| Summary: | AimTo study nurse managers’ perceptions and experiences with staff nurse structural empowerment and the impact on the nurse manager leadership role and style.BackgroundNurse managers’ leadership roles may be viewed as challenging given the complex needs of patients in the context of staff nurses’ involvement in clinical as well organizational decision-making processes, in interdisciplinary care settings.DesignQualitative phenomenological study MethodsIndividual semi-structured interviews of 8 medical or surgical nurse managers were conducted in a 600-bed Belgian university hospital between December 2013 and June 2014. This organization was undergoing a transformational process to convert from a classic hierarchical and departmental structure to one that was flat and interdisciplinary.ResultsNurse managers were familiar with and held positive attitudes about nurse structural empowerment in the hospital. They conveyed the positive impact of empowerment on their staff nurses that in turn improved the quality of care and patient safety. Structural empowerment was supported by several change initiatives at the unit and hospital levels and nurse managers’ experiences with these initiatives was reported as mixed because of the changing demands on their manager role and leadership style. In addition, pressure was experienced both by staff nurses and nurse managers through direct patient care priorities, tightly scheduled projects and miscommunication.ConclusionNurse managers reported a favourable impact of structural empowerment on staff nurses’ professional attitudes and the safety and quality of care on their units. However, they also reported that the empowerment process, created changing demands in the manager role as well as daily practice dilemmas with regard to needed leadership styles. Clear organisational goals and dedicated support for nurses as well as nursing unit managers will be imperative to sustain an empowered practice environment achieving the
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