Nurses’ expectations about the succession of leaders in the hospital context

a descriptive and exploratory study of a qualitative approach carried out with 36 nurses from a public university hospital selected using the snowball technique. The data collection was done through semi-structured interviews that were recorded and analyzed based on the assumptions of the Content Analysis technique, Thematic modality. Ethical criteria were adequately met.

Results:

the reports comprised two central categories, “Who Will Take My Place?” and “Potential and Openness to Plan the Succession of Leadership in Nursing,” the latter being divided into two subcategories: “Nursing leadership in the hospital five years from now” and “Strengths for the implementation of a leadership succession plan”.

Conclusion:

from the results, positive aspects of the diagnosis of the leadership profile in the institution that favor the development of succession planning were verified. In addition, it was possible to perceive the necessity of the development of this planning in the hospital and its importance for the succession of leadership in Nursing. In this context, this study presents itself with an innovative character for exposing a theme that aims to potentiate the future of Nursing.

Descriptors:
Leadership; Nurses; Nursing Staff; Professional Competence; Nursing Research; Nursing Supervisory

Characteristics	N Directors (05)	N Bosses (08)	N Leaders (07)	N Supervisors (16)	N Total (36)	%
Generation
Y^* * Y = Generation Y / Millennium (1981 to 2000);			01	10	11	30.5
X^† † X = Generation X (1965 to 1980);	02	05	05	05	17	47.2
Baby Boomers^‡ ‡ Baby Boomers = Baby Boomers (1946 to 1964)	03	03	01	01	08	22.2
Position
Board of Directors	05				05	2.8%
Head of Unit		08			08	22.2%
Clinical Leader			07		07	19.4%
Clinical Supervisor				16	16	44.4%
Did a specific course on leadership
Yes	02	04	03	02	11	30.6%
No	03	04	04	14	25	69.4%
Had any leadership guidance to perform the role
Yes	03		03	09	15	41.7%
No	02	08	04	07	21	58.3%

Who will take my place?

Both I and other Nursing leaders are close to retiring, it's only another five years, we sit down and talk about it, how it's going to be, who will replace us .... who will you lead? (D1)
From the beginning, when I was a team, I wanted to work with new people, I already knew some people, and I already thought that my days inside the institution were counted, so I thought I needed people to continue the service, I just planted the seed, it needs to bear fruit and bear good fruit, so I had this concern of having a new team. (D4)
Undoubtedly, it is a concern of all of us. It's very casual this conversation, a common conversation, when you need to change someone's place, when you need to go some to key places, you know, there is no formality in this sense, we talk about how it will be, but it's a question in our head . (C1)
In several moments, my immediate boss arrives and makes direct notes, you will replace
me. (C4)
I realize that yes, we have our Head of Nursing, who is a born leader, when someone new arrives, she says thus: "you will be our successor," she has a lot of that concern. (C8)
I talk a lot to the boys, because I want them to follow up, I'm jealous of the service. For him to be in good hands, then, all who have to want this. (D4)
The built cannot be discarded, so when someone is going to retire, there is a concern with who will replace that person's place, now, prepare a person to be assuming, we do not have that hierarchy to do it here, I've never seen, until because of the same sizing. (L7)

Potential and openness to plan succession of leadership in Nursing

Nursing leadership at the hospital in five years time

I think there will be a great demand for retirement, we had many at the beginning of this year and, five years from now, it must be bigger, I'll be in this group! This group of my group, we entered the public service in 90, we will be retired in five years or even less and you will assume and the prospect is good, as long as you are committed to the institution, at least knowledge, you are having, allied knowledge with commitment would be idea. (D5)
I see it as a very positive point, some people will have to retire compulsorily and this succession will have to happen whether they want it or not. (C4)
I think there has to be a total renewal in the nursing team, with training and courses, you have to have a lot of training to carry out a big hospital. (S13)
I'm sure we'll have great nurses, very skilled in leadership, I think there are a lot of people with potential. (D2)
I see with good perspective, are entering many new people with a very good profile. (D1)
Today is beautiful to think, we have a group of doctorates in Nursing with a greater and better qualification, with a more effective professionalization, with this ability to convey, to plan, to lead. I very much believe that this will bear fruit, yes, I want to see this Nursing from five years to now totally different here, by the commitment of these doctors who are forming here and are the professionals that will replace us. (C5)
I think it has to change, I think a lot of things get better when you see a new person doing it, I think it has to change, not that you have to change everybody, but there are some people who have been in the lead for a long time. (S1)

Strengths for the implementation of a leadership succession plan

If we think in a systematic way, we can have better educated leaders. (S14)
I think it's necessary to think about it because otherwise we will face very serious problems in a few years. (S6)
I think so, I think you should do it because being a leader today has changed your vision, in the old days, that was it, you said it and that's it, but today, no, to be a leader, you have to be able to lead, have an overview of the world, has changed a lot. If you develop this project here, the hospital has a lot to gain. (L2)
We have several tools for this, we have a cadre of masters, doctors, post-doctors, we have an approach to the university, we find availability of university professors, we find the doors open. You have to have good will and I'm noticing that goodwill exists. (L3)
I see that everyone is open to change too, and everyone wants the best for the future of the hospital, even those in management, they want the best too. (S11)
For Nursing, it is essential to think about it, it is as if you were lighting a little light there and saying that we can leave, that the ground is prepared and this is very important. We cannot lose what we have achieved, from the moment I see that it will continue and that this planning will appear and that I will not have this fear that tomorrow, when I leave, that it is ready, is ready. (D1)
This work you are doing is already opening up our awareness and concern. If you help make a model available, then there's going to be a building there, because this is happening to us now. If we can leave this product for everyone, as guidance, it will be too good because I believe in our profession, I believe in Nursing, I believe in the leadership power of those who are in here. (C5)

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Denize Bouttelet Munari. E-mail: boutteletmunari@gmail.com