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HEAD NURSES’ LEADERSHIP SKILLS: MENTORING AND MOTIVATING

STAFF NURSES ON RENDERING HIGH-QUALITY NURSING CARE

A Research Proposal presented to the

Graduate School of Nursing

In partial fulfilment of the requirements for the course

Methods of Research

By:

DANIEL RYAN M. ARRIOLA II, RN

1ST YEAR MAN

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Table of Contents
CHAPTER I ...................................................................................................................... 3
THE PROBLEM AND A REVIEW OF LITERATURE .............................................. 3
Review of Related Literature ....................................................................................... 5
Leadership Skills in Nursing .................................................................................... 5
Mentorship in Nursing .............................................................................................. 6
Motivation in Nursing ............................................................................................... 7
High Quality Care in Nursing .................................................................................. 9
Conceptual Framework .............................................................................................. 10
Statement of the Problem ........................................................................................... 11
CHAPTER II ................................................................................................................... 12
METHOD ........................................................................................................................ 12
Research Design........................................................................................................... 12
Participants .................................................................................................................. 12
Instrument.................................................................................................................... 13
Data-gathering Procedure .......................................................................................... 13
Data Analysis ............................................................................................................... 14
References ........................................................................................................................ 17
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Table of Figures

Figure 1: Conceptual Paradigm of the Study .................................................................... 10

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CHAPTER I
THE PROBLEM AND A REVIEW OF LITERATURE

Leadership pertains to the capability of the managements’ representatives in the

image of its managers to materialize the pre-set challenging goals, mission and vision of

the company. In addition, leadership is also about making logical instantaneous and

decisive measures which will outperform the competition and inspire the organization’s

members to perform well. (Kenton, 2019)

In the new era, it has been observed around the globe, especially by the higher

education that leadership styles have been refurbished monumentally to cope with the

new generation of people. It has been identified that rather than utilizing the authoritarian

leadership in all aspects of managing people and solving organizational obstacles, it is

best to individualize the type of leadership that one leader will be utilizing. There are

some people who prefer to be empowered for them to develop their skills in the most

profound avenue that they are aware of. On the hand, there are also individuals who

prefer to be dictated and just religiously follow the instructions and mandates of their

higher-ups. (Eddy & VanDerLinden, 2006)

Through numerous studies, it has been observed that the motivation of the nurses

to render high quality care is being affected by various factors such as: age, tenure,

autonomy given to the staff, educational level and other personal and organizational

factors like ambitions and promotions. Moreover, it has also been inculcated that the

eagerness of the staff nurses to extend their compassionate care towards their clients is
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somehow dependent to the leadership skills of their superiors. (Balijoon, Banjar, &

Banakhar, 2018)

Because of the facts mentioned, the researcher has been triggered to study and

gather more data regarding the motivation and eagerness of the Staff Nurses in rendering

high quality care in accordance to the leadership skills of their Head Nurses. Moreover,

the researcher has also the motivation to reveal the congruence of the Head Nurses’

leadership skills in terms of motivating their people towards the wellness and benefits of

the patients whom they are rendering the nursing care.

This study is being foreseen by the researcher as a guide for the Head Nurses and

even Nurse Supervisors and Managers in handling their Staff for them to render high-

quality nursing care among their clients. It is also being projected to be beneficial for

healthcare institutions in promulgating their career paths guidelines for nurses and

strategic planning on elevating the quality of their institution’s services through

mentorship and motivation.

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Review of Related Literature

Leadership Skills in Nursing

A dynamic vocation needs a well-versed leader at all times. Nursing profession is

very influential throughout the Healthcare team. The function of the Nursing Department

is quite vital in terms of almost all aspects of the patient care and management, making

the Nursing Professionals in need of developing leadership skills even during their early

stage or years in their careers. (Middleton, 2011)

Throughout the yesteryears and even previous generations, leaders have been

defined as someone who has a vison for the organization, a bulk of strategies and

techniques, profound plans and the desire to redirect all the members of an institution

towards the great future of the company. In addition, effective leaders have established an

image of someone who is capable of utilizing problem-solving skills, group maintenance

and control capabilities and group identification development aptitudes. It has also been

established that leaders must be influential enough to motivate theirs people to stay

focused towards the institution’s goals and to be motivated enough in rendering their

optimal services among their clients. (Nursing Times, 2011)

Another factor of Nursing Leadership in the Philippines is the environment of the

health care institution such as Hospitals, Clinics and even the community. The

management of the hospital greatly affect the leadership of the Head Nurses due to the

motivation that they are having within their system. It is quite factual that Head Nurses

shall not be able to motivate and encourage their staff nurses to render high quality care if
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they themselves are not being convinced by the institution’s culture to be productive

enough and to be encouraging enough for the staff nurses under his or her supervision.

Moreover, Head Nurses mentorship process among their subordinates are greatly affected

by their passion and dedication with their work. The Head Nurses themselves as leaders

must be a good example of being selfless in terms of their rendering of services among

their clients. Should the staff nurses be able to detect those qualities with their supervisor,

they will be eventually motivated and encouraged to give their all for the sake of

rendering high quality care for their patients. (Macabasag, et al., 2016)

Mentorship in Nursing

Mentorship requires a strong emotional and intellectual harmonies for it is a

relationship that is being considered to be reciprocal and dynamic. Mentorship is not

about creating and molding someone into your replica or just as your own image.

Mentorship is being determined as a process of extending empowerment and

opportunities to someone to excel into his own way. (Chopra, Edelson, & Saint, 2016)

Mentoring is very significant in all Professions especially in Nursing. Mentoring

in Nursing is the process wherein an experienced Nurse teaches a Novice Nurse. It is the

transfer of knowledge and wisdom from one Professional to another. In addition, it is

considered as a science and art of guidance process which comprises the skills on

inspiring, coaching, teaching, directing, and leading an individual who is new to an

institution who requires familiarization on the protocols and procedures on the area.

(Takvorian, 2019)
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Both the mentor and the mentee are having the same goal towards their very

relationship, and it is nurturing their knowledge, experience and wisdom in terms of their

profession. Moreover, this nourishment relationship can be classified as a commitment

and a promise between the mentor and the mentee. (McCloughen, O'Brien, & Jackson,

2009)

In the Philippines, it has been validated that Filipino nurses cannot be mentored

the same way every time. Every new Staff Nurse must been be taught according to his or

her personality. Mentoring Filipino nurses is somewhat congruent with taking care of the

patients and clients of the health care team which is all about making it individualized.

Creating a mentoring and training program should be based on the personality of the

individual. Moreover, even if the mentorship is being individualized, it does not mean

that the mentor should only utilize a single type of mentorship. Each mentor can always

vary his or her style circumstantially. (Mamauag & Mirafuentes, 2017)

Motivation in Nursing

Motivation in all aspects of fields are profoundly significant especially in the craft

of health care due to the fact that motivation has been categorized as the inspiration to

perform and the energy to finish an intervention. Motivation is too complex to describe;

nonetheless, it can be simplified as internal and/or external stimulus towards an

individual to work in accordance to an institution’s goals; consequently, in a hospital, it is

rendering high quality care for the clients. (Baljoon, Banjar, & Banakhar, 2018)
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In Nursing career, nurses are quite prone with burnout. They often work more

than number of hours that they are being required. They come at least 30 minutes before

their shift and go home inconsistently due to the varying workload that they have each

shift. This work can be draining for them, but most of the Nursing professionals are being

motivated through numerous avenues. Some may think about their reason on choosing

their profession; some think about their passion on taking care of other people; others

may think about the career that they are having. (Cooper, 2015)

Nurses can be enormously motivated with their profession; but it is up to the

management and their superiors especially their Head Nurses to do so for them to exhibit

their genuine talent and passion. (LaFerney, 2018)

Based on a research made in the Philippines, it has been identified that some of

the factors that motivate the Filipino Nurses is work and career security. Filipino nurses

tend to render care optimally if they know that their effort is not being wasted within the

institution that they are working with. It is very noteworthy for the nurses to be aware of

the career path that they are having. Majority of the Filipino nurses leave their

workplaces not because of low salary but because of a weak opportunity that they are

having. Most of the Filipino nurses are very goal oriented which make them to want

eagerly a clear path of their profession within an institution. (Egcas, 2017)

In addition, career paths can be solidified by educational and training programs of

the institutions such as scholarships and even sponsored trainings which are related to
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their expertise. Through this act of a health care facility, nurses are being motivated to

render a high-quality care for their patients. (Reyes & Conde, 2017)

High Quality Care in Nursing

All countries around the globe have been in pursuit of high-quality care for

generations. This is due to the fact that high-quality care elevates the safety of all clients

in all aspects and scenarios. In addition, acquiring the capability to possess such level of

service is also tantamount the greatest success that a single health institution may acquire.

(Amstrong, Rispel, & Penn-Kekana, 2015)

It has been found and accepted as a fact that nurses do play the majority of work

in terms of elevating the quality of care inside a healthcare institution such as a hospital.

It is because, the quality of the nursing services dictates the quality of care of the

institution due to the broad coverage of Nursing Services throughout patient care.

(Needleman & Hassmiller, 2009)

In relation to the congruence of headship of nurses, it has been established by at

least ten studies that the leadership skills of the Head Nurses greatly affect the quality of

nursing care in all institutions and in all nursing units. It has been discussed that it is on

the Head Nurse’s shoulders the weight of motivating and mentoring his or her staff

towards high-quality nursing care. (Verschueren, Kips, & Euwema, 2013)

In the Philippines, studies also presented that different groups of Staff Nurses

prefer various types of leadership such as Authoritarian, Democratic, Pro-active and

others. Furthermore, quality of nursing care has been found to be dependent to the
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leadership of a nursing unit head inside an institution, making it the leadership skills of a

Head Nurse quite crucial in terms of development of the quality of nursing care inside a

healthcare institution. (Jabonete & Concepcion, 2010)

Conceptual Framework

INPUT Process Output

• Participants • Leadeship • High-quality

Profile Skills Nursing Care
• Age Group • Mentorship
• Gender • Motivation
• Nurisng
Unit
• Tenure

Figure 1: Conceptual Paradigm of the Study

Figure 1 presents the conceptual framework of the study. The input data of the

research will be the profile of the participants (Staff Nurses) namely: Age group, Gender,

Nursing unit assignment and their tenure in the hospital. The data will undergo to the

process of mentorship and motivation through the leadership skills of their Head Nurses

which will eventually produce high-quality nursing care for the patients.
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Statement of the Problem

The main problem of the study is to identify the impact of Leadership skills of

Head Nurses among various nursing units over their Staff Nurses in producing high-

quality nursing care.

Specifically, it seeks answers to the following queries:

1. What is the demographic profile of the participants in terms of:

a. Age

b. Gender

c. Nursing Unit Assignment; and

d. Tenure in service

2. What is the preferred leadership style of the participants?

3. Is there a significant relationship with mentorship capacity of a Head Nurse and

the participants demographic profile?

4. Is there a significant relationship between the motivational capacity of a Head

Nurse and the participants demographic profile in rendering high-quality nursing

care?

5. Is there a significant relationship between the leadership skills of Head Nurses in

terms of mentorship and motivation with the quality of nursing care which is

being rendered by the Staff Nurses?

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CHAPTER II
METHOD

The chapter is composed of the study’s research design, participants, instrument,

data-gathering procedure, and data analysis.

Research Design

This study shall utilize the descriptive research design. This type of research

design is the most regularly applied technique in instructive research since it is simpler to

direct and valuable in getting the current status or state of the issue which are basic in

comprehension the past, present and what else to come. It incorporates all examinations

that have the reason to exhibit actualities concerning the nature and status of a gathering

of people or subject of study which one may wish to ponder. (Leedy & Ormod, 2019)

Because of the characteristic of the descriptive research design, the researcher has

considered it to be fitted to the objectives of the study since it shall deal with the current

situation within a healthcare institution.

Participants

The researcher has decided to target the 100 percent of the Nursing professionals

within a private hospital in Calamba City, Laguna since it has been found that the nursing

population in the said institution is below fifty (50) only, making it feasible to do a total

coverage among the target population of the research.

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Instrument

The researcher shall be utilizing a self-made questionnaire which will be based on

various healthcare regulatory bodies such as the Philippine Department of Health and the

World Health Organization.

The questionnaire shall be subject for approval of the researcher’s adviser and

statistician. It will undergo to a pilot test which will be validated for its credibility prior to

its distribution among the target population.

The questionnaire is projected to have three (3) parts which will be composed of

the participants’ demographic profile – Age, Gender, Nursing Unit Appointment and

Tenure of service. The second part will be having questions which will target their

preferred leadership in such situations; and lastly, the third part shall assess the effect of

their Head Nurses leadership skills in terms of mentorship and motivation in relation to

the quality of their nursing services.

Data-gathering Procedure

The data of the research which shall be tabulated and analyzed shall be collected

through this process:

First, a letter of request for the survey to procure shall be submitted by the

researcher to the Nursing Director of the selected private hospital. This request shall be

noted by the adviser of the researcher prior to its submission.

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Once the request has been approved, the researcher will set an appointment to

each nursing units of the target hospital through its Head Nurses. The schedule shall be

adjusted in accordance to the availability of the Staff Nurses, making their work

undisturbed.

On the appointment of the researcher with the participants, the objective and

nature of the study shall be explained to them completely and effectively making them

assured that the confidentiality of their answers shall be sacred.

After the affirmation of the participants, questionnaires shall be distributed,

subject for their answers. Once all the questionnaires have been filled-out, these data

shall be analyzed accordingly.

Data Analysis

The researcher shall utilize two (2) statistical programs in applying statistical

techniques over the collected data in accordance to the stated problems of the study

namely the Microsoft Excel and SPSS.

The following statistical techniques will be applied to ensure valid and reliable

analysis and interpretation of data:

1. Frequency calculates how often values occur within a range of values. The data

will be collected and tabulated to determine frequency of responses.

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2. Percentage is used as a descriptive statistic to denote the proportion contributed

by a part in a whole, thus this formula will be used.

𝑛
Formula: P = 𝑁 x 100

Where: P = percentage
n = number of responses under a particular category
N = total number of participants
3. Weighted mean is the arithmetic average of a set of values, or distribution;

however, for skewed distributions, the mean is not necessarily the same as the

middle value (median), or the most likely (mode).

Formula: Weighted mean

Where:
x̌ = mean or average
xi= midpoint
fi = frequency of participants
N = number of participants

4. The Pearson r or correlation coefficient that is denoted by r is a measure of the

strength of the straight-line or linear relationship between two variables. The

correlation coefficient takes on values ranging between +1 and -1.

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For the problems 1 and 2: the demographic profile of the participants and their

preferred leadership skills shall be analyzed with Frequency, Weighted Mean and

Percentage. On the other hand, problem numbers three (3), four (4) and five (5) shall be

analyzed with Pearson r making it feasible to present the correlations of the stated

variables.
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ROWENA ANDRES – PUA, MD

HOSPITAL ADMINISTRATOR
ST. JOHN THE BAPTIST MEDICAL CENTER, INC.

ZENAIDA TORRES, MD
MEDICAL DIRECTOR
ST. JOHN THE BAPTIST MEDICAL CENTER, INC.

THRU: DINAH ARANETA, RN, MN

NURSING DIRECTOR
ST. JOHN THE BAPTIST MEDICAL CENTER, INC.

Dear Doctors:

Greetings!

I, Daniel Ryan M. Arriola II, RN, a MA in Nursing Major in Nursing Administration,

hereby seek for your permission for me to conduct a survey among your nurses. This
activity shall be the foundation of my study in completion of my Master’s degree in San
Pablo Colleges.

Rest assured that your hospital’s name shall not be mentioned within the research and your
nurses’ work shall not be affected for my surveys will only be conducted during their
vacant hours.

Hoping for a positive response for your kind office;

Thank you very much and God bless.

Respectfully yours:

DANIEL RYAN M. ARRIOLA II, RN

MA in Nursing Major in Nursing Administration Student
Requestor
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Survey form No. _ _ _ _

Dear participants:

This is to humbly request you to fill out this form as a reference for my graduate school research study. Rest
assured that your identity shall never be disclosed to either your institution’s administration or any other third
party or individuals. Thank you very much.
I. Profile: Kindly shade the corresponding circle of your answer.
a. Age
o 19 – 23 years old o 34 – 38 years old
o 24 – 28 years old o 39 – 43 years old
o 29 – 33 years old o More than 43 years old
b. Gender:
o Male o Female
c. Nursing Unit Assignment
o Ward o ICU
o OR/DR o Dialysis
o NICU o Heart Station
d. Length of Tenure
o 0 – 1 year and 11 o 6 years – 7 years and
months 11 months
o 2 years – 3 years and o 8 years – 9 years and
11 months 11 months
o 4 years – 5 years and o More than 10 years
11 months
II. What is your preferred leadership style of your supervisor?
o Transformational Leadership
o Transactional Leadership – establishes clear chain of command
o Servant Leadership – power sharing
o Autocratic – significant power over staff
o Laissez-faire Leadership – hands off approach
o Democratic Leadership – participative
o Bureaucratic Leadership – strict adherence to the rules
o Charismatic Leadership – relies on positive charm
o Situational Leadership – utilization of other styles depending on the situation

III. On what degree does leadership style of your head nurse affects his or her mentorship process
for you?
o Not Affected at all o Moderately Affected
o Fairly Affected o Immensely Affected

IV. On what degree does your head nurse’s motivational skills affect your capacity to render high
quality nursing care?
o Not Affected at all o Moderately Affected
o Fairly Affected o Immensely Affected

V. For you, how important is your head nurse’s mentorship and motivational skills for you to strive
harder and to work more for the sake of serving high quality nursing care among your patients?
o Not important at all o Moderately Important
o Fairly Important o Immensely Important