Impact of charge nurses’ span of control on the work attitudes of nurses

Authors

  • N. López Ibort Hospital Clínico Lozano Blesa. Zaragoza. España
  • A. Boned Galán Hospital Universitario Miguel Servet. Zaragoza. España.
  • M. Cañete Lairla Universidad de Zaragoza. Zaragoza. España.
  • T. Antoñanzas Lombarte Hospital Universitario Miguel Servet. Zaragoza. España.
  • A. Gascón Catalán Universidad de Zaragoza. Zaragoza. España.

DOI:

https://doi.org/10.23938/ASSN.0970

Keywords:

Human resources, Charge nurse, Empowerment, Job satisfaction, Interpersonal relations

Abstract

Background. To determine the number of nurses who are supervised by a charge nurse in the Nursing Units of Aragonese general public hospitals and to analyze how this affects the organizational behaviors of nurses and the quality of the relationships established with the charge nurses.

Methods. Cross-sectional study carried out in nine public hospitals. Validated questionnaires were used to assess the working behavior of nurses and the quality of their relationships with charge nurses, and the charge nurse’s relationship with their immediate superior and nursing staff. We analyzed whether there was an association between these variables and the number of nurses per unit.

Results. The study included 2,541 nurses and 192 supervisors. The mean span of control was 29 (SD = 22.4). Statistically significant differences were observed with respect to empowerment (p<0.001), satisfaction (p = 0.027), perceived organizational support (p<0.001) and the quality of the nurse’s relationships with the supervisor (p<0.001) and the supervisor with her immediate superior (p<0.001), obtaining lower scores as the span of control increased. No significant associations were observed with respect to turnover intention, organizational citizenship behavior and organizational commitment.

Conclusions. The span of control is related to the perception of nurses’ organizational behaviors and with the quality of interpersonal relationships with the charge nurse, indicating a need to adjust the span of of control per unit in order to improve the quality of the management of the units.

Downloads

Download data is not yet available.

References

HOLM-PETERSEN C, ØSTERGAARD S, ANDERSEN PBN. Size does matter – span of control in hospitals. J Heal Organ Manag 2017; 31: 192-206. doi:10.1108/JHOM-04-2016-0073

GRUBAUGH ML, FLYNN L. Relationships among nurse manager leadership skills, conflict management, and unit teamwork. JONA J Nurs Adm 2018; 48: 383-388. doi:10.1097/NNA.0000000000000633

SIMPSON BB, DEARMON V, GRAVES R. Mitigating the impact of nurse manager large spans of control. Nurs Adm Q 2017; 41: 178-186. https://doi.org/10.1097/NAQ.0000000000000214

JONES D, MCLAUGHLIN M, GEBBENS C, TERHORST L. Utilizing a scope and span of control tool to measure workload and determine supporting resources for nurse managers. J Nurs Adm 2015; 45: 243-249. https://doi.org/10.1097/NNA.0000000000000193

Sluss D, Klimchak M, HOLMES J. Perceived organizational support as a mediator between relational exchange and organizational identification. J Vocat Behav 2008; 73: 457. https://doi.org/10.1016/j.jvb.2008.09.001

HOGG MA, MARTIN R, EPITROPAKI O, MANKAD A, SVENSSON A, WEEDEN K. Effective leadership in salient groups: revisiting leader-member exchange theory from the perspective of the social identity theory of leadership. Personal Soc Psychol Bull 2005; 31: 991-1004. https://doi.org/10.1177/0146167204273098

PAGE C, MARIE W, DENNY M, KERR I. “It’s the situation I’m in”: The importance of managerial context to effectiveness. J Manag Dev 2003; 22: 841-862. https://doi.org/10.1108/02621710310505458

CATHCART D, JESKA S, KARNAS J, MILLER SE, PECHACEK J, RHEAULT L. Span of control matters. J Nurs Adm 2004; 34: 395-399. https://doi.org/10.1097/00005110-200409000-00004

URWICK L. The manager’s span of control. Harv Bus Rev 1956; 34: 39-47.

SHIREY MR, MCDANIEL AM, EBRIGHT PR, FISHER ML, DOEBBELING BN. Understanding nurse manager stress and work complexity: Factors that make a difference. J Nurs Adm 2010; 40: 82-91. https://doi.org/10.1097/NNA.0b013e3181cb9f88

Ontario Association Hospital. Leading practices for addressing clinical manager span of control in Ontario, 2011. https://vdocument.in/span-of-control-final.html

CUMMINGS GG, MACGREGOR T, DAVEY M, HOW L, WONG CA, LO E et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. Int J Nurs Stud 2010; 47: 363-385. https://doi.org/10.1016/j.ijnurstu.2009.08.006

MCGILLIS HALL L, DORAN D, O´BRIEN PALLAS L, TRANNER J, TREGUNNO D, RUKHOLM E et al. Quality Worklife Indicators for Nursing Practice Environments in Ontario. Determining the Feasibility of Collecting Indicator Data, 2006. https://www.mcgillishall.com/wp-content/uploads/2010/05/QWIN_Report.pdf

GARY L., WULF N, WULF J. How many direct reports? Harvard Business Review, 2012. https://hbr.org/2012/04/how-many-direct-reports

CUPIT T, STOUT-AGUILAR J, CANNON L, NORTON J. Assessing the nurse manager’s span of control: a partnership between executive leadership, nurse scientists and clinicians. Nurse Lead 2019; 17: 103-108. https://doi.org/10.1016/j.mnl.2018.12.004

HORN P, KINICKI A. TOWARD a greater understanding of how dissatisfaction drives employee turnover. Acad Manag J 2017; 44. https://doi.org/10.5465/3069441

LIDEN RC, SPARROWE RT, WAYNE SJ. Leader-member exchange theory: The past and potential for the future. Res Pers Hum Resour Manag 1997; 15: 47-119.

Ministerio de Sanidad, Consumo y Bienestar Social. Gobierno de España. Explotación del registro de altas CMBD del Sistema Nacional de Salud. Notas metodológicas y glosario de términos, 2007. https://www.mscbs.gob.es/estadEstudios/estadisticas/cmbd/informes/notasMetodologicas.htm

KANTER R. Men and women of the corporation. New York: Basic Books, 1977.

VALDERRAMA B. Motivación inteligente. El impulso para lograr tus metas. Madrid: Pearson, 2010.

MOORMAN RH. Relationship between organizational justice and organizational citizenship behaviors: Do fairness perceptions influence employee citizenship? J Appl Psychol 1991; 76: 845-855. https://doi.org/10.1037/0021-9010.76.6.845

GRIFFETH R, HORN P, GAERTNER S. A meta-analysis of antecedents and correlates of employee turnover: update, moderator tests, and research implications for the next millennium. J Manage 2000; 26: 463-488. https://doi.org/10.1016/S0149-2063(00)00043-X

WRIGHT BE, DAVIS BS. Job satisfaction in the public sector: the role of the work environment. Am Rev Public Adm 2003; 33: 70-90. https://doi.org/10.1177/0275074002250254

EISENBERGER, R, HUNTINGTON, R, HUTCHISON, S, SOWA D. Perceived organizational support. J Appl Psychol 1998; 71: 500-507. https://doi.org/10.1037/0021-9010.71.3.500

TORDERA N, PEIRÓ J, RAMOS J, GONZÁLEZ-ROMÁ V. La calidad del intercambio lider-miembro (LMX) y el clima psicológico: un análisis longitudinal de sus relaciones recíprocas. Psicología (Lisboa) 2007; 21: 59-81. https://scielo.pt/pdf/psi/v21n1/v21n1a04.pdf

COHEN J. Statistical Power Analysis for the Behavioral Sciences (2nd ed). New York: Routledge, 1988. https://doi.org/10.4324/9780203771587

CASADO A, PRIETO L, ALONSO J. El tamaño del efecto de la diferencia entre dos medias: ¿estadísticamente significativo o clínicamente relevante? Med Clin 1999; 112: 584-588. http://esteve.org/wp-content/uploads/2018/01/136870.pdf

MCCUTCHEON AS, DORAN D, EVANS M, HALL LM, PRINGLE D. Effects of leadership and span of control on nurses' job satisfaction and patient satisfaction. Nurs Leadersh (Tor Ont) 2009; 22: 48-67. https://doi.org/10.12927/cjnl.2009.21154

MERRILL KC, PEPPER G, BLEGEN M. Managerial span of control: a pilot study comparing departmental complexity and number of direct reports. Nurs Leadersh (Tor Ont) 2013; 26: 53-67. https://doi.org/10.12927/cjnl.2013.23544.

WONG CA, ELLIOTT-MILLER P, LASCHINGER H, CUDDIHY M, MEYER RM, KEATINGS M et al. Examining the relationships between span of control and manager job and unit performance outcomes. J Nurs Manag 2015; 23: 156-168. https://doi.org/10.1111/jonm.12107

Ministerio de Sanidad, Consumo y Bienestar Social. Gobierno de España. Estadística Nacional de Hospitales, 2016. https://www.mscbs.gob.es/estadEstudios/estadisticas/docs/TablasSIAE2016/Tablas_nacionales.pdf

SPREITZER GM. Psychological empowerment in the workplace: dimensions, measurement, and validation. Acad Manag 1995; 38. https://doi.org/10.5465/256865

FRÍAS NAVARRO MDF, PASCUAL LLOBEL J, GARCIA PEREZ JF. Tamaño del efecto del tratamiento y significación estadística. Psicothema 2010; 12 (Suppl 2): 236-240. http://www.psicothema.es/pdf/555.pdf

KENDALL J’ M. Nurse manager span of control and the impact on employee engagement, 2018. https://uknowledge.uky.edu/dnp_etds/185.

SKAGERT K, DELLVE L, AHLBORG JR G. A prospective study of managers’ turnover and health in a healthcare organization. J Nurs Manag 2012; 20: 889-899. https://doi.org/10.1111/j.1365-2834.2011.01347.x

THIEL CE, HARDY JH, PETERSON DR, WELSH DT, BONNER JM. Too many sheep in the flock? Span of control attenuates the influence of ethical leadership. J Appl Psychol 2018; 103: 1324-1334. https://doi.org/10.1037/apl0000338

Hay Group. Factbook Recursos Humanos. (5th Ed). Cizur Menor (Navarra): Thomson-Aranzadi, 2006.

O’REILLY CA, CHATMAN J. Organizational commitment and psychological attachment: The effects of compliance, identification, and internalization on prosocial behavior. J Appl Psychol 1986; 71: 492-499. https://doi.org/10.1037/0021-9010.71.3.492

JÁIMEZ ROMÁN MJ. Organizaciones saludables: el papel del empoderamiento organizacional.Tesis Doctoral, Universidad de Granada (España), 2012.

MOWDAY RT, STEERS RM, PORTER LW. The measurement of organizational commitment. J Vocat Behav 1979; 14: 224-247. doi:https://doi.org/10.1016/0001-8791(79)90072-1

DE LA ROSA MD, CARMONA A. Cómo afecta la relación del empleado con el líder a su compromiso con la organización. Universia Bus Rev 2010; 26: 112-133. https://dialnet.unirioja.es/servlet/articulo?codigo=3231140.

PODSAKOFF PM, MACKENZIE SB, MOORMAN RH, FETTER R. Transformational leader behaviors and their effects on followers’ trust in leader, satisfaction, and organizational citizenship behaviors. Leadersh Q 1990; 1: 107-142. doi:https://doi.org/10.1016/1048-9843(90)90009-7

BIAGGINI, M, MENDOZA A. "Influencia del apoyo organizacional percibido, compromiso organizacional, satisfacción laboral, sexo y nivel del cargo sobre la ciudadanía organizacional.Trabajo de Grado de Licenciatura. Escuela de Psicología, Universidad Católica Andrés Bello, Caracas, (Venezuela), 2005. http://biblioteca2.ucab.edu.ve/anexos/biblioteca/marc/texto/AAQ4502.pdf.

TORDERA SANTAMATILDE N. Liderazgo, clima y respuestas afectivas en equipos de atención primaria. Un estudio longitudinal. Tesis Doctoral. Universitat de Valencia (España), 7 de marzo de 2002.

ARANAZ J, MIRA J. Cuestionario Font Roja: Un instrumento de medida de la satisfacción en el medio hospitalario. Todo Hospital 1988; 62: 63-66.

ORTEGA V. Adaptación al castellano de la versión abreviada de Survey of Perceived Organizational Support. Encuentros en Psicología Social 2003; 1: 3-6.

GRAEN GB, UHL-BIEN M. Relationship-based approach to leadership: Development of leader-member exchange (LMX) theory of leadership over 25 years: Applying a multi-level multi-domain perspective. Leadersh Q. 1995; 6: 219-247. https://doi.org/10.1016/1048-9843(95)90036-5

Published

2021-12-27

How to Cite

1.
López Ibort N, Boned Galán A, Cañete Lairla M, Antoñanzas Lombarte T, Gascón Catalán A. Impact of charge nurses’ span of control on the work attitudes of nurses. An Sist Sanit Navar [Internet]. 2021 Dec. 27 [cited 2025 Dec. 6];44(3):373-8. Available from: https://recyt.fecyt.es/index.php/ASSN/article/view/86019

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.