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Nurse Managers Describe Their Practice Environments

Warshawsky, Nora E. PhD, RN; Lake, Sharon W. PhD, RN; Brandford, Arica MSN, JD, RN

doi: 10.1097/NAQ.0b013e3182a2f9c3
Original Articles

Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.

University of Kentucky, College of Nursing, Lexington, Kentucky. Dr Lake is now with Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Correspondence: Nora E. Warshawsky, PhD, RN, University of Kentucky, 557 College of Nursing, Lexington, KY 40536 (

No acknowledgments, credits, disclaimers, or conflicts of interest to report.

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