Conducting the orchestra in aged care: the leadership role of the registered nurse

PhD Thesis


Taylor, Melissa. 2017. Conducting the orchestra in aged care: the leadership role of the registered nurse. PhD Thesis Doctor of Philosophy. University of Southern Queensland. https://doi.org/10.26192/5c0764a7baf8a
Title

Conducting the orchestra in aged care: the leadership role of the registered nurse

TypePhD Thesis
Authors
AuthorTaylor, Melissa
SupervisorPerrin, Cheryl
Moloney, Clint
Institution of OriginUniversity of Southern Queensland
Qualification NameDoctor of Philosophy
Number of Pages329
Year2017
Digital Object Identifier (DOI)https://doi.org/10.26192/5c0764a7baf8a
Abstract

The registered nurse (RN) position in the residential aged care setting is a role that encompasses the position of care coordinator, staff liaison and educator and one that orchestrates the direction of care of residents. This research is grounded in interpretive phenomenology. The philosophical and methodological grounding and structure of the research draws on the tenets of Hans George Gadamer’s premise of hermeneutic phenomenology. This premise guides the research in an exploration of the ‘what is’ of the leadership role of the RN working in residential aged care environments. Interviews were conducted with registered and enrolled nurses and unregulated health care workers and equated to the thirteen clinical care staff participants from across two states in Australia in four aged care settings.

The study suggests that the leadership role of the RN was identified as a fine balance between the leading, sometimes following and at other times the silent observer available and willing to intervene or converse when the time was seen as right. The study identified that RN leadership was a multidimensional phenomenon. Two key areas appeared in the leadership role, identified as the understanding of the leadership role and the application of leadership in practice. The realisation of how the understanding and the application of the RN leadership role were perceived and received by aged care staff was important. The RN sets the scene, coordinates the care and engages other staff in the unified practice of caring under the auspices of their leadership role.

The implications for the residential aged care sector is seen in the leadership enacted by the RN, the missed opportunities or the capacity of the RNs employed in the sector to both have a voice, an understanding and an ability to practically apply the leadership required. It was the difference or indifference seen, heard and expressed through the clinical care staff participants that created the dissonance or consonance in leadership expressed by those working in the setting. The research has identified clinical leadership as a key component in the understanding and application of leadership by the RN in the residential aged care setting. To enable this in practice the RN requires education for leadership in practice, rather than leadership by style or characteristic.

Keywordsclinical leadership, leadership, registered nurse, residential aged care, distributed leadership, communication, structural empowerment, Kanter
ANZSRC Field of Research 2020420306. Health care administration
420502. Aged care nursing
Byline AffiliationsSchool of Nursing and Midwifery
Permalink -

https://research.usq.edu.au/item/q4v95/conducting-the-orchestra-in-aged-care-the-leadership-role-of-the-registered-nurse

Download files


Published Version
Taylor_2017_whole.pdf
File access level: Anyone

  • 864
    total views
  • 344
    total downloads
  • 3
    views this month
  • 1
    downloads this month

Export as

Related outputs

Contribution of peer group supervision to nursing practice: An interpretive phenomenological study
Tulleners, Tracey, Taylor, Melissa and Campbell, Christina. 2024. "Contribution of peer group supervision to nursing practice: An interpretive phenomenological study." Nurse Education in Practice. 75. https://doi.org/10.1016/j.nepr.2024.103903
Digital health literacy to enhance workforce skills and clinical effectiveness: A response to ‘Digital health literacy: Helpful today, dependency tomorrow? Contingency planning in a digital age’
Haydon, Helen M., Snoswell, Centaine L., Jones, Cindy, Carey, Melissa, Taylor, Melissa, Horstmanshof, Louise, Hicks, Richard, Lotfaliany, Mojtaba and Banbury, Annie. 2023. "Digital health literacy to enhance workforce skills and clinical effectiveness: A response to ‘Digital health literacy: Helpful today, dependency tomorrow? Contingency planning in a digital age’." Australasian Journal on Ageing. 42 (4), pp. 803-804. https://doi.org/10.1111/ajag.13257
The experience of nurses participating in peer group supervision: A qualitative systematic review
Tulleners, Tracey, Campbell, Christina and Taylor, Melissa. 2023. "The experience of nurses participating in peer group supervision: A qualitative systematic review." Nurse Education in Practice. 69. https://doi.org/10.1016/j.nepr.2023.103606
Learning from the experiences of residents: January to July 2022 floods
Taylor, Mel, Miller, Fiona, Johnston, Kim, Ryan, Barbara, Lane, Anne, King, Rachel, Narwal, Harriet, Miller, Madeleine, Simon, Helga and Dabas, Dipika. 2023. "Learning from the experiences of residents: January to July 2022 floods." The Australian Journal of Emergency Management. 38 (3), pp. 27-30.
Peer group clinical supervision for community health nurses: Perspectives from an interpretive hermeneutic study
Tulleners, Tracey, Taylor, Melissa and Campbell, Christina. 2021. "Peer group clinical supervision for community health nurses: Perspectives from an interpretive hermeneutic study." Journal of Nursing Management. 30 (3), pp. 684-693. https://doi.org/10.1111/jonm.13535
Health literacy, dementia knowledge and perceived utility of digital health modalities among future health professionals
Haydon, Helen M., Lotfaliany, Mojtaba, Jones, Cindy, Chelberg, Georgina R., Horstmanshof, Louise, Taylor, Melissa, Carey, Melissa, Snoswell, Centaine L., Hicks, Richard and Banbury, Annie. 2022. "Health literacy, dementia knowledge and perceived utility of digital health modalities among future health professionals." Australasian Journal on Ageing. 58 (4), pp. 253-263. https://doi.org/10.1111/ajag.13149
Educating the educators: Implementing cultural safety in the nursing and midwifery curriculum
Best, Odette, Cox, Leonie, Ward, Aletha, Graham, Coralie, Bayliss, Luke, Black, Barbara, Burton, Lucinda, Carey, Melissa, Davis, Teresa, Derrington, Kate, Elliott, Jessie, Jayasinghe, Thenuja, Luyke, Trish, Maher, Dianne, McGregor, Rowena, Ng, Linda, O'Malley, Lee, Roderick, Geraldine, Sheridan, Georgina, ..., Walker, Jan. 2022. "Educating the educators: Implementing cultural safety in the nursing and midwifery curriculum." Nurse Education Today. 117, pp. 1-6. https://doi.org/10.1016/j.nedt.2022.105473
Development of an Electronic Interdisciplinary Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Interdisciplinary Guideline Adherence in the Emergency Department: Modified Delphi Study
Isaac, Hancy, Keijzers, Gerben, Yang, Ian A., Lea, Jackie, Taylor, Melissa and Moloney, Clint. 2022. "Development of an Electronic Interdisciplinary Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Interdisciplinary Guideline Adherence in the Emergency Department: Modified Delphi Study." International Journal of Chronic Obstructive Pulmonary Disease. 17, pp. 1089-1106. https://doi.org/10.2147/COPD.S358254
Mapping of Modifiable Factors with Interdisciplinary Chronic Obstructive Pulmonary Disease (COPD) Guidelines Adherence to the Theoretical Domains Framework: A Systematic Review
Issac, Hancy, Moloney, Clint, Taylor, Melissa and Lea, Jackie. 2022. "Mapping of Modifiable Factors with Interdisciplinary Chronic Obstructive Pulmonary Disease (COPD) Guidelines Adherence to the Theoretical Domains Framework: A Systematic Review." Journal of Multidisciplinary Healthcare. 15, pp. 47-79. https://doi.org/10.2147/JMDH.S343277
Nursing care in rural and remote areas
Taylor, Melissa. 2020. "Nursing care in rural and remote areas." Koutoukidis, Gabrielle and Stainton, Kate (ed.) Tabbner’s Nursing Care. Elsevier. pp. 23-31
Exploring factors contributing to Chronic Obstructive Pulmonary Disease (COPD) guideline non-adherence and potential solutions in the emergency department: interdisciplinary staff perspective
Issac, Hancy, Taylor, Melissa, Moloney, Clint and Lea, Jackie. 2021. "Exploring factors contributing to Chronic Obstructive Pulmonary Disease (COPD) guideline non-adherence and potential solutions in the emergency department: interdisciplinary staff perspective." Journal of Multidisciplinary Healthcare. 14, pp. 767-785. https://doi.org/10.2147/JMDH.S276702
The impact of interprofessional practice models on health service inequity: an integrative systematic review
Carey, Melissa Jane and Taylor, Melissa. 2021. "The impact of interprofessional practice models on health service inequity: an integrative systematic review." Journal of Health, Organization and Management. 35 (6), pp. 682-700. https://doi.org/10.1108/JHOM-04-2020-0165
Review of interprofessional practice models for impact on health service inequities
Carey, Melissa and Taylor, Melissa. 2019. "Review of interprofessional practice models for impact on health service inequities." Health Services Research Association of Australia & New Zealand 11th Health Services and Policy Research Conference: Addressing Health Service Inequities to Improve Health Systems Performance (HSRAANZ 2019). Auckland, New Zealand 04 - 06 Dec 2019 Sydney, Australia.
Mapping of modifiable barriers and facilitators with interdisciplinary chronic obstructive pulmonary disease (COPD) guidelines concordance within hospitals to the Theoretical Domains Framework: a mixed methods systematic review protocol
Issac, Hancy, Moloney, Clint, Taylor, Melissa and Lea, Jackie. 2020. "Mapping of modifiable barriers and facilitators with interdisciplinary chronic obstructive pulmonary disease (COPD) guidelines concordance within hospitals to the Theoretical Domains Framework: a mixed methods systematic review protocol." BMJ Open. 10 (7). https://doi.org/10.1136/bmjopen-2019-036060
Attitudes towards breech management among a team of maternity clinicians in Australia undertaking breech training
Rattray, Janene, Rigg, Elizabeth, Partridge, Bradley and Taylor, Melissa. 2020. "Attitudes towards breech management among a team of maternity clinicians in Australia undertaking breech training." Women and Birth. 33 (4), pp. E348-E356. https://doi.org/10.1016/j.wombi.2019.08.002
Flooded with evidence: using a 'spillway' model to improve research implementation in nursing practice
Moloney, Clint, Ralph, Nicholas and Taylor, Melissa. 2016. "Flooded with evidence: using a 'spillway' model to improve research implementation in nursing practice." Australian Journal of Advanced Nursing. 34 (1), pp. 23-31.
ACCERT: aged care community education research training
Moloney, Clint W. and Taylor, Melissa. 2013. "ACCERT: aged care community education research training." Joanna Briggs Institute International Convention (JBI 2013): The 2013 Campaign for Getting Evidence into Policy. Adelaide, Australia 21 - 23 Oct 2013 Melbourne, Australia. https://doi.org/10.1111/1744-1609.12034
Professional skills for nurses and other health professionals: contexts and capability of practice
Perrin, Cheryl, Stanley, David and Taylor, Melissa. 2015. "Professional skills for nurses and other health professionals: contexts and capability of practice." Lawrence, Jill, Perrin, Cheryl and Kiernan, Eleanor (ed.) Building professional nursing communication. Port Melbourne, Australia. Cambridge University Press. pp. 182-204
The sum of all parts: an Australian experience in improving clinical partnerships
Taylor, Melissa A., Brammer, Jillian D., Cameron, Michelle and Perrin, Cheryl A.. 2015. "The sum of all parts: an Australian experience in improving clinical partnerships." Nurse Education Today. 35 (2), pp. 297-303. https://doi.org/10.1016/j.nedt.2014.10.003
Assessment and non-pharmacological management among adults with a dementia diagnosis in a residential care setting: a best practice implementation project
Hynes, Antonia, Beirne, Sue, Taylor, Melissa and Moloney, Clint. 2014. "Assessment and non-pharmacological management among adults with a dementia diagnosis in a residential care setting: a best practice implementation project." JBI Database of Systematic Reviews and Implementation Reports. 12 (9), pp. 489-501. https://doi.org/10.11124/jbisrir-2014-1686
Malnutrition screening among elderly people in a community setting: a best practice implementation project
Craven, Dana, Munn, Zachary, Moloney, Clint and Taylor, Melissa. 2014. "Malnutrition screening among elderly people in a community setting: a best practice implementation project." JBI Database of Systematic Reviews and Implementation Reports. 12 (3), pp. 1-18. https://doi.org/10.11124/jbisrir-2014-1454