PhD in Nursing Science Program

An Exploration of Nurse Manager Work Activities in Acute Care Settings Amanda Stefancyk Oberlies

Dissertation under the direction of Professor Ann F. Minnick

The nurse manager has been described as one of the most important assets to a hospital success and is believed to be critical to inpatient unit operations . The purpose of this study was to explore nurse manager work activities including where, and with whom the work activities take place. There is a scarcity of literature about nurse manager work activities, and what has been published is flawed methodologically. This study examined the work activities of eight nurse managers at two academic medical centers in the Midwest. Work activity data were collected using non-participant observation and each nurse manager was observed for two, eight-hour work days. Twelve observations were recorded each hour and included at least one activity, one location, and one person. Interview, self-report, and artifact collection were used to capture additional data about the nurse manager, the unit, and the nurse manager's work activities. During four months of data collection 1,518 observations were made. Nurse managers were observed most frequently conducting desk work, schedule meetings, and personal activities. The nurse manager's office and meeting room were the most frequently observed locations. The nurse manager was observed performing work activities most frequently alone and with a subordinate nurse. Nurse managers reported spending the most time in desk work and scheduled meeting activities. The absolute difference was calculated for the observed and self-reported act ivit ies. There were statistically significant differences between observed and self-reported clinical and personal activities (p = .002 and p= .001, respectively). Intraclass correlation statistics were generated and statistically significant agreements were observed for scheduled meetings, unscheduled meetings, desk work, telephone and rounds (ric = 0.72-0.83, p <.01). With this foundational work completed, future research may build upon the knowledge generated including the linkage of nurse manager act ivities to patient and staff outcomes. This study added to the knowledge that self-report is an acceptable research method for cert ain activities.