title: Nurse manager cognitive decision-making amidst stress and work complexity.
abstract: OBJECTIVE
  The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.
  
  
  BACKGROUND
  Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.
  
  
  METHODS
  This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.
  
  
  RESULTS
  The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.
  
  
  CONCLUSIONS
  Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.
  
  
  CONCLUSIONS
  Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity.
authors: University of Southern Indiana College of Nursing and Health Professions, Evansville, IN 47712, USA. mrshirey@usi.edu
authors: Maria R
authors: MR
authors: Shirey
authors: Patricia R
authors: PR
authors: Ebright
authors: Anna M
authors: AM
authors: McDaniel
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015400:Clinical Nursing Research; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D009718:Nurse Administrators; D013315:Stress, Psychological; D016526:Workload