Leadership competencies within the context of nursing management, in private healthcare organisations in KwaZulu-Natal.

Doctoral Degree. University of KwaZulu-Natal, Durban.Background: Leadership forms a critical part of the healthcare management process and works synergistically with the other functions of planning, organising and controlling. Nurse managers do not display all the competencies and behaviours that are essential for effective leadership because there is no leadership competency model available within the healthcare organisations in South Africa. Research aim: The aim of this study was to determine the current state of nurse leader effectiveness from the perspectives of direct line managers as well as the subordinates reporting to them. Research method: This was a quantitative, cross-sectional study conducted among 239 nurses and 33 line managers. The nurses were selected using probability proportional to sampling techniques from four private hospitals in KwaZulu-Natal, South Africa. Since there was a small group of nurse managers, all were included in the sample. A self-administered questionnaire was used to collect the data. The subordinates rated their line managers‘ leadership competencies using the NHS 360degree leadership competency tool, which was adapted to the South African healthcare context. The line managers rated their own leadership competencies using the same tool. Results: The findings suggest that although there were more positive responses to the leadership behaviours tested across the nine leadership dimensions, there are certain important leadership competencies that require development. The highest reported nurse manager competency ratings included inspiring a shared purpose (73%), leading with care (69%) and the ability to evaluate information (71.5%). In contrast, the lowest reported nurse manager competencies included the line managers knowledge of what is needed to make well judged decisions (56%); the ability of the line manager to describe future changes in a way that inspires hope, reassures staff, the patients and the public (43%); the line managers ability to explain controversial and complex plans in a way that different groups can hear, understand and accept (43%); the manager‘s ability to shape future plans with the team (40%) ; the manager‘s ability to create a common purpose to unite the team and enable them to work seamlessly together to deliver (55%); the line manager constantly looking for opportunities to celebrate and reward high standards (46%); sharing stories and symbols of success that create pride in achievement (45%); the line manager‘s ability to provide long term mentoring and coaching (46%) ; the line manager‘s ability to spot high potential individuals in the team and focus developmental efforts on them (45%) and the line manager‘s ability to use stories, and other memorable approaches to increase his/her impact (37%). There was a significantly positive correlation found among all the leadership dimensions for both employees and subordinates. Conclusion: Although there were more positive responses to the leadership behaviours tested across the nine leadership dimensions, there are certain important leadership competencies that require development. Interestingly, the line managers have a positive perception of all the leadership competencies across the nine dimensions. Despite the widespread acknowledgement of the importance of leadership, there are barriers to effective leadership