title: Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study.
abstract: OBJECTIVE
  To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style.
  
  
  BACKGROUND
  Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings.
  
  
  METHODS
  Qualitative phenomenological study.
  
  
  METHODS
  Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model.
  
  
  RESULTS
  Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication.
  
  
  CONCLUSIONS
  Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit managers are imperative to maintaining an empowering practice environment which can ensure the best care and healthy, engaged staff.
authors.affiliation: Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Nursing, Antwerp University Hospital Antwerp, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Van Bogaert
authors.affiliation: Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium.
authors.forename: Lieve
authors.initials: L
authors.lastname: Peremans
authors.affiliation: Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Nursing, Antwerp University Hospital Antwerp, Belgium.
authors.forename: Marlinde
authors.initials: M
authors.lastname: de Wit
authors.affiliation: Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Nursing, Antwerp University Hospital Antwerp, Belgium.
authors.forename: Danny
authors.initials: D
authors.lastname: Van Heusden
authors.affiliation: Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Department of Health Care, Karel de Grote University College Antwerp Antwerp, Belgium.
authors.forename: Erik
authors.initials: E
authors.lastname: Franck
authors.affiliation: Division of Nursing and Midwifery Sciences, Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp Antwerp, Belgium ; Academia for Welfare and Health, HZ University of Applied Sciences Vlissingen Vlissingen, Netherlands.
authors.forename: Olaf
authors.initials: O
authors.lastname: Timmermans
authors.affiliation: School of Nursing, The University of North Carolina at Chapel Hill Chapel Hill, NC, USA.
authors.forename: Donna S
authors.initials: DS
authors.lastname: Havens
keywords: nurse managers; patient safety; qualitative study; quality of care; structural empowerment