This study investigated the relationships between seven workload factors and patient and nurse outcomes. (1) Background: Health systems researchers are beginning to address nurses’ workload demands at different unit, job and task levels; and the types of administrative interventions needed for specific workload demands. (2) Methods: This was a cross-sectional correlational study of 472 acute care nurses from British Columbia, Canada. The workload factors included nurse reports of unit-level RN staffing levels and patient acuity and patient dependency; job-level nurse perceptions of heavy workloads, nursing tasks left undone and compromised standards; and task-level interruptions to work flow. Patient outcomes were nurse-reported frequencies of medication errors, patient falls and urinary tract infections; and nurse outcomes were emotional exhaustion and job satisfaction. (3) Results: Job-level perceptions of heavy workloads and task-level interruptions had significant direct effects on patient and nurse outcomes. Tasks left undone mediated the relationships between heavy workloads and nurse and patient outcomes; and between interruptions and nurse and patient outcomes. Compromised professional nursing standards mediated the relationships between heavy workloads and nurse outcomes; and between interruptions and nurse outcomes. (4) Conclusion: Administrators should work collaboratively with nurses to identify work environment strategies that ameliorate workload demands at different levels.

To describe and compare registered nurse (RN) and licensed practical nurse (LPN) emotional exhaustion, intention to leave and reasons for leaving. Different skill mix/care delivery models are being used to address nurse shortages and rising health-care costs. Skill mix may include RNs and LPNs. More LPNs are being employed in areas, such as acute care, that have been previously staffed by all RNs. Little is known about nurse outcomes since the introduction of LPNs to acute care settings. This study was a cross-sectional correlational design. A stratified, random sample of acute care nurses completed surveys via Fluidsurveys. The survey was modelled after the RN4CAST nursing workforce survey. For both groups of nurses higher levels of emotional exhaustion were associated with intention to leave and workload was the most frequent reason cited for intention to leave. More RNs than LPNs cited career advancement as a reason to leave, and more LPNs than RNs identified poor salary as a reason to leave. Emotional exhaustion is linked to intention to leave health care. Nurse managers should address work environment factors associated with turnover intentions, such as professional development opportunities and shared decision-making.

OBJECTIVE: The aim of this study was to examine the effects of specific cognitions or aspects of psychological empowerment on 5 major aspects of leader empowering behaviors. BACKGROUND: Leader empowering behaviors are linked to important employee outcomes such as work effectiveness. Psychologically empowered leaders are known to use more empowering behaviors in their practice. There is limited research examining what aspects of psychological empowerment are most associated with different aspects of leader empowering behaviors. METHODS: Data from a sample of 103 frontline and midlevel nurse leaders were analyzed after they participated in a leadership development program. RESULTS: Psychological competence was the strongest predictor of the total score for leader empowering behaviors and 4 of 5 subscale scores, and meaning was the 2nd strongest predictor. Autonomy was not a significant predictor. CONCLUSION: Psychological empowerment, particularly in the form of psychological competence, is an important leader characteristic and should be a focus of leadership development strategies.

Aim The purpose of this study was to examine the main and interaction effects of perceived organisational support, span of control and leadership rank on novice nurse leaders’ organisational commitment. Background As nurse leaders’ organisational commitment is eroded at times of healthcare restructuring, it is important to study factors associated with organisational commitment. Methods Cross-sectional data from 69 novice nurse leaders, collected via mailed surveys at two time points, were analysed using hierarchical regression. Results The findings supported our hypotheses about the positive effect of perceived organisational support, the positive effect of leadership rank and the negative effect of span of control on novice nurse leaders’ organisational commitment. In addition, perceived organisational support was shown to moderate the negative effect of span of control on novice nurse leaders’ organisational commitment at time 2. Conclusion Organisational strategies aimed at supporting nurse leaders, and attention to span of control, are required to enhance the organisational commitment of novice nurse leaders. Implications for nursing management Nurse leaders with a wide span of control, in particular those with little leadership experience, need to adopt leadership strategies that maximise their effectiveness, such as organising smaller work groups or teams within their wide span of control.

A collaborative project between an academic healthcare faculty and a professional development director resulted in the design, delivery and evaluation of an inter-professional collaborative leadership workshop with ongoing leadership development activities. The workshop attendees were five inter-professional teams from one large, urban cancer care center in Taipei, Taiwan. The workshop included didactic instruction complemented with team discussions and interactive exercises. Continued practice was encouraged, such as appreciative inquiry exercises and rotated team leadership. Evaluation involved the use of a cross-culturally validated collaborative practice tool and follow-up interviews and focus groups. Although the formal workshop was a 1-day session, continued organizational support and systematic approaches to collaborative leadership practice in clinical settings were necessary components for transfer of learning from the workshop to real life. This paper will include an overview of the foundational leadership concepts covered in the workshop. The instructional strategies, evaluation methods and outcomes will be discussed. The limitations and strengths of this collaborative leadership project will be provided, as well as future plans for a collaborative leadership development program.