Analysis critique and evaluation methods

¶ … Leadership Profiles of Senior Nurse Executives by E.A. Hemman

In a changing health care environment, the need for a change in leadership is evident. Communities are largely becoming aware of the holistic health care needs of its citizens. These communities are becoming more and more knowledgeable about health care needs and how to meet them. For these and other reasons they have placed a fair burden on the health care system to focus more closely on primary care and communication.

To meet demands of this change health care agencies have moved away from traditional non-practitioner management positions and toward clinically experienced administrators. In this analysis I will describe the findings of the researcher, E.A. Hemman in Leadership Profiles of Senior Nurse Executives, the nurses backgrounds, the rational, the health care application, and I will critique the author's understanding, rationale and conclusions.

Naturally, the role of the clinically experienced administrator falls heavily on Master's level nursing professionals. According to Hemman and others, it has then become increasingly important to profile those individuals who will or are filling these new roles, so as to understand their strengths and possible weaknesses. In an attempt to render the whole system more globally effective in the goal of effective management of holistic care, changing education curriculum and/or reformulating management procedure through consensus building.

The leadership stratification style used by Hemman in this article is stratified systems theory describing three hierarchical functional domains: strategic, organizational and production. Each of the three levels of management are further analyzed by these four general categories decision making, information giving-seeking, influencing people, and building relationships and resulted in these research questions:

What are the leadership behaviors of senior nurse executives located in four different acute care hospitals?

What is the leadership profile for these executives?

To what degree does the stratified systems theory conceptual framework assist in understanding and interpreting senior nurse executive behavior and profile?

The Nurses profiled were those in the executives in the highest-ranking position in the health care facilities profiled.

In this study, a senior nurse executive is the registered nurse occupying the highest executive position in an acute care hospital. He or she is ultimately responsible for nursing activities throughout the organization and, in the organizational chart, these executives are responsible to the hospital administrator or chief executive officer as part of the executive-level, decision-making management team. (Hemman 2000)

Nurse executives found in these positions are majority female, usually above the age of 46 and married, ethnicity was underrepresented in the studies that Hemman used but what information was available places the percentage of white at 70 black at 3 and other ethnicities encompassing the other. Educationally the nurses were expected in most positions to hold a MSN or above. The length of time in current position averages about 5 years but Hemman in quick to point out that this is probably due to the rapidly changing system rather than individual nurses employment habits.

Hemman's rational for performing this research/review was to fill a void in the profile information of senior nurse executives in regards to stratified systems theory. "The main implication of this study lies in the development of future leaders and managers." (Hemman 2000) Profiling these professionals after some of the major changes in the health care system have occurred is, for Hemman and other health care professional important to understanding the needs for both future adjustment of the executive system, the effectiveness of the changes so far and possibly the potential for the need to change the current educational curriculum for new nurses as well as for continuing education curriculum to better meet the needs of the system. "...leadership profiles can be incorporated in leadership education and training programs or any curriculum designed to prepare nursing leaders for executive level positions...leaders can use them to analyze their leadership patterns and also the profiles of their immediate supervisors." (Hemman 2000)

The leadership profile, stratified systems theory, is currently recognized as one of the most telling gauges for the effectiveness of the leadership style of the positions profiled. "These leader behaviors were developed by Yukl (1997) and consisted of a comprehensive classification of effective leader and manager behavior." (Hemman 2000) he hierarchical nature of this outline style is proposed to assist the future executive in the understanding of the transitional role of their position.

Each hierarchical stage of executive development requires a higher percentage of time be spent in the focus area of the higher leadership stratifications.

The application of this research into a healthcare facility has elements of those above, future education, current leadership effectiveness and adjustment and also includes element outlined below, the type of delivery system profiled is a kind of archetypal delivery system applicable to more than just a rural setting. The research review performed by Hemman was largely constituted of rural hospital or primary health delivery systems. Hemman has profiled the type of system that will probably meet most of the population's basic health care needs.

In a more urban setting it could be argued that the same sort of system provision would be available and the major difference would be the more readily available access to either second opinion information or specialty care, otherwise the delivery system is much like the delivery system in a rural setting. This can be associated with the social theories that place most urban dwellers in a somewhat limited regional environment where they obtain all or most of the necessities of their daily needs.