The Career Development of Black Female Chief Nurse Executives

This qualitative study was designed to explore the career development of Black female chief nurse executives. Although a small proportion of Black female nurses have achieved positions at the nurse executive level, there remains a paucity of Black female nurse executives in this crucial position which raised the question of what factors contributed to this lack of advancement, but, more important, what factors have contributed to the success of the few who have achieved such level of success in healthcare organizations. The purpose of the study was to explore the career paths of Black female chief nurse executives with a view of understanding the factors which both facilitate and hinder the career development of these leaders in healthcare organizations. The guiding research question was, How do Black female nurse executives in this sample describe their career development? The participants in this study were Black female chief nurse executives located throughout the United States who, for the most part, were raised in segregation with a strong family foundation. To collect data, semistructured telephone interviews were conducted with 10 Black female chief nurse executives throughout the United States. The transcripts from the interviews were transcribed, coded, and analyzed. Using Super’s (1990, 1996), and Gottfredson’s (1981, 1996, 2002, 2005) career development theories and critical race theory (Crenshaw, 1995; Delgado, 2000) as the theoretical framework, the researcher found that the participants’ career development was influenced by (a) strong support system, (b) guidance, (c) influence of diversity, and (d) servant leadership. The findings help us understand the factors that have contributed to their successes as Black chief nurse executives. With the increasingly diverse population and concurrent increasing diversity in nursing and concerns about healthcare disparities, it is imperative that organizations attract, hire, develop, retain, and advance qualified Black nurses. Future studies addressing not only the career development of Black nurses but nurses in general might be informed by the present study’s findings. Recommendations are offered for nursing practice, education, and organizational policy.

The career development of Black female chief nurse executives

This qualitative study was designed to explore the career development of Black female chief nurse executives. Although a small proportion of Black female nurses have achieved positions at the nurse executive level, there remains a paucity of Black female nurse executives in this crucial position which raised the question of what factors contributed to this lack of advancement, but, more important, what factors have contributed to the success of the few who have achieved such level of success in healthcare organizations. The purpose of the study was to explore the career paths of Black female chief nurse executives with a view of understanding the factors which both facilitate and hinder the career development of these leaders in healthcare organizations. The guiding research question was, How do Black female nurse executives in this sample describe their career development? The participants in this study were Black female chief nurse executives located throughout the United States who, for the most part, were raised in segregation with a strong family foundation. To collect data, semistructured telephone interviews were conducted with 10 Black female chief nurse executives throughout the United States. The transcripts from the interviews were transcribed, coded, and analyzed. Using Super’s (1990, 1996), and Gottfredson’s (1981, 1996, 2002, 2005) career development theories and critical race theory (Crenshaw, 1995; Delgado, 2000) as the theoretical framework, the researcher found that the participants’ career development was influenced by (a) strong support system, (b) guidance, (c) influence of diversity, and (d) servant leadership. The findings help us understand the factors that have contributed to their successes as Black chief nurse executives. With the increasingly diverse population and concurrent increasing diversity in nursing and concerns about healthcare disparities, it is imperative that organizations attract, hire, develop, retain, and advance qualified Black nurses. Future studies addressing not only the career development of Black nurses but nurses in general might be informed by the present study’s findings. Recommendations are offered for nursing practice, education, and organizational policy.

Effects of two intervention strategies on the behavior of nurses and nurse students related to advance directives

Advance directives are one mechanism for preserving the rights of individuals to exercise some control over their health care when serious illness may prevent them from direct participation. Nurses, as the health care providers with the closest and most sustained contact with critically ill and dying patients, are positioned to assist patients to plan for future health care needs. Although a majority of nurses favor the concept of advance directives for their patients and for themselves, they have not played a significant role in facilitating advance health care planning with their patients nor implemented advance health care planning for themselves.^ Research has also shown that differing forms of education and counseling increase the completion rates for advance directives in selected populations, mostly the elderly and seriously ill. Not yet developed are effective educational strategies to assist nurses and nurse students to make optimal contributions in assisting their clients' plans for future health care decision-making. This study sought to determine whether specific learning strategies (a) increased the involvement of nurses and nurse students in facilitating advance care planning with patients and (b) increased the percentage of the nurses' and nurse students' own personal advance care planning activities.^ The study compared two learning interventions and two populations, nurses and nurse students. The participants were randomly assigned to one of the two learning interventions, L1 or L2. Participants in L1 received a lecture, discussion and exploration of the forces impacting on advance directive behavior. Participants in L2 received the same intervention components with the additional component of group practice completing advance directives.^ Analysis of the data by chi-square and logistic regression did not support the hypotheses that the practice component would make a difference in the participants' facilitation of advance care planning with patients or in their own personal advance care planning activities. There were significant differences in post-intervention behavior between the nurse and nurse student groups. The nurses in the study did significantly more facilitation of advance care planning with patients and completed significantly more advance care documents than the nurse students post-intervention. However, the nurse students held more post-intervention family discussions than did the nurses. ^

A comparison of the leadership styles of the leaders at New World School of the Arts

The purpose of this study was to determine if the perceived leadership styles of the leaders at New World School of the Arts were different according to their roles in the organization. The study focused on the top leaders of the organization: the Provost who heads the college program, and the Principal who heads the high school program.^ The Leadership Practices Inventory (LPI) Self and Observer developed by Kouzes and Posner (1990) was used to examine and compare the perceived differences between the leaders and the programs. The LPI measures five practices of exemplary leadership. The LPI Self and Observer was administered to the leaders, administrative subordinates, and faculty. In addition to the LPI a Demographic Inventory was used to collect data about the respondents.^ This study used a causal-comparative design to determine if differences existed between the leaders at NWSA as perceived by the leaders themselves and their respective administrative subordinates and faculty. T tests were conducted on the mean differences between the five leadership practices measured by the LPI. All tests were declared significant if exceeding the 5% level $(p={<}.05).$^ Significant differences were found within the college program across all five practice areas. To a lesser degree, significant differences were found within the high school in three practice areas: Inspiring, Enabling, and Modeling. Three significant differences were found between the college and high school in two practice areas, Enabling and Encouraging.^ There is little consensus of opinion within the college regarding the operative leadership style. Within the high school there is substantial similarity of perception regarding the operative leadership style. There is substantial similarity of perception between the programs regarding the operative leadership style. ^

The relationship between participation in unethical behaviors during the nursing student experience and participation in unethical behaviors as a registered nurse

The effect of unethical behaviors in health care settings is an important issue in the safe care of clients and has been a concern of the nursing profession for some time. The purpose of this study was to examine the relationship between use of unethical behaviors in the nursing student experience and the use of unethical behaviors in the workplace as a registered nurse. In addition, the relationship between the severity of unethical behaviors utilized in the classroom, clinical setting and those in the workplace was examined. To insure greater honesty in self-report, only a limited number of demographic variables were requested from participants.^ During the summer of 1997, a 56 item questionnaire was distributed to registered nurses enrolled in either undergraduate or graduate courses in a public or private institution. The participants were asked to self-report their own use of unethical behaviors as well as their peers use of unethical behaviors. In order to assign a severity score for each item, nursing school faculty were asked to rate severity of unethical behaviors which could be used during the nursing student experience and nursing administrators were asked to rate unethical behaviors which could be used in the workplace.^ A significant positive relationship was found between individuals' use of unethical behaviors during nursing school and those used in the workplace $r=.630.$ A significant positive relationship was found between the severity of unethical behaviors used in the nursing student experience and the severity of unethical behaviors used in the workplace $r=.637.$ No relationship was found between years of practice, type of initial nursing education and whether or not the participant was raised inside or outside the United States and the use of unethical behaviors. ^

Laypersons' awareness of the role and function of the nurse practitioner

The purpose of this descriptive study was to document the level of awareness that laypersons have regarding the role and function of the nurse practitioner (NP). An instrument developed for a similar study, conducted in 1994, comparing patients' and physicians' level of knowledge of the role and function of the NP, had a low reliability. Revision of the instrument was required before further use could be justified.^ A pilot study of 25 laypersons was conducted to ensure that the revised tool was reliable prior to conducting a study. Reliability for the pilot sample was 0.84.^ The study results indicated that the majority of the sample (83%), (n = 100) knew that a NP was a registered nurse who was qualified to diagnose and treat minor illnesses. The level of layperson awareness was limited regarding prescriptive privileges, well-woman exams, and the NPs' ability to perform physical exams, and interpret lab results and x-rays. ^

Sequence analysis of complementary DNAs encoding C3 in the nurse shark ({\it Ginglymostoma cirratum\/})

Mammalian C3 is a pivotal complement protein, encoded for by a single gene. In some vertebrate species multiple C3 isoforms are products of different C3 genes. The goal of this study was to determine whether multiple genes encode for shark C3. A protocol was developed for the isolation of mRNA from shark blood for the isolation of C3 cDNA clones. RT-PCR amplification of mRNA, using sense (GCGEQNM) and antisense (TWLTAYV) primers encoding conserved regions of human C3, yielded 21 clones. The C3-like clones isolated shared 97% similarity with each other and 40% similarity to human C3. RACE-PCR amplification of shark liver RNA, using gene specific primers, yielded products ranging from 1800bp to 3000bp. Deduced amino acid sequence, corresponding to 408bp of the 1800bp fragment, was obtained which showed 51% similarity to human C3. These results suggest that nurse shark C3 might be encoded for by more than one gene. ^

A study of leadership behaviors for Breaking Ranks leaders in public secondary schools

This research will investigate what it will take to develop principals who will embrace the recommendations of reform as proposed by National Association of Secondary School Principals (NASSP, 1996) in the Breaking Ranks document. Breaking Ranks is based on the belief that it is within the dynamics of the school culture that principals must gain insight into strategies for improving the schools for which they are held responsible. Given this context, it is important to examine perspectives that are held by principals who lead schools that embrace the concepts of reform as proposed by NASSP, thereby, could be deemed “Breaking Ranks” schools. It is within these schools that the new role of the principal develops. NASSP has identified seven key recommendations for leadership development; “attributes that need nourishing” (p. 12) for the success of school reform. The seven recommendations are included in Breaking Ranks. ^ The purpose of this study is to identify and describe how principals put the seven recommendations into practice as they function in their schools. In addition, this study will gather information on the characteristics, support, skills, and training these principals identify as critical aspects and components of their success. This is a study of principal leadership at four high school sites where “Breaking Ranks” principals have been identified. ^ This research plan will be designed to utilize an inquiry-based process with a panel of experts and four “Breaking Ranks” principals. This study will describe: (1) how a panel of experts identify what they believe needs to be done in order to put the recommendations of the Breaking Ranks document into practice and their identification of principals who are breaking ranks; (2) how identified principals say they have been able to put the recommendations of the Breaking Ranks document into practice; (3) How both groups identify and describe: (a) the characteristics and behaviors of a “Breaking Ranks” principal; (b) the new leadership skills as described by the seven recommendations identified in the Breaking Ranks document; (c) the support necessary in order to meet the recommendations in the Breaking Ranks document; and (d) The training needed in order to become “Breaking Ranks” principals; and (4) how the process of creating “Breaking Ranks” principals can be described by experts who have studied it theoretically and principals who have demonstrated it in their schools. ^

Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.

Antibacterial proteins and peptides in nurse shark ( Ginglymostoma cirratum) peripheral blood leukocytes

In many vertebrate and invertebrate species mediators of innate immunity include antimicrobial peptides (AMPs) such as peptide fragments of histones and other proteins with previously ascribed different functions. Shark AMPs have not been described and this research examines the antibacterial activity of nurse shark (Ginglymostoma cirratum) peripheral blood leukocyte lysates. Screening of lysates prepared by homogenizing unstimulated peripheral blood leukocytes identified muramidase (lysozyme-like) and non-muramidase antibacterial activity. Lysates were tested for lysozyme using the lysoplate assays, and antibacterial (AB) activity was assayed for by a microdilution growth assay that was developed using Planococcus citreus as the target bacterium. Fractionation of crude lysates by ion exchange and affinity chromatography was followed by a combination of SDS-PAGE with LC/MS-MS and/or N-terminal sequence analysis of low molecular weight protein bands (<20 kDa). This yielded several peptides with amino acid sequence similarity to lysozyme, ubiquitin, hemoglobin, human histones H2A, H2B and H4 and to antibacterial histone fragments of the catfish and the Asian toad. Not all peptide sequences corresponded to peptides potentially antibacterial. The correlation of a specific protein band in active lysate fractions was accomplished by employing the acid-urea gel overlay assays in which AB activity was seen as zones of growth inhibition on a lawn of P. citreus at a position corresponding to that of the putative AB protein band. This study is the first to describe putative AMPs in the shark and their potential role in innate immunity.^

Moral Leadership: A Model for Educational Leaders in the 21st Century

Furthering the understanding of and exploring the literature on moral leadership models is the purpose of this research paper. A review the literature was undertaken, synthesizing concepts and offering a new paradigm for educational leaders.

An Exploratory Analysis of John Dewey's Writings: Implications for School Leaders

The purpose of this study was to synthesize the operational definition of education through an exploratory analysis of John Dewey’s writings. Dewey’s definition of education changed from 1938 to 1896. Findings suggest that schools promote more social and emotional learning through instructional activities such as service-learning.

Female Secondary School Leaders: At the Helm of Democratic Schooling and Social Justice

We chose the philosophical tradition of phenomenology as the qualitative methodology to study four women school leaders. Semi-structured interview data indicated that their professional experiences impacted how their leadership practices advance social justice in their education organizations, espouse the belief that equity matter, and exemplify the torchbearers of democratic ideals.

Race, Gender, & Leadership: Perspectives of Female Secondary Leaders

Female secondary principals not only have to deal with internal and external pressures to lead successfully but are scrutinized because of their gender (Shakeshaft, 1993; Skrla & Young, 2003; Thurman, 2004). The purpose of this study was to investigate how female secondary principals from one southwestern state teased out complex views of leadership, gender, and race.

Emotional Intelligence and Organizational Commitment Among Private Club Board and Committee Volunteer Leaders: A Pilot Study

This pilot study explored the relationship between emotional intelligence and organizational commitment among provate club board and committee volunteer members. The top three items, ranked by mean scores, of each of three EI dimensions -- IN, OUT, and RELATIONSHIPS wer discussed. A sample of 57 volunteer leaders furhter was split into high EI and low EI groups based on respndents' overall EO median score. Statistical differences between high and low EI groups in three aspects of organizational commitment - affective, continuance, and normative commitment - wer present. 4 t-test results showed that the difference between high and low EI groups in affective commitment among private club volunteer leaders was statistcally significant at p <.05.