Een Duits verzorgingstehuis nodigde recent aangekomen vluchtelingen uit die geïnteresseerd waren in werken in de ouderenzorg. Het doel van deze studie was om inzicht te krijgen in hoe gevestigde zorgverleners en eerstegeneratie immigranten nieuwkomers sleutelden aan waarden om de zorg voor mensen met dementie vorm te geven. Deze etnografische studie omvatte 200 uur observatie, 24 diepte-interviews en twee focusgroepinterviews met zes immigranten van de eerste generatie en zes gevestigde personeelsleden. De gevestigde zorgverleners en immigranten van de eerste generatie toonden zich bereid en in staat om te sleutelen aan situaties waarin verschillende waarden een rol speelden. Wanneer de werklast echter te zwaar wordt, kunnen medewerkers uit beide groepen gevoelens van machteloosheid, onverschilligheid en demotivatie ervaren. Institutionele beperkingen hebben een negatieve invloed op de interactie tussen gevestigde zorgverleners en immigranten van de eerste generatie die nieuwkomers zijn en beïnvloeden hun uitvoering van de zorg voor geriatrische bewoners met dementie. In dergelijke situaties wordt het cruciaal voor het personeel om een ondersteunende supervisor te hebben die hen kan helpen om te gaan met de dagelijkse stressfactoren van hun praktijk.
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Most nurse leadership studies have concentrated on a classical, heroic, and hierarchical view of leadership. However, critical leadership studies have argued the need for more insight into leadership in daily nursing practices. Nurses must align their professional standards and opinions on quality of care with those of other professionals, management, and patients. They want to achieve better outcomes for their patients but also feel disciplined and controlled. To deal with this, nurses challenge the status quo by showing rebel nurse leadership. In this paper, we describe 47 nurses’ experiences with rebel nurse leadership from a leadership-as-practice perspective. In eight focus groups, nurses from two hospitals and one long-term care organization shared their experiences of rebel nurse leadership practices. They illustrated the differences between “bad” and “good” rebels. Knowledge, work experience, and patient-driven motivation were considered necessary for “good” rebel leadership. The participants also explained that continuous social influencing is important while exploring and challenging the boundaries set by colleagues and management. Credibility, trust, autonomy, freedom, and preserving relationships determined whether rebel nurses acted visibly or invisibly. Ultimately, this study refines the concept of rebel nurse leadership, gives a better understanding of how this occurs in nursing practice, and give insights into the challenges faced when studying nursing leadership practices.
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Nurse clinician-scientists are increasingly expected to show leadership aimed at transforming healthcare. However, research on nurse clinician-scientists' leadership (integrating researcher and practitioner roles) is scarce and hardly embedded in sociohistorical contexts. This study introduces leadership moments, that is, concrete events in practices that are perceived as acts of empowerment, in order to understand leadership in the daily work of newly appointed nurse clinician-scientists. Following the learning history method we gathered data using multiple (qualitative) methods to get close to their daily practices. A document analysis provided us with insight into the history of nursing science to illustrate how leadership moments in the everyday work of nurse clinician-scientists in the “here and now” can be related to the particular histories from which they emerged. A qualitative analysis led to three acts of empowerment: (1) becoming visible, (2) building networks, and (3) getting wired in. These acts are illustrated with three series of events in which nurse clinician-scientists' leadership becomes visible. This study contributes to a more socially embedded understanding of nursing leadership, enables us to get a grip on crucial leadership moments, and provides academic and practical starting points for strengthening nurse clinician-scientists' leadership practices. Transformations in healthcare call for transformed notions of leadership.
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