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The purpose of this paper is to examine relationships between internationally educated nurses’ (IENs’) performance in a registered nurse competency assessment process and the outcomes of their nursing registration applications. Assessments of nursing practice competencies, IEN applicant characteristics and registration outcomes were explored.

This is a secondary statistical analysis of a subset of IEN application data from a previous study in combination with assessment data from an additional database. Application data between 2008 and 2011 were analyzed using univariate/bivariate analyses and regression models to explore the relationship of performance in the assessment process and outcomes of the registration process.

Competency categories IEN applicants had difficulties with (from least to most) were Professional Responsibility and Accountability, Ethical Practice, Self-Regulation, Service to the Public, Knowledge-Based Practice: Specialized Body of Knowledge and Knowledge-Based Practice: Competent Application of Knowledge. IENs educated in the UK and USA had the highest scores and odds of meeting competencies. Applicants educated in India and Asia had lower scores and odds ratios. All national entry-to-practice examination and registration eligibility competencies were significantly related to registration outcomes. Applicants passing the exam had higher competency scores while applicants ineligible for registration had lower competency scores.

Limitations include integrity of data extracted from active databases, IEN motivation to complete the RN registration process and conversion of assessment scales for research analysis.

Results inform regulation policies that improve IEN registration processes and may be informative to regulators, assessment centers, educational institutions and IENs.

The purpose of this paper is to share preliminary evidence about nurse managers’ (NMs) role stressors and coping strategies in acute health-care facilities in Western Canada.

A qualitative exploratory inquiry provides deeper insight into NMs’ perceptions of their role stressors, coping strategies and factors and practices in the organizational context that facilitate and hinder their work. A purposeful sample of 17 NMs participated in this study. Data were collected through individual interviews and a focus group interview. Braun and Clarke’s (2006) six phase approach to thematic analysis guided data analysis.

Evidence demonstrates that individual factors, organizational practices and structures affect NMs stress creating an evolving role with unrealistic expectations, responding to continuous organizational change, a fragmented ability to effectively process decisions because of work overload, shifting organizational priorities and being at risk for stress-related ill health.

These findings have implications for organizational support, intervention programs that enhance leadership approaches, address individual factors and work processes and redesigning the role in consideration of the role stress and work complexity affecting NMs health.

It is anticipated that health-care leaders would find these results concerning and inspire them to take action to support NMs to do meaningful work as a way to retain existing managers and attract front line nurses to positions of leadership.

The purpose of this paper is to illustrate the formation of the Leadership Development Initiative (LDI) and to demonstrate how the program was collaboratively tailored to meet the organizational and developmental needs of leaders in the organization, using a learning cohort approach for implementation.

This paper describes how the LDI was designed, implemented, and assessed through its various stages of formation. Beginning with theory, a learning cohort approach was envisioned to not only bridge organizational departments by bringing leaders from all divisions to learn together, but would also be more sustainable in the long term. A participatory action research study was used to enhance program development and to ultimately explore the effectiveness of the LDI.

The LDI was critical to developing leadership and management competencies/skills, organizational networking, relationship building, and fostering a philosophy of leadership as collaborative visionary practice toward a common goal.

The conceptual framework of the LDI using a learning cohort approach may provide an approach for further development of leadership programs in other healthcare organizations.

The LDI demonstrated how internally developed leadership programs can be an effective approach, with evaluation and application of research findings to continually improve and enhance the program, when resources are limited but the desire to learn is not.

The LDI program is a peer based, cohort approach established through a conceptual framework based on advanced leadership theories and practices.

The purpose of this paper is to test a model linking physical therapy (PT) and occupational therapy (OT) practitioners’ perceptions of resonant leadership, structural empowerment and psychological empowerment to their experiences of spirit at work (SAW), job satisfaction and organizational commitment within the Canadian workplace.

The authors tested the model using LISREL 8.80 and survey data from 101 OTs and 169 PTs, randomly selected by the Alberta professional licensing associations. Content analysis of responses to the open-ended comments section provided additional depth and insight.

Analysis of results culminated in minor modifications to the original theoretical model, creating separate PT and OT models. Both models revealed a good fit with the observed data. Several SAW concepts accounted for moderate to large amounts of variance in both PT and OT models, indicating that SAW is a comprehensive workplace outcome.

Theory was derived from business and nursing research literature due to limited rehabilitation research literature. Discussion of OT results must consider the small sample size. This study is initial exploratory research.

Each discipline-specific model provides professionals, health care leaders and policy makers with a rich body of information upon which to base beneficial workplace decisions. SAW will guide leaders in the holistic development and enrichment of the work environment.

This research contributes to the substantive knowledge of the OT and PT disciplines, particularly in the areas of leadership, workplace structural organization and indicators of healthy work environments such as SAW, empowerment, job satisfaction and organizational commitment.

The study purpose was to assess the evidence on the effects of hospital restructuring that included layoffs, on nurses who remained employed, using a systematic review of the research literature to contribute to policy formation. Papers addressing research, hospital restructuring resulting in layoffs, effects on nurses, and a stated relationship between the independent and dependent variables were included. Data were extracted and the quality of each study was assessed. The final group of included studies had 22 empirical papers. The main effects were significant decreases in job satisfaction, professional efficacy, ability to provide quality care, physical and emotional health, and increases in turnover, and disruption to healthcare team relationships. Nurses with fewer years of experience or who experienced multiple episodes of restructuring experienced greater effects. Other findings remain inconclusive. Further research is required to determine if these effects are temporal or can be mitigated by individual or organizational strategies.

Authentic leadership is an emerging theoretical model purported to focus on the root component of effective leadership. The purpose of this paper is to describe the relevance of authentic leadership to the advancement of nursing leadership practice and research and address the question of whether this is a new theory for leadership or an old one in new packaging.

The paper outlines the origins and key elements of the model, assesses the theoretical, conceptual and measurement issues associated with authentic leadership and compares it with other leadership theories frequently reported in the nursing literature.

The emerging authentic leadership theory holds promise for explaining the underlying processes by which authentic leaders and followers influence work outcomes and organizational performance. Construct validity of authentic leadership has preliminary documentation and a few studies have shown positive relationships between authenticity and trust. Furthermore, the clarity of the authenticity construct and comprehensiveness of the overall theoretical framework provide a fruitful base for future research examining the relationship between authentic leadership and the creation of healthier work environments.

A clear focus on the relational aspects of leadership, the foundational moral/ethical component, a potential linkage of positive psychological capital to work engagement and the emphasis on leader and follower development in the authentic leadership framework are closely aligned to current and future nursing leadership practice and research priorities for the creation of sustainable changes in nursing work environments.

The purpose of this paper is to explore the underlying theoretical assumptions and implications of current micro-level performance management and evaluation (PME) practices, specifically within health-care organizations. PME encompasses all activities that are designed and conducted to align employee outputs with organizational goals.

PME, in the context of healthcare, is analyzed through the lens of critical theory. Specifically, Habermas’ theory of communicative action is used to highlight some of the questions that arise in looking critically at PME. To provide a richer definition of key theoretical concepts, the authors conducted a preliminary, exploratory hermeneutic semantic analysis of the key words “performance” and “management” and of the term “performance management”.

Analysis reveals that existing micro-level PME systems in health-care organizations have the potential to create a workforce that is compliant, dependent, technically oriented and passive, and to support health-care systems in which inequalities and power imbalances are perpetually reinforced.

At a time when the health-care system is under increasing pressure to provide high-quality, affordable services with fewer resources, it may be wise to investigate new sector-specific ways of evaluating and managing performance.

In this paper, written for health-care leaders and health human resource specialists, the theoretical assumptions and implications of current PME practices within health-care organizations are explored. It is hoped that readers will be inspired to support innovative PME practices within their organizations that encourage peak performance among health-care professionals.

Using data from a feminist discourse analysis of comments on Facebook news articles, this research outlines backlash and regulatory practices directed towards youth activists Greta Thunberg, X González and Malala Yousafzai. A conceptual framework of semiotic violence highlights how these comments function to silence, delegitimise, vilify and punish sociopolitically active girls who challenge the status quo. The first mode of semiotic violence works to symbolically annihilate girl activists by silencing or rendering their political contributions invisible. The most obvious manifestation of this is instructing girls to shut up and go away. Additionally, their activism is ignored by refusals to acknowledge it as appropriate through suggestions they focus on gender-normative activities, such as domestic chores, playing with dolls and finding boyfriends. Undermining girls’ agency by describing them as puppets, mouthpieces, script readers, pawns and tools is also common. Here, girls’ contributions are rendered invisible through implications that they are being brainwashed and manipulated. The second mode of semiotic violence reinforces ideologies that girls are not politically competent and punishes them for being outspoken. This includes explicitly discrediting girls’ knowledge and abilities. Regulating their emotionality is also prevalent. This is consistent with Liberal political theory which justified women’s exclusion from public life by associating men with reason and women with emotion. Finally, insults degrade them for transgressing into a space demarcated as an adult and masculine realm. The semiotic violence directed towards these ‘girl power’ figures highlights that many people do not believe girls have the right to assert their sociopolitical opinion.

An overview of the impact of dementia that focuses on underdeveloped countries across the globe, and migrant and minority ethnic communities within the developed world. Increased longevity increases the risk of dementia and brings new challenges in terms of cultural perspectives and cultural obligations in the care of elders. The chapter examines these challenges in detail and their consequences in planning for support and care.