Expectations for the role of head nurse held by head nurses, nurses, directors of nursing, and doctors : a survey in four teaching hospitals

Expectations and perceptions of expectations for the role of Head Nurse were investigated in four teaching hospitals of McGill University, Montreal, Canada. Head Nurses, nurses, Directors of Nursing, and doctors were respondents. The study examined three questions: What are the expectations held for the Head Nurse within groups? Are there differences in expectations held for the Head Nurse across groups? Are there differences between expectations of nurses and doctors for the Head Nurse, and Head Nurse perceptions of expectations of nurses and doctors?Factor analysis was performed on responses of Head Nurses, nurses, and doctors separately. Expectations within groups were determined by frequencies, means, and standard deviations. Differences in expectations between groups were tested by chi-squares.Conceptualizations of the Head Nurse as manager, clinician, patient care co-ordinator, and teacher were supported. Five factors, identified as doctor's helper, clinical leader, communication link, determiner of quality of care, and manager, accounted for 67 to 82% of variance in all groups. All groups agreed that the Head Nurse should be a determiner of quality of care given. Significant differences in expectations between groups were found in regard to the Head Nurse as doctor's helper, and clinical leader, and in regard to other activities related to patients, staff, and the unit. Head Nurses tended to overestimate nurse expectations for the Head Nurse, and underestimate doctor expectations for the Head Nurse