An examination of the effects of hospital restructuring on nurses: How emotionally intelligent leadership styles mitigate these effects.

摘要

The overall aim of this research was to determine how the multiple episodes of hospital restructuring in the 1990s in Alberta, Canada, which had led to the layoff of thousands of nurses, affected nurses who remained employed. Given the assumption that the restructuring of hospitals will continue in one form or another due to ongoing fiscal challenges and healthcare reform initiatives, it is important to find ways to mitigate these effects. In this research, I focused on whether and how the leadership styles of nursing leaders, as perceived by the nurses, mitigated or intensified the effects of hospital restructuring on nurses.; This doctoral research was comprised of three empirical studies, each of which led to a manuscript for publication. The first study of this thesis was a systematic review of the research literature on the effects of hospital restructuring including layoffs, on individual nurses who remained employed. In this second study, I examined each of three published factor-analytic models claiming to measure the construct of the nursing practice environment, and focused my discussion on the theoretical and measurement implications of choosing either factor analysis or structural equation modeling as a research method. The third study was an examination of the impact of emotionally intelligent leadership styles as defined by Daniel Goleman, on the effects of hospital restructuring on nurses. A fourth manuscript was developed representing a beginning theory of mitigation, which may guide the initial developmental phase of a future research program in leadership science.; The combined findings of the papers in this thesis illustrate that hospital restructuring that included layoffs, had some significant negative physical and emotional health effects on nurses who remained employed. Dissonant leadership styles intensified many of these effects of hospital restructuring on nurses. Resonant leadership styles mitigated many of the effects on nurses and are necessary to ensure healthy nursing staff and to help rebuild healthy nursing practice environments. My findings suggest that by investing energy into relationships with their nurses, resonant nursing leaders not only positively affect the health and well being of their nurses, but also ultimately, the outcomes for patients.