Table 6 Sample quotes on leadership

Senior leadership’s visibility and communication at frontlines.

I have worked here for many years; I don’t think I have ever met any of the senior management in this hospital or had a chance to discuss anything with them so I feel they could probably come around a lot more to our department, especially when we constantly have bed crises ………. and we are ...... the frontline of the hospital.

Senior leadership’s visibility and communication at frontlines.

There is a lot of, I find horizontal conversations happening but not a lot of top down communication. So, a lot of the feelings from nurses is that senior management have no idea about what is going-on on the floor. A lot of people feel that way because we don’t hear the background, we don’t hear what [the senior leaders] are talking about. We just see the very end result and [senior leaders] just say “hey we are doing this”.……… we don’t hear all the discussions that they are having in senior management meetings.

Senior Leadership and inclusive policy making.

As [senior leaders] are trying to make the unit safe, or the patients safe, they’re not asking for the staff to comment or participate in those meetings where they created [policies] ………. unless you have frontline staff that are most affected by a policy, you’re never going to create a safe policy because you cannot sit in an office and not practice and not deal with the day to day ins and outs of the physical unit and know that that policy is an appropriate policy to implement.

Supervisory leadership and safety related communication.

There is a huddle board that gets done, patient huddle board, for the most part it gets done on daily basis and there the nurse manager discusses what could be safety issues ………. and you feel free to bring up anything you want to in-front of the group, so more suction equipment, sometimes that might be a safety issue. Now, [the unit] has ordered some extra suction equipment so that we can have enough for patients in every room.

Supervisory leadership and relational competency.

I really like my [supervisory leader], she is really approachable, to be honest. I feel comfortable with her ......... the other day we had a patient and I felt like there was a lot of buck passing in his care. He was a homeless man, he couldn’t go back to the shelter, he needed a nursing home. They refused to admit him to the hospital so he was [downstairs] for 5 days which seems a little inappropriate to me and then there were issues like getting his meds from the pharmacy because they only send those for admitted patients and the kitchen wouldn’t send him a warm meal because they only send warm meals for admitted patients. I went to [my supervisory leader] and complained, passed on all my concerns about the patient. She was quite open to my concerns and how to fix what was happening ………... [she] did call the food services and talked to their supervisor and talked to the pharmacy and kind of said, this is the situation and you need to appropriately change polices for this patient.