Nurse manager cognitive decision-making amidst stress and work complexity
Article first published online: 14 FEB 2012
© 2012 Blackwell Publishing Ltd
Journal of Nursing Management
Special Issue: This issue: Promoting excellence - Evidence-based Practice at the Bedside and Beyond Issue editors: Kristiina Hyrkas and James P. Rhudy Jr
Volume 21, Issue 1, pages 17–30, January 2013
How to Cite
SHIREY, M. R., EBRIGHT, P. R. and McDANIEL, A. M. (2013), Nurse manager cognitive decision-making amidst stress and work complexity. Journal of Nursing Management, 21: 17–30. doi: 10.1111/j.1365-2834.2012.01380.x
- Issue published online: 22 JAN 2013
- Article first published online: 14 FEB 2012
- Accepted for publication: 7 December 2011
- complexity science;
- nurse manager cognitive decision-making;
- nurse manager cognitive work;
- stress and coping;
- work complexity
Aim 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.
Implications for Nursing Management 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.