From caring to managing and beyond: an examination of the head nurse's role

Aim. The aim of this study was to depict the essence of what head nurses do, and how they perform their managerial role. Methods. To achieve this, the work behaviour of 48 head nurses was examined by a semi-structured observation technique for 6 hours each. Results. Results demonstrated that head nurses spent a large proportion of their time in clinical practice, followed by co-ordinating care, operating the unit's functions, and leading staff. Personnel management and quality improvement occupied only a marginal share of head nurses' time. Conclusions. These results implied that head nurses exhibited a management style orientated to maintenance rather than to re-creation, focusing more on the 'doing' and the 'here and now' aspects of the job than on leading, planning, and proactive problem solving.