Browsing by Author "Van der Heever, Mariana"
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- ItemA framework to facilitate the appointment of women nurses of colour to leadership positions in hospitals(Stellenbosch : Stellenbosch University, 2018-12) Van der Heever, Mariana; Van der Merwe, A. S.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : Background: Notwithstanding a 79% African majority and the implementation of the Employment Equity Act (EEA) in 1998, the employment equity reports of the Department of Health in the Western Cape and private health sector nationally in South Africa show under-representation of African and Coloured nurses in leadership positions. International and national literature indicate that the appointment of women to leadership positions tends to be influenced by issues related to race, class and gender. The purpose of the study was to develop a framework to facilitate the appointment of women nurses of colour to leadership positions in hospitals. The objectives were to: Explore the influence of the EEA on the appointment of nurses in leadership positions Explore the opinions of nurses regarding the influence of race, class and gender on the appointment of nurses in leadership positions Explore the practices imbedded in the selection processes of nurses in leadership positions as experienced by those involved in the selection processes Develop a race, class and gender sensitive framework to support nurses in their preparation for leadership positions Design: A concurrent mixed methods design was employed using a quantitative cross-sectional descriptive survey and qualitatively, interpretive phenomenology. The study was based on the philosophy of pragmatism. Population and setting: The study was conducted in the public and private health care sectors in the Western Cape and Gauteng provinces. Quantitative research: The survey was completed by n=573 professional nurses (return rate =83%). The researcher used a structured questionnaire with Likert scale and open-ended questions. Data was analysed with SPSS statistical software, version 24, and the assistance of a statistician. Inferences of the Likert scale questions showed that racial, gender and hierarchical relationships in the workplace had improved since the implementation of the EEA. However, inferences from the open-ended responses revealed the opposite. The findings demonstrated distrust in the promotion systems applied by the public and private health sector. Qualitative research: Interviews were conducted with 5 nurse leaders and another 40 interviews were conducted with people who had participated in the selection processes of nurses appointed to leadership positions: successful and unsuccessful candidates, human resource staff and the chairperson of selection committees e.g. nursing service managers. The researcher observed distinct efforts to accommodate the EEA during formal promotion processes. However, interview questions were sometimes revealed before the time and nepotism did occur. Other findings include stereotyping of the abilities of women of colour resulting in overt and covert racial discrimination. There were also distinct efforts to promote those similar to those who made the appointments e.g. males appointing other males. The influence of class on promotion varied from factors such as professional dress code and sound conduct to being able to converse in eloquent English and physical attractiveness. Findings confirmed the intersecting influence of race, class and gender to marginalize women of colour. Lastly, the framework was developed from the meta-inferences (the integrated inferences from the quantitative and qualitative findings) and focuses on improving the credibility of the promotion process, diversity training, succession-planning and the creation of healthy managerial structures.
- ItemAn ideal leadership style for unit managers in intensive care units of private health care institutions(Stellenbosch : University of Stellenbosch, 2009-03) Van der Heever, Mariana; Damons, Anneleen; Stellenberg, E. L.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science.ENGLISH ABSTRACT: The work environment in critical care units in South Africa is hampered by a profound shortage of nurses, heavy workloads, conflict, high levels of stress, lack of motivation and dissatisfaction among the staff. The task of managing a C.C.U. has therefore become a challenge. It is important that unit managers apply a leadership style that matches these challenges. The aim of this study was to investigate the ideal style of leadership. The objectives set for the study were to identify the ideal leadership style required in the following areas: administrative functions education functions patient care research An explorative, descriptive research design was applied, with a quantitative approach to determine the ideal leadership style for unit managers in critical care units of private health care institutions. The research sample consisted of all nurses working permanently in eleven private hospitals in the Cape Metropolitan area. A questionnaire consisting of predominantly closed questions was used for the collection of data, which was collected by the researcher in person. Ethical approval was obtained from the Committee of Human Science Research at Stellenbosch University. Permission to conduct the research was obtained from the institutions and informed consent from the participants. A pilot study was conducted to test the questionnaire at a private hospital which did not form part of the study. A 10% sample of the relevant staff, namely 27 participants were involved in this study. The validity and reliability was assured through the pilot study and the use of a statistician as well as experts in nursing and a research methodologist. Data was tabulated and presented in histograms and frequencies. Statistical significant associations were drawn between variables, using the Chi-square test. The Spearman rank (rho) order correlation was used to show the strength of the relationship between two continuous variables. Findings of the study show that participatory leadership style and transformational leadership approach were valued in all four (4) of the objectives. Emphasis was placed on consultation prior to any decisions. Nurses requested an opportunity to give feedback on a regular basis regarding the unit managers conduct (Chi-square test p = 0.025). They also agreed that unit managers should apply the necessary rules and procedures (Chi-square test p = 0.016). A huge request was made for integrity, trust, impartiality, openness, approachability and particularly honesty. The nurses also maintained that the nurse manager’s behaviour should be congruent. Furthermore, the results indicate that nurses would like to be empowered by: being involved in the scheduling of off-duties taking the lead in climate meetings being granted opportunities (to all categories of nurses) to attend managerial meetings. N = 41 (48.2%) of nurses admitted that unit managers would instruct them to cope with insufficient staffing pertaining to ventilated patients, putting them under severe strain and at risk legally. N = 39 (47%) of nurses admitted that unit managers only consider qualifications and experience in the delegation of tasks if the workload in the unit justifies it. Safe patient care is not always a priority. N = 99 (96%) of nurses agreed that autocratic behaviour relating to task delegation exists. Recommendations included the application of transformational leadership and participatory management. The aim to create a healthier, more favourable work environment for critical care nurses will hopefully be attained through applying the ideal leadership style and leadership approach.