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Nurses' Relational Leadership Struggles on Positioning in Strategic Hospital Crisis Management: A Qualitative
Arjan Verhoeven1, Erik van de Loo2, Henri Marres1
1Radboud University Medical Center, Otorhinolaryngology, Head and Neck Surgery, Nijmegen, Netherlands.
Journal of Nursing Management
|April 14, 2025
Summary
Nurses often lack strategic roles during hospital crises, experiencing relational leadership struggles. Addressing power dynamics and enhancing nurse involvement in decision-making is crucial for effective crisis management.
Area of Science:
- Healthcare Management
- Nursing Leadership
- Crisis Response
Background:
- Nursing leadership studies often overlook relational dynamics, focusing instead on skills.
- Nurses are vital in bedside care but excluded from strategic crisis decision-making.
- Research indicates a need for nurses' equal participation in healthcare governance.
Purpose of the Study:
- To explore nurses' experiences of their positioning during hospital crises.
- To identify challenges nurses face in crisis management structures.
- To understand the impact of relational leadership on nurses' roles in crises.
Main Methods:
- Qualitative interpretive study using interviews and focus groups during the COVID-19 crisis.
- Interviewed 64 chairs of nurse councils.
- Conducted four focus groups with 34 participants to deepen findings.
Main Results:
- Nurses' views varied on crisis management priorities, contributions, and value of involvement.
- Identified three key relational leadership struggles: navigating, positioning, and collaborating.
- Discovered that nurses' limited strategic participation hinders their crisis management role.
Conclusions:
- Nurses' poor positioning in crisis management stems from exclusion from strategic decisions.
- Lack of intervention from hospital leaders (board members, physicians, managers) exacerbates this issue.
- Clear frameworks and policies are needed to define nurses' crisis roles and address power dynamics.
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