revisits the ways in which contradictory expectations and pressures are experienced by nursing employees and management practitioners spread 17 years apart.

Not only does leadership produce changes, but those changes produce leadership in organisations. The purpose of this paper is to present a theoretical and empirical analysis of the transformation of leadership at two different historical points in a health care organisation. It leans on the perspective of social constructionism, drawing especially from the ideas of Berger and Luckmann (1966). The paper seeks to improve understanding of how leaders themselves construct leadership in relation to organisational change.

The empirical material was gathered in a longitudinal case study in a nursing organisation in two different historical and situational points. It consists of written narratives produced by nurse leaders that are analysed by applying discourse analysis.

The empirical study revealed that the constructions of leadership were dramatically different at the two different historical and situational points. Leadership showed up as a complex, fragile and changing phenomenon, which fluctuates along with the other organisational changes. The results signal the importance of agency in leadership and the central role of “significant others”.

The paper questions the traditional categorisation and labelling of leadership as well as the cross-sectional studies in understanding leadership transformation. Its originality relates to the longitudinal perspective on transformation of leadership in the context of a health care organisation.

This article examines how a profit-centered restructuring of labor relations in an academic medical center undermined team-based care practices in its intensive care unit. The Institute of Medicine has promoted team-based care to improve patient outcomes, and the staff in the intensive care unit researched for this paper had established a set of practices they defined as teamwork. After hospital executives rolled out a public relations campaign to promote its culture of teamwork, they restructured its workforce to enhance numerical and functional flexibility in three key ways: implementing a “service line” managerial structure; cutting a range of staff positions while combining others; and doubling the capacity of its profitable and highly regarded intensive care unit. Hospital executives said the restructuring was necessitated by changes to payment models brought forth by the Affordable Care Act. Based on 300 hours of participant-observation and 35 interviews with hospital staff, findings show that the restructuring lowered staff resources and intensified work, which limited their ability to practice care they defined as teamwork and undermined the unit’s collective identity as a team. Findings also show how staff members used teamwork as a sensitizing concept to make sense of what they did at work. The meanings attached to teamwork were anchored to positions in the hospitals’ organizational hierarchy. This paper advances our understanding of he flexible work arrangements in the health care industry and their effects on workers.

The purpose of this paper is to examine nurses’ attitudes towards safety culture in six Saudi Arabian intensive care units (ICUs).

The study is descriptive with a cross-sectional design. The Safety Attitude Questionnaire (SAQ)-ICU version was distributed and 216 completed questionnaires were returned.

The findings provide a basis for further research on Saudi Arabian ICU safety culture. This study showed that the SAQ-ICU can be used to measure safety climate to identify areas for improvement according to nurse attitudes and perceptions. Findings indicate that ICU safety culture is an important issue that hospital managers should prioritise.

The SAQ-ICU questionnaire, used to measure safety climate in Saudi Arabian ICUs, identifies service strengths and improvement areas according to attitudes and perceptions.

To the knowledge, this is the first study to use SAQ to examine nurses’ safety culture attitudes in Saudi Arabian ICUs. The present findings provide a baseline and further details about Saudi Arabian ICU safety. Study participants represented nine nationalities, indicating the nursing workforce's diversity, which is expected to continue in the future. Such a nursing cultural heterogeneity calls for further studies to examine and evaluate attitudes and values to improve ICU safety culture.

Hospital nurse managers are in the middle. Their supervisors expect that they will monitor and discipline nurses who commit errors, while also asking them to create a culture that fosters reporting of errors. Their staff nurses expect the managers to support them after errors occur. Drawing on interviews with 20 nurse managers from three tertiary care hospitals, the study identifies key exemplars that illustrate how managers monitor nursing errors. The exemplars examine how nurse managers: (1) sent mixed messages to staff nurses about incident reporting, (2) kept two sets of books for recording errors, and (3) developed routines for classifying potentially harmful errors into non-reportable categories. These exemplars highlight two tensions: the application of bureaucratic rule-based standards to professional tasks, and maintaining accountability for errors while also learning from them. We discuss how these fundamental tensions influence organizational learning and suggest theoretical and practical research questions and a conceptual framework.

The purpose of this article is to assess whether tele‐nursing in Scotland (NHS24), when compared with traditional face‐to‐face nursing, facilitates greater employee control over working time and therefore a potentially better work‐life balance.

The article draws on evidence from two independent research projects; a survey of 64 ward nurses and midwives, which involved face‐to‐face interviews; and a field study of tele‐nursing in a large site in Scotland, using interviews and observations of 15 nurse advisors or tele‐nurses.

Three elements of work organisation are central in shaping nurses' working hours and their control over the balance between their work and their home life: the management of working hours; the degree of mutual dependency of nurses within teams; and the nature of patient care.

The two pieces of research reported offer a strong basis for comparative study. However, the two projects were designed independently, though research questions overlapped and one researcher conducted the field work in both settings; there is an imbalance in the number of interviews conducted in each setting; and the nurse advisor interviewees are of the same clinical grade, whereas a variety of grades and clinical areas are represented among the hospital nurse interviewees.

This is the first study of work‐life balance amongst tele‐nurses. The research demonstrates that call centre work has rationalised, depersonalised and yet enabled more “control” by nurses over their work‐life balance, while paradoxically offering less autonomy in their task environment. In conventional work settings professional values make it difficult for nurses to disengage from the workplace.

The purpose of this paper is to determine the managerial capabilities that are required of medical and nursing managers, in a Christian-affiliated hospital in Israel, in order to promote the job satisfaction of their subordinates.

Data were gathered via questionnaires, administered to 107 doctors and nurses of a small Christian-affiliated hospital in Israel, regarding the job satisfaction of the respondents, and their evaluation of the managerial capabilities of their medical and nursing superiors. Correlations and regressions were carried out on the data.

Overall managerial capabilities of medical and nursing managers were shown to be significantly related to how their subordinates felt about their teams and about their work. The results suggest differences between nurses and doctors. When analyzed for the two dimensions of managerial capabilities and the two dimensions of job satisfaction, the results were significant for the nurses, but not significant for the doctors. When tested for Christians vs non-Christians, the results for the nurses were the same as in the sample as a whole; whereas for the doctors, there were differences between the two religious groups.

The sample is small and culturally specific, thus limiting the generalization potential of this study.

Findings of this research may have practical implications regarding hospitals’ recruitment, promotion, instruction and follow-up policies.

This study sheds light on the issue of hospital management and leadership within a specific cultural-religious setting, which has not been previously investigated.