Ethical and Relational Leadership: How Nurse Managers Address Underperformance in Clinical Practice-A Qualitative...

Area of Science:

• Healthcare Management
• Nursing Leadership
• Organizational Behavior

Background:

• Staff underperformance is a persistent challenge in clinical practice, impacting patient care and team dynamics.
• Effective management of underperformance is crucial for maintaining high standards in healthcare settings.

Purpose of the Study:

• To explore the experiences of nurse managers in addressing staff underperformance.
• To identify the challenges and strategies employed by nurse managers in performance management.

Main Methods:

• Qualitative descriptive design.
• In-depth, semi-structured interviews with 10 nurse managers.
• Thematic analysis using Braun & Clarke's six-stage framework.

Main Results:

• Four key themes emerged: Proactive Communication, Relational and Ethical leadership, learning on the job, and adhering to policy/HR processes.
• These themes highlight the complex factors influencing nurse managers' experiences with underperformance.
• Nurse managers integrate ethical and relational leadership to manage underperformance constructively.

Conclusions:

• Nurse managers utilize ethical and relational leadership to address underperformance, balancing accountability with staff dignity and patient safety.
• Developing these leadership capabilities can enhance effectiveness and accountability in nursing practice.
• Findings inform evidence-based performance management strategies in healthcare.