Practice environment perceptions of first-line managers of nursing

As the health care system experienced a complex tapestry of transitions in the past decade, first-line managers (FLMs) strived to maintain a sense of stability for themselves and their staff in chaotic work environments. Individuals across the nation are striving to ensure health care team members have quality work environments. The paucity of literature examining the perceptions FLMs have of their work environment prompted this study. This study provided FLMs employed in regional and provincial hospitals in Saskatchewan “a voice” to share their perceptions of their work environments with others. It is an adaptation of the descriptive survey design used by Remus, Smith, and Schissel (2000) in their study of staff nurses. The adaptation was based on the literature, making it applicable to FLMs, and incorporating the six Quality Worklife Indicators (QWI) of the Canadian Nurses Association’s (CNA’s) Quality Professional Practice Environments framework. The questionnaire also incorporated open-ended questions that enabled respondents to elaborate on their perceptions of their work environments.The total population of 113 FLMs in regional (FLMRs) and provincial (FLMPs) hospitals in Saskatchewan was invited to participate in this study. Sixty-nine respondents (61.1%) chose to do so. FLMRs had a higher, although not significant, response rate, (67.6% n=23) than did FLMPs (58.2% n=46). The researcher attempted to make personal contact and correspond with each invited participant when distributing the questionnaires. In the open ended questions, participants in this study described intertwined multidimensional roles and responsibilities resulting in unmanageable workloads. They faced daily challenges involving relationships, putting out fires, balancing system/personnel relationships, staffing issues, resources, time, and salary. FLMs who successfully resolved their challenges felt a sense of accomplishment or reward, increasing their self confidence in their ability to successfully fill their roles as a FLM. FLMs described that being a change agent, teamwork, recognition by others, relationships, working with patients, and control over practice as the most rewarding elements within in their practice environments. The Environment Perception Scale responses reflected positive perceptions of work environments on all subscales except control over workload. Overall, FLMPs had a slightly more positive perception of their work environments than did FLMRs, except on the control over workload subscale. However, there were no significant differences between the groups except on the innovation and creativity subscale, where FLMRs scored significantly lower.Study results offer senior administrators, professional associations, government, educators, and others an opportunity to increase their understanding and awareness of the perceptions FLMs have of their practice environment. Awareness of these perceptions will facilitate supporting or strengthening the rewards FLM’s perceive in their practice environments, resulting in a richer practice environment. Identification and awareness of the perceived challenges is the first step in addressing them. Educators will find these results useful in better preparing future leaders of nursing for formal management roles