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Degree

Ph.D., Antioch University, Leadership and Change, 2008.

Abstract

This study concentrates on the voice of registered nurses as they describe their experiences of leadership within the nontraditional, non-institutional, non-hospital environment of assisted living. It further expounds upon regulatory and corporate information as context for the nurses’ leadership experiences. The desire to hear nurses describe their personal experiences of leadership influenced the decision to use grounded theory as a methodological process. The belief that voice requires context to be most effectively understood influenced, in turn, the addition of a situational analysis approach to the grounded theory methodology. As a result, interviews and scrutiny of contextual elements form the core of this study. The expectation that registered nurses will assume a leaderly presence has increased during the past 20 years as significant changes in the overall climate of health care have taken place. The study identifies many of the factors included in this change, specifically an alteration in the locus of care from hospitals exclusively to more diverse settings. Because of the limited presence of physicians in the extra-hospital world, nurses and administrators now form a leadership dyad in these settings and are charged with managing organizations delivering complex chronic patient care. Assisted living is a creative residential option that has been developed for elders who prefer individual choice in addition to physical care support. This study analyzes the themes and overriding influences explicated in personal interviews with nursing leaders in a variety of assisted living communities in one state. It also describes the contributing elements inherent in the healthcare and assisted living environments for their contextual implications. One important aspect of this study is its separation of nurse and physician leadership elements. It seeks to highlight those factors that emerge as supporting or denigrating nursing leadership experiences in an environment that is not itself mired in the conventional role expectations of the traditional healthcare world. It is anticipated that this study will bring to light the pressure that nurses feel as they are caught between the inherent value of patient advocacy and the corporate and regulatory requirements of assisted living communities.

Subject Headings

Health care; Nursing

Keywords

nursing; leadership; assisted living; situational analysis; grounded theory

Committee / Advisors

Elizabeth Holloway, PhD (Committee Chair)
Peter Vaill, DBA (Committee Member)
Laurien Alexandre, PhD (Committee Member)
Heather Young, PhD (Committee Member)

Pages

276p.

Document number: antioch1209080819
Permalink: http://rave.ohiolink.edu/etdc/view?acc_num=antioch1209080819

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