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Nurse managers: being deviant to make a difference

Published online by Cambridge University Press:  24 October 2019

Sandra Crewe Open the ORCID record for Sandra Crewe [Opens in a new window]  and
Antonia Girardi Open the ORCID record for Antonia Girardi [Opens in a new window]
Sandra Crewe*
Affiliation:
Murdoch Business School, Murdoch University, 90 South Street, Murdoch, WA 6150, Western Australia, Australia
Antonia Girardi
Affiliation:
Murdoch Business School, Murdoch University, 90 South Street, Murdoch, WA 6150, Western Australia, Australia
*
*Corresponding author. Email: [email protected]
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Abstract

Within healthcare, studies support that nurse manager leadership behaviours positively influence nursing outcomes. However, how this behaviour promotes positive outcomes is less well understood. Integrating a ‘positive deviance framework’ and a ‘model for reflection’, this paper uniquely uncovers positive nurse manager behaviours that deviate from ‘business as usual’ in managing and leading healthcare staff. Applying an interpretivist lens to qualitative data collected from 24 nurse managers from Australia and Seychelles, the outcomes illustrate examples of positive leadership, exemplary performance, and uncommon behaviours and actions amongst nurse managers resulting in positive nursing experiences and positive organisational outcomes. Nurse managers practising positive leadership and taking on an employee champion role, underscore these behaviours. This study contributes to the research of positive outcomes, processes, and attributes of healthcare organisations and their members.

Keywords

positive deviancepositive organisation scholarship in healthcarepositive leadershipnurse managers
Type
Research Article
Information
Journal of Management & Organization , Volume 26 , Special Issue 3: Positive Organisational Scholarship in Healthcare (POSH) , May 2020 , pp. 324 - 339
Copyright
Copyright © Cambridge University Press and Australian and New Zealand Academy of Management 2019

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References

Anthony, M. K., Standing, T. S., Glick, J., Duffy, M., Paschall, F., Sauer, M. R., … Dumpe, M. L. (2005). Leadership and nurse retention: The pivotal role of nurse managers. Journal of Nursing Administration, 35(3), 146–155. doi:10.1097/00005110-200503000-00008CrossRefGoogle ScholarPubMed
Belbin, C., Erwee, R., & Wiesner, R. (2012). Employee perceptions of workforce retention strategies in a health system. Journal of Management & Organization, 18(5), 742–760. doi:10.5172/jmo.2012.18.5.742CrossRefGoogle Scholar
Bish, M., Kenny, A., & Nay, R. (2015). Factors that influence the approach to leadership: Directors of nursing working in rural health services. Journal of Nursing Management, 23(3), 380–389. doi:10.1111/jonm.12146CrossRefGoogle ScholarPubMed
Blake, N., Leach, L. S., Robbins, W., Pike, N., & Needleman, J. (2013). Healthy work environments and staff nurse retention. Nursing Administration Quarterly, 37(4), 356–370. doi:10.1097/NAQ.0b013e3182a2fa47CrossRefGoogle ScholarPubMed
Bourgeault, I. L., Dingwall, R., & De Vries, R. G. (2010). The SAGE handbook of qualitative methods in health research (pp. 128–151). Los Angeles: SAGE.CrossRefGoogle Scholar
Briggs, D., Cruickshank, M., & Paliadelis, P. (2012). Health managers and health reform. Journal of Management & Organization, 18(5), 641–658. doi:10.1017/S1833367200000584CrossRefGoogle Scholar
Brown, P., Fraser, K., Wong, C. A., Muise, M., & Cummings, G. (2013). Factors influencing intentions to stay and retention of nurse managers: A systematic review. Journal of Nursing Management, 21(3), 459–472. doi:10.1111/j.1365-2834.2012.01352.xCrossRefGoogle ScholarPubMed
Cameron, K. (2012). Positive leadership, strategies for extraordinary performance (2nd ed.). San Francisco, CA: Berrett-Koehler Publishers Inc. Retrieved from https://learning-oreilly-com.libproxy.murdoch.edu.au/library/view/positive-leadership-2nd/9781609945664/xhtml/ch01.htmlGoogle Scholar
Cameron, K., & Caza, A. (2004). Contributions to the discipline of positive organizational scholarship – introduction. American Behavioral Scientist, 47(6), 731–739. doi:10.1177/0002764203260207CrossRefGoogle Scholar
Cameron, K., Mora, C., Leutscher, T., & Calarco, M. (2011). Effects of positive practices on organizational effectiveness. The Journal of Applied Behavioral Science, 47(3), 266–308. doi:10.1177/0021886310395514CrossRefGoogle Scholar
Cameron, K., & Wooten, L. (2009). Leading Positively – Strategies for Extraordinary Performance – At-a-Glance. Centre for Positive Organizational Scholarship. Stephan M. Ross: School of Business, The Regents of the University of Michigan. Retrieved from https://www.bing.com/search?q=Leading+Positively%E2%80%93Strategies+for+Extraordinary+Performance%E2%80%93At-a-Glance.&form=IENTHT&mkt=en-au&https://msn=1&refig=4fc910160e124500a21722d22e3f2885Google Scholar
Cameron, K. S. (2008). Paradox in positive organizational change. The Journal of Applied Behavioral Science, 44(1), 7–24. doi:10.1177/0021886308314703CrossRefGoogle Scholar
Cameron, K. S. (2013). Practicing positive leadership: Tools and techniques that create extraordinary results (1st ed.). San Francisco: Berrett-Koehler Publishers. Retrieved from https://search-ebscohost-com.libproxy.murdoch.edu.au/login.aspx?direct=true&db=nlebk&AN=581863&site=ehost-liveGoogle Scholar
Cameron, K. S., Dutton, J. E., & Quinn, R. E. (2003). An introduction to positive organizational scholarship. In Cameron, K. S., Dutton, J. E., & Quinn, R. E. (Eds.), Positive organizational scholarship: Foundations of a new discipline (1st ed., pp. 3–13). San Francisco, CA: Berrett-Koehler.Google Scholar
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. ANS, 1(1), pp. 13–24. Retrieved from http://samples.jbpub.com/9780763765705/65705_ch03_v1xx.pdfGoogle Scholar
Chiok Foong Loke, J. (2001). Leadership behaviours: Effects on job satisfaction, productivity and organizational commitment. Journal of Nursing Management, 9(4), 191–204. doi:10.1046/j.1365-2834.2001.00231.xCrossRefGoogle ScholarPubMed
Cowden, T., Cummings, G., & Profetto-McGrath, J. (2011). Leadership practices and staff nurses’ intent to stay: A systematic review. Journal of Nursing Management, 19(4), 461–477. doi:10.1111/j.1365-2834.2011.01209.xCrossRefGoogle ScholarPubMed
Crewe, S. (2017). Understanding nurse manager leader behaviours and their impact on nurse retention. Paper presented at the Australian and New Zealand Academy of Management Conference 2017, held at RMIT University, Melbourne, 5–7 December. Retrieved from https://www.anzam.org/past-event-material/past-conference-papers/?swp_category_limiter=0&swpquery=crewe&submit=SearchGoogle Scholar
Crewe, S., & Girardi, A. (2018). Nurse Manager as Employee Champion: Results from a scoping review examining retention in healthcare. Paper presented to the Australian and New Zealand Academy of Management Conference 2018, held at Massey University, Auckland, 4–7 December. Retrieved from https://www.anzam.org/wp-content/uploads/2018/12/ANZAM-Conference-Proceedings-2018.pdfGoogle Scholar
Cummings, G. G., Olson, K., Hayduk, L., Bakker, D., Fitch, M., Green, E., … Conlon, M. (2008). The relationship between nursing leadership and nurses' job satisfaction in Canadian oncology work environments. Journal of Nursing Management, 16(5), 508–518. doi:10.1111/j.1365-2834.2008.00897.xCrossRefGoogle ScholarPubMed
Dadich, A., Collier, A., Hodgins, M., & Crawford, G. (2018). Using positive organizational scholarship in healthcare and video reflexive ethnography to examine positive deviance to new public management in healthcare. Qualitative Health Research, 28(8), 1203–1216. doi:10.1177/1049732318759492CrossRefGoogle Scholar
Dadich, A., Fulop, L., Ditton, M., Campbell, S., Curry, J., Eljiz, K., … Smyth, A. (2015). Finding brilliance using positive organizational scholarship in healthcare. Journal of Health Organization and Management, 29(6), 750–777. doi:10.1108/JHOM-11-2013-0256CrossRefGoogle Scholar
Dawson, P., Farmer, J., & Thomson, E. (2011). The power of stories to persuade: The storying of midwives and the financial narratives of central policy makers. Journal of Management and Organization, 17(2), 146–164. doi:10.1017/S1833367200001589CrossRefGoogle Scholar
Doran, D., McCutcheon, A. S., Evans, M. G., MacMillan, K., McGillis Hall, L., Pringle, D., … Valente, A. (2004). Impact of the manager's span of control on leadership and performance. Ottawa, Ontario: Canadian Health Services Research Foundation. Retrieved from https://pdfs.semanticscholar.org/cc3e/934eb5c322b912d34bdd191838d3cd984387.pdfGoogle Scholar
Duffield, C. (1991). First-line nurse managers: Issues in the literature. Journal of Advanced Nursing, 16(10), 1247–1253. doi:10.1111/j.1365-2648.1991.tb01535.xCrossRefGoogle ScholarPubMed
Duffield, C., Diers, D., O'Brien-Pallas, L., Aisbett, C., Roche, M., King, M., & Aisbett, K. (2011). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, 24(4), 244–255. doi:10.1016/j.apnr.2009.12.004CrossRefGoogle ScholarPubMed
Duffield, C., Roche, M., O'Brien-Pallas, L., Catling-Paull, C., & King, M. (2009). Staff satisfaction and retention and the role of the nursing unit manager. Collegian, 16(1), 11–17. doi:10.1016/j.colegn.2008.12.004CrossRefGoogle ScholarPubMed
Duffield, C., Wood, L. M., Franks, H., & Brisley, P. (2001). The role of nursing unit managers in educating nurses. Contemporary Nurse, 10(3–4), 244–250. doi:10.5172/conu.10.3-4.244CrossRefGoogle ScholarPubMed
Duffield, C. M., Roche, M. A., Blay, N., & Stasa, H. (2010). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20(1–2), 23–33. doi:10.1111/j.1365-2702.2010.03478.xCrossRefGoogle Scholar
Farrell, M. (2018). Leadership reflections: Leadership paradoxes. Journal of Library Administration, 58(2), 166–173. doi:10.1080/01930826.2017.1412712CrossRefGoogle Scholar
Feather, R. (2015). Tools assessing nurse manager behaviours and RN job satisfaction: A review of the literature. Journal of Nursing Management, 23(6), 726–735. doi:10.1111/jonm.12202CrossRefGoogle Scholar
Francis, H., & Keegan, A. (2006). The changing face of HRM: In search of balance. Human Resource Management Journal, 16(3), 231–249. doi:10.1111/j.1748-8583.2006.00016.xCrossRefGoogle Scholar
Fulop, E. L., Kippist, L., Dadich, A., Hayes, K., Karimi, L., & Symth, A. (2019). What makes a team brilliant? An experiential exploration of positivity within healthcare. Journal of Management & Organization, 25(4), 591–612. doi:10.1017/jmo.2018.56CrossRefGoogle Scholar
Fulop, L., Dadich, A., Ditton, M., Campbell, S., Curry, J., Eljiz, K., … Smyth, A. (2013). Working on the edge: Positive Organisational Scholarship in Healthcare (POSH) and looking for what's good in healthcare. The Proceedings of the 27th Australian and New Zealand Academy of Management Conference 2013, held at Hobart, 4–6 December. Retrieved from http://www.anzam.org/?attachment_id=4088Google Scholar
Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13(1), 117, 1–8. doi:10.1186/1471-2288-13-117CrossRefGoogle ScholarPubMed
Gibbs, G. (2013). Practical methods to implement the experiential learning cycle. In Gibbs, G. (Ed.), Learning by doing, a guide to teaching and learning methods by Graham Gibbs (1988) (1st ed., pp. 49–50). Wheatley Oxford: Oxford Further Education Unit, Brookes University. Retrieved from https://thoughtsmostlyaboutlearning.files.wordpress.com/2015/12/learning-by-doing-graham-gibbs.pdfGoogle Scholar
Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., … Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108–123. doi:10.2174/1874434601711010108CrossRefGoogle ScholarPubMed
Havens, D. S. (2011). Positive organizational scholarship: Tools for leading with excellence. Nurse Leader, 9(5), 26–30. doi:10.1016/j.mnl.2011.07.004CrossRefGoogle Scholar
Hayes, L. J., O'Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., … North, N. (2012). Nurse turnover: A literature review – an update. International Journal of Nursing Studies, 49(7), 887–905. doi:10.1016/j.ijnurstu.2011.10.001CrossRefGoogle ScholarPubMed
Heckert, A., & Heckert, D. (2002). A new typology of deviance: Integrating normative and reactivist definitions of deviance. Deviant Behavior, 23(5), 449–479. doi:10.1080/01639620290086486CrossRefGoogle Scholar
Heidari, M., Seifi, B., & Gharebagh, Z. (2017). Nursing staff retention: Effective factors. Annals of Tropical Medicine and Public Health, 10(6), 1467–1473. doi:10.4103/ATMPH.ATMPH_353_17Google Scholar
Herington, M. J., & van de Fliert, E. (2018). Positive deviance in theory and practice: A conceptual review. Deviant Behavior, 39(5), 664–678. doi:10.1080/01639625.2017.1286194CrossRefGoogle Scholar
Johnson, B. (2014). Reflections: A perspective on paradox and its application to modern management. The Journal of Applied Behavioral Science, 50(2), 206–212. doi:10.1177/0021886314524909CrossRefGoogle Scholar
Kearin, M., Johnston, J., Leonard, J., & Duffield, C. (2007). The impact of hospital structure and restructuring on the nursing workforce. Australian Journal of Advanced Nursing, 24(4), 42–46. Retrieved from https://search-informit-com-au.libproxy.murdoch.edu.au/documentSummary;dn=402851506406439;res=IELHEAGoogle Scholar
Kippist, L., Dadich, A. M., Fulop, L., Hayes, K. J., Karimi, L., & Smyth, A. (2016). Understanding positivity in healthcare teams: a research odyssey. The Proceedings of the 30th Australian and New Zealand Academy of Management Conference 2016, 6–9 December, held at QUT Business School, Brisbane, Australia. Retrieved from https://researchdirect.westernsydney.edu.au/islandora/object/uws:38290Google Scholar
Kleinman, C. (2004a). The relationship between managerial leadership behaviors and staff nurse retention. Hospital Topics, 82(4), 2–9. doi:10.3200/HTPS.82.4.2-9CrossRefGoogle Scholar
Kleinman, C. S. (2004b). Leadership and retention: Research needed. Journal of Nursing Administration, 4(3), 111–113. doi:10.1097/00005110-200403000-00001CrossRefGoogle Scholar
Kleinman, C. S. (2004c). Leadership: A key strategy in staff nurse retention. The Journal of Continuing Education in Nursing, 35(3), 128–132. doi:10.3928/0022-0124-20040501-09CrossRefGoogle Scholar
Langley, A., Smallman, C., Tsoukas, H., & Van De Ven, A. H. (2013). Process studies of change in organization and management: Unveiling temporality, activity, and flow. Academy of Management Journal, 56(1), 1–13. doi:10.5465/amj.2013.4001CrossRefGoogle Scholar
Lavine, M. (2012). Positive deviance: A metaphor and method for learning from the uncommon. In Cameron, K. S. & Spreitzer, G. M. (Eds.), The Oxford handbook of positive organizational scholarship (pp. 1014–1026). New York, NY: Oxford University Press.Google Scholar
Lawrence, N., & Richardson, J. (2014). To explore and understand the leadership experiences of modern matrons, within an acute NHS trust. Journal of Nursing Management, 22(1), 70–79. doi:10.1111/j.1365-2834.2012.01432.xCrossRefGoogle ScholarPubMed
Leslie, J. B., Li, P. P., & Zhao, S. (2015). Managing paradox blending east and west philosophies to unlock its advantages and opportunities. Greensboro, NC: Center for Creative Leadership. Retrieved from https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwjynfTj0sTgAhXbe30KHbvdBx4QFjAAegQIChAC&url=https://%3A%2F%2Fwww.ccl.org%2Fwp-content%2Fuploads%2F2015%2F11%2FManaging-Paradox.pdf&usg=AOvVaw0FVfX-6h7iCTTEFhR6LDKVCrossRefGoogle Scholar
Martin, J., & Wright, S. (2018). The application of Cameron's positive leadership model in a New Zealand law enforcement organisation. New Zealand Journal of Employment Relations (Online), 43(1), 36–55. Retrieved from http://libproxy.murdoch.edu.au/login?url=https://search-proquest-com.libproxy.murdoch.edu.au/docview/2119885008?accountid=12629Google Scholar
McDermott, A., & Keating, M. (2011). Managing professionals: Exploring the role of the hospital HR function. Journal of Health Organization and Management, 25(6), 677–692. doi:10.1108/14777261111178556CrossRefGoogle ScholarPubMed
McNeese-Smith, K. D. (1997). The influence of manager behavior on nurses’ job satisfaction, productivity, and commitment. The Journal of Nursing Administration, 27(9), 47–55. doi:10.1097/00005110-199709000-00011CrossRefGoogle ScholarPubMed
Mertens, W., Recker, J., Kohlborn, T., & Kummer, T. (2016). A framework for the study of positive deviance in organizations. Deviant Behavior, 37(11), 1288–1307. doi:10.1080/01639625.2016.1174519CrossRefGoogle Scholar
Pascale, R. T., & Sternin, J. (2005). Your company's secret change agents. Harvard Business Review, 83, 72–81. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=16951542&site=ehost-liveGoogle ScholarPubMed
Pearson, A., Laschinger, H., Porritt, K., Jordan, Z., Tucker, D., & Long, L. (2007). Comprehensive systematic review of evidence on developing and sustaining nursing leadership that fosters a healthy work environment in healthcare. International Journal of Evidence-Based Healthcare, 5(2), 208–253. doi:10.1111/j.1479-6988.2007.00065.xGoogle Scholar
Pinkerton, S. (2003). Retention and recruitment. Supporting the nurse manager to improve staff nurse retention. Nursing Economic$, 21(1), 45–46. Retrieved from http://link.galegroup.com.libproxy.murdoch.edu.au/apps/doc/A98134895/ITOF?u=murdoch&sid=ITOF&xid=e95d3e34Google Scholar
Smith, W. K., & Lewis, M. W. (2012). Leadership skills for managing paradoxes. Industrial and Organizational Psychology, 5(2), 227–231. doi:10.1111/j.1754-9434.2012.01435.xCrossRefGoogle Scholar
Smith, W. K., Lewis, M. W., & Tushman, M. L. (2016). “Both/and” leadership. Boston: Harvard Business Review, 2016(May), 62–70. Retrieved from https://hbr.org/2016/05/both-and-leadershipGoogle Scholar
Spreitzer, G. M., & Sonenshein, S. (2004). Toward the construct definition of positive deviance. American Behavioral Scientist, 47(6), 828–847. doi:10.1177/0002764203260212CrossRefGoogle Scholar
Studer, Q. (2004). The value of employee retention: Throughout my years in healthcare administration, I used to think, “life will be good if we can just re-engineer to cut expenses”. Healthcare Financial Management, 58(1), 52–57. Retrieved from http://link.galegroup.com.libproxy.murdoch.edu.au/apps/doc/A112451708/AONE?u=murdoch&sid=AONE&xid=85156948Google Scholar
Taunton, R. L., Boyle, D. K., Woods, C. Q., Hansen, H. E., & Bott, M. J. (1997). Manager leadership and retention of hospital staff nurses. Western Journal of Nursing Research, 19(2), 205–226. doi:10.1177/019394599701900206CrossRefGoogle ScholarPubMed
Townsend, K., Wilkinson, A., Allan, C., & Bamber, G. (2012). Mixed signals in HRM: The HRM role of hospital line managers. Human Resource Management Journal, 22(3), 267–282. doi:10.1111/j.1748-8583.2011.00166.xCrossRefGoogle Scholar
Tuckett, A., Winters-Chang, P., Bogossian, F., & Wood, M. (2015). ‘Why nurses are leaving the profession … lack of support from managers’: What nurses from an e-cohort study said. International Journal of Nursing Practice, 21(4), 359–366. doi:10.1111/ijn.12245CrossRefGoogle ScholarPubMed
Ulrich, D. (1997). Human resource champions, the next agenda for adding value and delivering results. Boston, Massachusetts: Harvard Business School Press.Google Scholar
Ulrich, D., Kryscynski, D., Ulrich, M., & Brockbank, W. (2017). Leaders as paradox navigators. Leader to Leader, 86, 53–59. doi:10.1002/ltl.20322CrossRefGoogle Scholar
Wang, H., Sui, Y., Luthans, F., Wang, D., & Wu, Y. (2014). Impact of authentic leadership on performance: Role of followers’ positive psychological capital and relational processes. Journal of Organizational Behavior, 35(1), 5-21. doi:10.1002/job.1850CrossRefGoogle Scholar