Managerial Competencies among Nurse Managers at Universitas
Sumatera Utara Hospital in Medan, Indonesia
Setiawan, Dewi Elizadiani Suza and Farida Linda Sari Siregar
Faculty of Nursing, Universitas Sumatera Utara, Medan, Indonesia
Keywords: Managerial Competency, Nurse Manager, Teaching Hospital.
Abstract: Background: Head nurses serve as front-line managers which have complex, important roles in providing
health care in hospitals. They have strong influence on quality and patient’s outcomes. They are responsible
in transform strategic planning and goals defined by head of nursing division into nursing operational plan.
The purpose of this study was to explore managerial competencies of nurse managers at Universitas Sumatera
Utara (USU) hospital. Methods: This study was one cycle of an action research study that was carried out at
USU hospital as one of teaching hospital in Medan, Indonesia. Ten nurse managers were involved in this
study. Focus group discussion was used to collect data. Transcript verbatim was made after an in-depth FGD
and then was analyzed by using content analysis technique. Results: This study found 5 domain of managerial
competencies of nurse managers at Universitas Sumatera Utara (USU) hospital. They were (1) function of
ward management (planning, staffing, organizing, directing, and controlling), (2) management of patient care
(identification of patient acuity, collaborating, coordinating, checking patient’s status and checking
completeness of discharge documents ), (3) leadership (decision maker, conflict mediator, lobbying,
bargaining), (4) self and staff development (updating knowledge and skills and interpersonal relation), (5)
and, function of preceptorship (supervising, teaching, role modeling, selecting case). Conclusion: Nurse
managers in a hospital have to master a set of managerial competency in order to manage effective daily ward
operational. It is recommended that a hospital to set standardized managerial competency for nurse managers
as requirements for a nurse to be a nurse manager.
1 INTRODUCTION
Nurses manager in hospitals function as front-line
managers who have complex and important roles in
health services. As front-line managers in hospitals,
nurse managers have a strong influence on the quality
of hospital services and patient outcomes. They are
responsible for changing the strategic plan and goals
set by the nursing field into operational plans. They
are also required to be able to play a role in clinical
and administrative leadership while being responsible
for patient care activities for 24 hours (Thrall, 2006).
Nurse Managers are responsible for creating a
safe and healthy environment to support the work of
the health care team and contribute to involvement
with patients (AONE, 2015). Nurse Managers act as
leaders who play an important role in the lives of
nurses to ensure quality patient outcomes and are
required to have the ability to interpret general
concepts and integrate them into clinical and
managerial performance (Chase, 2010).
Nurse Managers in carrying out their duties must
have various competencies. In Indonesia, nurse
manager competencies are explained in job
descriptions based on the Indonesian Ministry of
Health standards, one of which is conducting
managerial activities and functions in the field of
work (PPNI, AIPNI, AIPDiKI, 2012). Managerial
competence is a series of knowledge, skills,
behaviors, and attitudes that a person needs to be
effective in diverse managerial work (Khadka,
Gurung & Chaulagain, 2014). Managerial
competence provides valuable value and improves
performance in management processes that benefit
employees and organizations (Krajcovicova,
Caganova & Cambal, 2012).
Krajcovicova, Caganova & Cambal (2012)
mentions that there are 4 pillars of managerial
competence, namely knowing the organization,
Setiawan, ., Suza, D. and Siregar, F.
Managerial Competencies among Nurse Managers at Universitas Sumatera Utara Hospital in Medan, Indonesia.
DOI: 10.5220/0010101909290932
In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramification Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages
929-932
ISBN: 978-989-758-449-7
Copyright
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 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
929

leading and managing people, managing resources,
and communicating effectively. Gunawan and
Aungsuroch (2016) also explained that the nurse
managerial competence consists of several
components, namely self-development, planning,
organizing, leading, managing legal and ethical issues
and providing health services.
In general, the managerial competence of nurse
managers is still considered lacking. Khadkaarch,
Gurung and Chaulagain (2014) found that nurse
managers who are currently working in Kathmandu
Valley hospitals need to improve their managerial
competencies by attending hospital management
courses and training. In Indonesia, the nurses of
hospital managers are still not many who have
educational backgrounds who are equipped with the
knowledge and practice of nursing management.
USU Hospital is one of the health services in
Medan. All nurse managers at the USU Hospital have
a bachelor education background but are relatively
long inexperienced in managing nursing services in
hospitals. In addition, they also still need to improve
their competence as nurse managers. Therefore, the
creation of a managerial competency model for nurse
managers at the USU hospital is very necessary so
that all nurse managers master the managerial
competence. The existence of this model is very
helpful for the nurse manager so that it can be used as
a guide in carrying out his role as a professional nurse
manager. The purpose of this study was to explore
managerial competencies of nurse managers at USU
hospital.
2 METHOD
The research design used in this study is action
research. Action research design is suitable to be used
to develop a nurse nurse competency model in
leading innovation and changes in nursing services at
a Universitas Sumatera Utara. The action research
method that will be used is a method developed by
Kemmis and McTaggart (1988) which consists of 4
phases, namely planning, acting, observing, and
reflecting.
The action research method was chosen in this
study because this method can identify problems in
practice and offer methods for solving the problems.
In addition, action research was chosen in this study
with the reason for its potential to help bridge the gap
between theory, research and nursing practice.
Participants in this study were all heads of rooms
from 10 service units at USU Hospital.
3 RESULTS
The total participants in the study were 10 people
where all participants were female, ranging in age
from 27 to 40 years and as head of the ward.
Demographic data from participants is shown in
Table 1.
Table 1. Participant characteristics.
Characteristic f %
Sex
Female 10 100
Male 0 0
Age
< 30 years 1 10
31 - 40 years 9 90
Marital status
Married 10 100
Single 0 0
Education
Bachelor 9 90
Master 1 10
Years in Hospital
1 – 5 1 10
6 – 10 8 80
> 10 1 10
Experience as Head Nurse
1 – 3 years 7 70
4 – 8 years 3 30
Clinical Training
Never 2 20
1 – 3 years 7 70
4 – 8 years 1 10
Management Training
Never 7 70
1 – 3 times 2 20
>8 times 1 10
Number of Staff
1 – 10 1 10
11 – 20 8 80
>20 1 10
ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramification Researches
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This study found 5 domain of managerial
competencies of nurse managers at USU hospital.
They were (1) function of ward management
(planning, staffing, organizing, directing, and
controlling), (2) management of patient care
(identification of patient acuity, collaborating,
coordinating, checking patient’s status and checking
completeness of discharge documents), (3) leadership
(decision maker, conflict mediator, lobbying,
bargaining), (4) self and staff development (updating
knowledge and skills and interpersonal relation), and
(5) function of preceptorship (supervising, teaching,
role modeling, selecting case).
3.1 Function of Ward Management
Nurse Managers at USU hospital stated that they have
to master 5 functions of ward management planning,
staffing, organizing, directing, and controlling in
order to carry out their main duties as a nurse
manager. These basic competencies are common
competencies for all front-line manager in many
hospitals around the world. These basic competencies
are useful in managing day-by-day nursing service in
the ward. Having these basic competencies made the
participant more confidence in ensuring
completeness of nursing administrative tasks are
smoothly run.
3.2 Management of Patient Care
All participants in involving in this study believed
that they have to poses competencies related to
management of patient care. This competency include
identification of patient acuity, collaborating,
coordinating, checking patient’s status and checking
completeness of discharge documents. Even though,
direct nursing care for patients are carried out by staff
nurses, nurses who serve as in charge nurse also
involve in managing patient care. Patient with new
admission need to classify into 3 level of care: total
care, partial care, or minimum care. A nurse manager
also need to collaborate and coordinate patient care
with other health care teams. Finally, before patients
discharge from the ward, head nurse as manager will
check the completeness of discharge document.
3.3 Leadership
Nurse Managers in this study perceived that
leadership is very important competency they have to
master. This leadership characteristics include
decision maker, conflict mediator, lobbying, and
bargaining. These leadership characteristic are
required to ensure that all nursing duties in the ward
will be effectively employed by staff nurses. By
having this characteristic, nurse manager will gain
respect and trust from their nurse staff so that they
lead the progression of clinical practice in the ward.
3.4 Self and Staff Development
Nurse Managers stated that another competency they
need to master is related to self and staff
development. These include updating knowledge and
skills and interpersonal relation. As a leader in his
unit, the nurse manager has an important role in
developing the knowledge and skills of both himself
and the staff so that they can carry out the latest
evidence-based services. They also have to keep
abreast of the latest technology and ensure that
everything can run and produce positive outcomes for
both patients and hospitals.
Nurse managers are also responsible for
improving interpersonal relations both among them
and also with other health workers. The better
interpersonal relations developed by the nursing team
in the unit, the better the quality of services provided
to patients.
3.5 Function of Preceptorship
USU Hospital is a teaching hospital. Therefore, in
addition to providing nursing services for their
customers, nurse managers also serve as preceptor for
nursing students. This function of preceptorship that
covers the nurse manager includes supervising,
teaching, role modeling, and selecting cases.
The involvement of nurse managers in the clinical
learning process of nursing students has the
consequence that they must be able to provide
supervision to students in performing nursing
procedures. They must also teach the practice of
nursing services they provide to patients and families.
In addition they must be an example of the role of
both as a nurse and also as a professional manager.
Finally, the nurse manager has the task of determining
which patients are the responsibility of the student in
the room who performs nursing practice under the
guidance of the nurse manager.
Managerial Competencies among Nurse Managers at Universitas Sumatera Utara Hospital in Medan, Indonesia
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4 DISCUSSION
The results show that there are 5 managerial
competencies run by nurse managers at USU
Hospital.They were (1) function of ward management
(planning, staffing, organizing, directing, and
controlling), (2) management of patient care
(identification of patient acuity, collaborating,
coordinating, checking patient’s status and checking
completeness of discharge documents), (3) leadership
(decision maker, conflict mediator, lobbying,
bargaining), (4) self and staff development (updating
knowledge and skills and interpersonal relation), and
(5) function of preceptorship (supervising, teaching,
role modeling, selecting case). This competency has
been carried out by all nurse nurses at USU Hospital
since the hospital operated in 2016.
Having basic management function is compulsory
for nurse managers in order to run daily ward
operational. They should be competent on planning,
organizing, staffing, directing, and controlling in
running a ward. These 5 basic management function
will help them to achieve the ultimate purposes of
their position as a head nurse.
Nurse managers who have competencies on basic
management function have been proved to be succeed
in play their roles. A study by Rashed, Al Torky, and
Morsey (2015) found that there is correlation between
head nurses' management functions and nursing
productivity at medical units, surgical unit, post
operative ICU, casualty intensive care unit.
As a leader in the ward, of course, the nurse
manager is able to show his leadership spirit to his
subordinates. With effective leadership, the
implementation of nursing practice and nursing
services can run well. In addition, solid leadership
will produce better patient outcomes by increasing
nursing skills through increasing staff skills and
competencies (Frankle, 2008).
As a preceptor, the nurse manager prepares
nursing students using a variety of clinical skills
where nursing is practiced. To do this appropriately,
they must have competencies in clinical teaching.
These competencies paired with their knowledge and
skills on clinical areas will guide students to achieve
their clinical placement goals. Participants in this
study performed teaching roles, selecting cases,
supervising, and role modeling for students. By doing
this kind of competencies, nurse managers will help
students to be professional nurses in the future.
5 CONCLUSIONS
Nurse managers in a hospital have to master a set of
managerial competency in order to manage effective
daily ward operational. It is recommended that a
hospital to set standardized managerial competency
for nurse managers as requirements for a nurse to be
a nurse manager.
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