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After the unexpected departure of a chief nursing officer: How nurses experienced leadership transition in an acute care hospital

Michael Robert Bleich, University of Nebraska - Lincoln

Abstract

This study addressed how hospital Registered Nurses experienced the unexpected departure of their Chief Nursing Officer (CNO) and the succession events that followed. The human resource interventions that were used and projected as meaningful to restore equilibrium were uncovered. A naturalistic inquiry was conducted. The nurse participants were purposefully selected from management, coordinating, and clinical practice roles. Semi-structured tape recorded interviews, field notes, and artifacts were used in the analysis which revealed 38 themes clustered into six reporting categories. The data confirmed that nurses at all levels experienced various emotions over the CNO's departure, with those hierarchically situated the closest to the CNO experiencing the most intense loss. The duration of emotional responses ranged from several days to two months. Some staff experienced apathy and diminished work output. Patient care was indirectly affected due to extra time spent in shift report and at the nurses' station discussing rumors, and by management and staff resignations that were partially attributed to the CNO's departure. The CNO's departure symbolized a downward spiral for the organization, resulting in employee job insecurity. The importance of the search for a successor was validated. The search marked an opportunity for staff to project future hopes for the nursing division and served to solidify for nurses the attributes they desired in a CNO. The search became tainted when the CEO projected support of an internal candidate before the legitimate search was conducted. In a change-driven environment, an internal candidate may have an edge over outside applicants in gaining the appointment. Human resource interventions restore a destabilized nursing division, however few formal strategies were implemented beyond rumor control and initial staff communication. Recommended interventions were classified into four strategic areas: communication, transition, search process and candidate authentication, and CNO stabilization. The replacement CNO faces a formidable task of taking charge by honoring staff emotions, establishing nursing division priorities, filling position vacancies, and promoting a future vision.

Subject Area

Health care|Nursing|Management

Recommended Citation

Bleich, Michael Robert, "After the unexpected departure of a chief nursing officer: How nurses experienced leadership transition in an acute care hospital" (1998). ETD collection for University of Nebraska-Lincoln. AAI9903761.
https://digitalcommons.unl.edu/dissertations/AAI9903761

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