Leda förändring genom relationer, processer och kultur
Salmela, Susanne (2012-09-21)
Salmela, Susanne
Åbo Akademi - Åbo Akademi University
21.09.2012
Julkaisu on tekijänoikeussäännösten alainen. Teosta voi lukea ja tulostaa henkilökohtaista käyttöä varten. Käyttö kaupallisiin tarkoituksiin on kielletty.
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi-fe202002145483
https://urn.fi/URN:NBN:fi-fe202002145483
Tiivistelmä
The aim of this dissertation is to contribute a new knowledge synthesis of what it entails to lead change from a caring science perspective. The nurse leader is, especially during larger organizational changes, of great importance to how the nursing care is managed by keeping the caring tradition alive and through the shaping of the caring culture and care communion. The overall hermeneutical research approach, with an application of methodological triangulation, has been influenced by Gadamer’s, Ricoeur’s and Ödman’s views on hermeneutics with understanding and explanation that are complimentary.
The research’s central question, “What does it entail to lead change from a caring science perspective?”, is anchored through four underlying questions. The first of these pertained to the meaning content of the concept “change” as well as how the concept is shaped. The method was a hermeneutical conceptual determination on the ontological and contextual levels, in accordance with Koort’s method of concept determination. Using a questionnaire, care personnel’s views (597 in total) on the coming merger and change as well as their expectations of leaders during a change process were sought in order to find an answer to what the conditions were for a change or a change process with intended goals and effects. The answers to how a nurse leader and her task are formed during a change as well as how nurse leaders perceived change and the coming change process were garnered from in-depth interviews of nurse leaders (17 in total).
The results show that a nurse leader leads change by leading relationships, processes and culture and through a supportive, reflective and culture-bearing leadership with the aim to realize genuine and sustainable change. In order to realize a genuine and sustainable change, i.e. an inner transformation and remodeling as becoming, both thought patterns and actions must be changed.
The direction and effort towards change should be based on a clear and meaningful goal and vision that emanate from shared values. An arena for dialogue should be developed so that the change, likewise the goals and mission of care, is rooted and developed into action and change. The nurse leader’s primary task or mission is to provide each individual patient with good care, in other words to serve the patient, with responsibility and emanating from an ethical attitude. In serving the patient, there is a trust that the change benefits the patient and the patient’s care, but the nurse leaders’ adaptation to the change occurred without any greater engagement. The nurse leaders were even worried about the task of being a nurse leader, the care situation and their mandate as patient advocates. A nurse leader is also a bearer of culture, which means that even culture is important during a change process. By leading a culture, the nurse leader creates an open, confirming and evidence based atmosphere with core values that express the prevailing spirit and culture.
The research’s central question, “What does it entail to lead change from a caring science perspective?”, is anchored through four underlying questions. The first of these pertained to the meaning content of the concept “change” as well as how the concept is shaped. The method was a hermeneutical conceptual determination on the ontological and contextual levels, in accordance with Koort’s method of concept determination. Using a questionnaire, care personnel’s views (597 in total) on the coming merger and change as well as their expectations of leaders during a change process were sought in order to find an answer to what the conditions were for a change or a change process with intended goals and effects. The answers to how a nurse leader and her task are formed during a change as well as how nurse leaders perceived change and the coming change process were garnered from in-depth interviews of nurse leaders (17 in total).
The results show that a nurse leader leads change by leading relationships, processes and culture and through a supportive, reflective and culture-bearing leadership with the aim to realize genuine and sustainable change. In order to realize a genuine and sustainable change, i.e. an inner transformation and remodeling as becoming, both thought patterns and actions must be changed.
The direction and effort towards change should be based on a clear and meaningful goal and vision that emanate from shared values. An arena for dialogue should be developed so that the change, likewise the goals and mission of care, is rooted and developed into action and change. The nurse leader’s primary task or mission is to provide each individual patient with good care, in other words to serve the patient, with responsibility and emanating from an ethical attitude. In serving the patient, there is a trust that the change benefits the patient and the patient’s care, but the nurse leaders’ adaptation to the change occurred without any greater engagement. The nurse leaders were even worried about the task of being a nurse leader, the care situation and their mandate as patient advocates. A nurse leader is also a bearer of culture, which means that even culture is important during a change process. By leading a culture, the nurse leader creates an open, confirming and evidence based atmosphere with core values that express the prevailing spirit and culture.
Kokoelmat
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