The effect of head nurse behaviors on nurse job satisfaction and performance

Many nursing executives ponder the repeated problems at the unit level and occasionally surmise that effective supervision at that level holds the key to quality patient care. These pragmatic concerns, while commonplace, have yet to be explored empirically. The relationship of head nurse direction and support on subordinate job satisfaction and performance is not clearly understood. This study examines these relationships in the context of three moderating factors--role clarity, job anxiety, and unit size. Additionally, head nurse support is examined as a moderator of relationships between head nurse direction and subordinate satisfaction and job performance. Using a sample of 103 registered nurses in a medium-capacity metropolitan general hospital, the results show some significant correlations between head nurse behavior and job satisfaction and performance, and in moderating the effects of job anxiety, unit size, and support. The study highlights the need for replication in other settings. Additionally, other variables relevant to job satisfaction and performance such as life stressors (death or illness in the family) require investigation. The findings of this study reveal implications for management at the unit level and the importance of understanding subordinate behaviors in the context of head nurse support and direction.