Exploring the transition from staff nurse to ward sister/manager – An exploratory case study

Background
The ward sister/manager figure has traditionally been considered the ward based
clinical leader. This role has evolved over time in response to professional and
political demands; despite or because of this, reports of role ambiguity exist and
the ward sister/manager position has become increasingly difficult to recruit to,
with nurses arguably looking to roles perceived to have greater influence and
status, but less onerous managerial responsibility. Understanding the nature of
this role and the factors that may impact upon the transition from staff nurse to
ward sister/manager is of great significance. The gaps in understanding related to
development in preparation for and in the early stages of this role, led to this
research, with the aim of understanding the experience of the transition and the
impact of organisation factors, and whether they facilitate or hinder the process
of transition for this group of nurses.
Study design
A case study approach consisting of interviews and documentary analysis was
undertaken in one metropolitan National Health Service hospital, underpinned by
a critical realist approach. The case study comprised interviews with six nurses,
repeated over time with three of those nurses, who had recently participated in a
leadership development programme and key informants who were senior
practitioners within the organisation or who were recommended by participants,
in combination with strategy and policy scrutiny and website analysis. Ritchie and Spencer’s Framework approach was used to support the management and
subsequent analysis of the data.
Findings
The ward sister/manager role was identified as a vital role, but the managerial
components of the role served as a significant disincentive to participants.
Participants required support from significant role models during the transition
process, although the degree of support, both required and available, varied.
Motivating factors and the sense of job satisfaction were essential for developing
a sense of self-fulfilment. A range of support mechanisms were present and
utilised across the organisation but these appeared disparate and the lack of a
unifying vision for nursing services was apparent.
Contribution to knowledge
Developing into the ward sister/manager role involves a significant transition that
has not previously been acknowledged. Job satisfaction in the ward
sister/manager role is significantly affected by organisational factors, as well as
individual factors. The organisation itself contributes to the role legitimacy of this
role.