BONGA UNIVERSITY DEPARTMENT OF

NURSING
TITLE: ASSESSMENT OF LIFE EXPERIENCE OF NURSE
MANAGER: CHALLENGES AND OPPORTUNITY IN BONGA
GEBERETSADIK SHAWOGENERAL HOSPITAL SOUTH WEST
REGION IN 2023.
By: GROUP 6 MEMBRES

May ;2023

BONG Ethiopian
By: GROUP 6 MEMBRES

NAME ID NO. DEPARTMENT

AYNGIDA ARGAW RU/0583/13 NURSING

GETACHEW BIRHAN RU/0190/13 NURSING

MOGESIE KINDIEB RU/0914/13 NURSING

SITOTAW DAGNAW RU/1095/13 NURSING

TIGIST ALEBACHEW RU/1196/13 NURSING

YENENESH KASAHUN RU/0108/13 NURSING

Abstract
To explore the challenges facing hospital nurse manager (HNM) in selected hospitals in the south west
region in ETHIOPIA. Method the study which had exploratory qualitative design, involved the
recruitment of 12 HNMS from the public hospitals in the south west region of BONGA purposive
sampling was used and data were collected through semi structured interviews .the conventional
content was analysis approach was adopted for data analysis. The revealed several managerial
challenges of being HNMS in performing their role .these includes lack of managerial preparedness,
clear Job descriptions of and support interference by other managers and in adequate nursing staff and
material resources . all of these compromised quality of nursing care participants found their role
tedious and stressful. but also regard it as an opportunity of learn new ideas .

Background. Nursing managers have a critical role at the hospitals. The current study aims to investigate
different experiences of nursing managers. Method. This is a qualitative study that investigates the
experiences of 11 nursing managers in Shiraz, Iran. Semi structured interviews and thematic analysis
were, respectively, applied for data collection and analysis. Results. It could be found from the current
investigation that nursing managers have a critical role at the hospitals, and their creativities have more
impacts on procedures compared to organizational orders. There are four major challenges faced by
nursing managers including nursing shortage, structural deficiencies, lack of authorities, and burnout.
Although shortage is considered as the most important challenge, there are more emphasizes on the
improvement of their controlling power in order to prevent their fatigue and burnout. Conclusion. This
study showed that creativity of nursing managers is the most important factor of system management;
also, shortage and deficiencies are recognized as the most significant challenges faced by them.
According to the current study, the shortage of nursing staff is the central issue that has to be
considered.

ACKNOWLEDGEMENT
Firstly we would like to thank BONGA University, College of Health Science, Department of Nursing for
giving this opportunities to prepare this community based training program proposal, Secondly, we
would like to thank our supervisor MR (USMAN ) NURU for their unlimited support, constructive
comment and suggestions throughout the developments of these project.Finally our gratitude goes to
study participants for their voluntary participation on this study
 Abbreviation and acronym
HNM------------- hospital nurse manager

WHO world health organization

BSC Bachelors science course

AHA American health association

G/S/G/H Geberestadike shawo general hospital

Table of Contents
Acknowledgement_________________________

List of acronym_____________________________

Introduction_______________________________

Back Ground of __________________

Statement of Problems__________________

Significance of Study_____________________

2.Objectiveof __________________________

2.1. General Objective_____________________

2.2. Specific Objective_____________________

3.Methods and Materials_____________________

3.1 Study area and Period _______________

3.2 Study Design ______________________

3.3 Study Population____________________

3.3.1 Source of Population__________

3.3.2 Study Population______________

3.4 Inclusion and Exclusion ________________

3.5.Sample Size Determination_______________

3.6.Sampling Procedure _____________________

3.7. Data Collection Tools and Procedure ________

3.8.Study Variables__________________________

3.9.Operational Definition ___________________

3.10.Data Quality Source______________________

3.11.Data processing and Analysis_____________

3.12.Ethical Consideration____________________

3.13.Disseminationofplan___________________
4. Result _________________________________

5. discussion ----------------------------------------------------------------------------------------

6. Recommendation----------------------------------------------------------------------------------

7. refferance ------------------------------------------------------------------------

List of table and table

INTRODUCTION
Background

Nursing managers play a critical crucial role at the hospitals; therefore, they are considered as the
captain of hospitals, and the effective actions of first-line nurse manager lead to the organizational
success [1]. A professional nurse manager has perfect actions and has to manage the changes, cultural
integrations, retentions, and direction of staff attitudes towards changes of healthcare structures [2, 3].
They also play an important role in establishing creativities in the work place and procedures, job
satisfaction, and nurse’ retention [4–7]. Significant factors including the improvement of work place
empowerment, organizational commitment, and job satisfaction of nurse managers are highly
influenced by the management styles of organizations; moreover, they fill the gap between two fields of
management and medicine [8]. Although nursing managers have a vital role in improving the work
environment, their efficacy is highly affected by their work place [4].

Several researchers have investigated the roles of nursing managers due to its importance. A qualitative
research carried out in an Australian critical care unit showed that junior novice would create a
submissive identity despite the existence of interprofessional relationships with the lack of individual
valuing and low self-esteem [9]. According to the investigations carried out on rural hospitals in Uganda,
nurse managers who work in healthcare settings with poor resources are faced with various challenges
of quality improvement including limited patient participation, lack of materials, and limited human
resources [10]. The transition of nurses into nurse managers is associated with various experiences
including struggling in management transition, seeking opportunities for transformation, lack of power
to perform commitments, lack of preparation, and leading others by serving [11]. Aitamaa et al.
investigated conflicts of practical situations, lack of appreciation, ignoring the problems, and
experienced inadequacy [12]. Also, it was shown in an integrative review that there are several
challenges associated with transition programs such as lack of transparency of objectives, course
content, time frame, and type of provided supports [2]. However, more investigations have to be carried
out in different contexts.

During the past decades, many great transformations occurred in the field of nursing in Iran including
the establishment of widespread nursing schools at public and private universities, as well as the
development of public and private hospitals. These transformations are mainly due to the increasing
need for admission beds and made this career become a thriving job in the Iranian society and
promoted its social status. Therefore, several high school students choose this major; however, there
are many problems associated with nursing in Iran including fatigue and burnout [5, 6], early retirement
[13], nursing shortages, job dissatisfaction, poor social positions of nurses, the gap between theory and
practice, lack of community-based nursing care, lack of appropriate student recruiting systems,
shortages in nursing educational curriculums [14], lack of nursing positions in policy making at
macrolevels, unemployment, shortage, unclear role, poor image of nursing, and low self-esteem [15,
16]. Although several investigations have been carried out regarding nursing challenges in Iran, there is
lack of information about how nursing managers are faced with challenges in these situations.
Specifically, there is lack of qualitative knowledge about experiences of nursing managers. Therefore,
this study investigates these experiences based on challenges and mainly aims to answer this question:
“what are the major challenges of nursing managers?”

Nursing managing is a boring task. Managers have to solve problems many of which are not their tasks.
They are responsive for everything and may sometimes face with serious challenges. Participants
believed that their management was associated with pressures that reduced their potential. Managers
apply continuous management approaches, and it leads to their fatigue and, consequently, burnout.

Nurse managers are required to provide a vision for their staff. They must also create a stimulating
environment where staff feel safe, both in the sharing of knowledge and in the risk-taking behaviours
needed for creativity. The challenge comes with the need to serve both those who provide care and
those who receive care [1]. Other challenges include continual organisational change and the high
demands put on the whole healthcare team [2, 3]. High nursing competence is important; yet, this was
challenging when nursing competence is drained by high turnover of nurses. Managers were constantly
concerned that they might not be able to provide optimal quality of care to the patients [3]. Wu et al. [4]
suggest that nurse managers can help experienced nurses feel a sense of accomplishment when they
successfully solve practical problems, and should recruit nurses who possess the characteristics of
positive energy. Pipe and BORTZ [5] highlight mindfulness as an approach that can help nurse managers
be more resilient and effective in their performance. Nurse managers sometimes feel trapped by
competing values, especially the tensions generated by demands for both quality and efficiency [6]. Loss
of trust and confidence in nurse managers and organizations is the root of today’s workforce issues [7].
Udod and Care [8] reveal a serious concern about stressors in nurse managers’ work roles, stressors
which are of great importance to personal well-being and organizational outcomes. It is suggested that
nurse managers cope less effectively when they are exposed to stressors such as unrealistic work
expectations or the need for a broader range of competencies.

Without the benefit of formal educational programmes and lacking feedback on performance, nurse
managers suffer stress and job dissatisfaction [8]. Nurse managers highlighted the necessity of
professional, developmental and personal support in order to deal with increasingly complex and
demanding situations and to face major challenges [9]. Meeting the challenge of stress management,
and enhancing coping strategies, are of utmost importance when fostering a work environment that
enables employees to work efficiently and thus achieve positive outcomes for both patients and the
organisation [9]. To succeed, nurse managers should reward their employees’ selfless acts towards
others. These acts might involve motivating oneself, helping others and giving without expecting,
especially at times when team members themselves display signs of burnout or reduced professional
commitment. In this way, nurse managers can encourage and recognise the inner positive
characteristics of nurses [10]. Therefore, nurse managers should look to the individual development
needs of staff and make sure they have time allotted for this support [11].

Warna-Furu et al. [12] support the notion that virtues are essential for a successful working life and that
increasing one’s capacity to be virtuous can increase one’s physical health and well-being. Previously,
the four virtues of pride, generosity, love and honesty were highlighted as being important in working
life [13], which showed the connection between virtue and health when it comes to the concept of the
meaning of work. Further, Wärnå et al. [13] found that pride as a virtue paves the way to the inner
domains of health. This means the necessity of determining whether health becomes noticeable in
working life when it comes to the employee’s ideas of the meaning of work. They claim that the
connection between pride and health constitutes a new approach to the subject of health in working
life. Solbakken et al. [14] expanded the conceptual understanding of caring in nursing leadership, and
identified five relationship-based rooms in “the house of leadership”, which represented aspects of
leadership. These rooms were the patients’ room, the staff room, the organisational room, the
superior’s room and the secret room. While providing leadership, nurse managers moved back and forth
between the different rooms in order to develop a caring atmosphere.Moreover, fostering a culture of
safety is essential in the perioperative setting and depends on nurse managers taking on the challenge
of ensuring that structures and processes are in place so that patient safety can be maintained [15]. Lack
of studies in perioperative settings regarding the topic of nurse managers’ challenges in their everyday
work justified conducting the current study, which aims

To provide an understanding of the challenges and complexities of the perioperative setting [15].

STATEMENT OF PROBLEMS
The problem statement explains the patient’s current health problem and the nursing interventions
needed to care for the patient. Statement of the Problems The mission and aim of the Nursing
profession are on providing respectable care by diagnosing and treating human responses to health and
illness, Nurses are exposed to workrelated fatigue, stress, burnout, and negligence, due to this Nurse
managers had low decisionmaking participation, and un proportional power-sharing (7), undesirable
image, not considered as a profession, and less attention for self-government and independence (16).
An explorative study on Nurse leaders’ views on clinical ladders as the strategy in professional
development in Norway among Nurse leaders recognized that the majority (76.5%) of Nurse leaders’
have no chance to involve in monetary and top-level decision making and have very low encouragement
in the use and mobilization of resource (17). Nurses account for the largest number of other
professionals (17, 18), but the absence of chance in decision making involvement at various levels,
dearth of the supportive structure, negative image, seeing the profession as incompetent, and work
overload highly affect health care decision making involvement (19). Insufficient resources and
manpower are factors that extremely affect and cause little administrative decision-making involvement
of Nursing managers (13). Decision making participation among Nurse managers is the character of
professional autonomy and practices of one’s occupation through one’s education and professional
identity, but health care organizational factors including non-standard Nurse patient ratio, workload,
and nonexistence of clear job description lead to poor decision making involvement among Nurse
managers (20). A study on factors that facilitate head Nurses’ autonomy in decision making in Egypt
indicate that active and independent involvement of Nurse managers in health care decision making
have boundless fruitful effect in the health care system, there are unlimited benefits to health care
delivery, but they face various obstacles to participate in decision making (14, 21). In developing
countries, the health care system is not advanced due to the nonexistence of Nurse managers'
participation in decision making, despite good competency of managerial and leadership skill, there are
professional inequalities that hamper decision-making participation (21). 4 Nurse managers' decision-
making involvement had so many health service benefits including reduce medico-legal error, advance
the service and increase client satisfaction. In our country, Ethiopian decision-making involvement of
Nurse managers and associated factors are not studied and not determined. Therefore, this study was
done to fill this gap

SIGNIFICANCE OF THE STUDY

 most of health related problems in Ethiopia are preventable, community health assessment is an
important tool to identify health status, health related problems and factors that could affect the society
health. The result of this survey can be used by governmental and non- governmental institutions to
solve the community health related problems. This study can also use as line data for further study.

For the hospital ,This study attempts to investigate health status the hospital in bonga Geberetsadik
shawogeneral hospital for generating necessary information for decision making and putting corrective
actions.to know about health and health related problems and their risk ,to know about the
transmission, control and prevention of the problem.

Therefore, this study helps to lay down in research project on the felt lead of hospital and advance
interventions to reduce patients l problems and improve the livelihood of the hospital.

For nurse manager; it will build nurse confidence, help to be active Care, to implement the theoretical
knowledge in solving hospital problem, important for competency, practice the habit of team work and
help for higher research program.

In General, This Study Is Important For Give Students A Sense Of Social Responsibility By Enhancing
Them To Obtain A Clear Understanding Of The Needs hospital And Problem It Faced, Student Enable To
Relate Theoretical Knowledge To Practical Training And Makes Them Better To Prepared For Life And
Their Future Integration In To The Working Of Environment. It Initiate Other Who Want To Study
hospital Problem Further.

OBJECTIVES
2.1 General Objective
To assess the life experience of NURSE manager challenges and opportunity in Bonga geberetsadik
shawogeneral hospital in south west region in Ethiopian 2023.

2.2 .Specific objectives

 To assess socio demographic status manager of nurse in the hospital.

 To assess nurse manager challenge status in the hospital.
 To assess challenge of nurse burnout status of the hospital.
  To assess challenge of stuff retention status of the hospital.
 To assess challenge of adequately training staff status of the hospital.
 To assess patient experience status of the hospital.
 To assess safety of the job status in the hospital.
 To assess the life experience of NURSE manager of opportunity in the hospital.
 To assess the relationship status of nurse in the hospital.
 To assess team work status of the hospital

Conceptual framework of objectives of the life experience Of Nurse manager of challenges and
opportunity in hospital.

Socio demographic states for example age, sex, occupation.

Most challenge of nurse managers in hospital e.g. knowledge, infrastructure, punctuality,

carelessnes

Challenge of environmental status e.gstressfull, conflict

Hazard about Occupational safety e.g. toxic chemicals, sharp injury materials, infectious disease

3 METHOD AND MATERIALS

3.1 study area and period.

The study was conducted from May 12/023 In Bonga geberetsadik shawogeneral hospital is
located in KAFFA zone, BONGA Town, South West Ethiopia Region state at 449 KMS far from
Addis Ababa(The capital city of Ethiopia) and the weather condition of this hospital or climate is
WOYNA-DEGA. This hospital total profession is 5143 of whom 2191 are males and 2952 are
females .

3.2 Study Design

Hospital based descriptive cross sectional survey was conducted.

3.3 Population source.

3.3.1 Source of population
All nurse will be all wards Nurse who works in hospital.
 3.3.2 Study Population.
Nurses in the hospital who selected number of wards sampling in the hospital

3.4 INCLUSION AND EXCLUSION CRITERIA

INCLUSION CRITERIA:

 Nurse manager who works in the bonga geberetsadik shawogeneral hospital

 Aprofessional they have been graduated to nurse.
 Nurses who works more than 6 month in the hospital.

Exclusion criteria:

Have been graduated for other department.

Aphyssion who is working out side bonga Geberetsadik shawogeneral hospital .

3.5 Sample size determination

Selected 4 wards were assigned by the life experience Of NURSE manager of challenges and opportunity
in Bonga geberetsadik shawogeneral hospital student members among 5 ward counted as 20 wards in
the hospital.

3.6 sampling procedure

A simple random sampling technique was used from those households in Bonga geberetsadik
shawogeneral hospital thus sample was selected by by random sampling method among wards found in
the hospital.

3.7 Data collection tools and procedures

Semi-structured questionnaires were prepared in Amharic version to collect data. The
questionnaire consists of socio-demographic, challenge of nurse manager, challenge of nurse
burnout status , challenges of stuff retention, challenge of adequately training staff status,
patient experience status, safety job status, common hazard about the occupational safety,how
to get experience Of NURSE manager in different ways, professional affiliations in the
hospital.handling ethical issues during the data collection and the method of data collection
using the prepare questionnaires.

3.8. Study variable

 Lack of knowledge nurse manager
 Lack of infrastructure the hospital
  Lack of experience of nurses managers
 Common hazard of the the environment
 Opportunity of nurses managers in hospital
 Challenge of nurse managers in hospital
Operational definition
Well-being is a positive outcome that is meaningful for people and for many
sectors of society, because it tells us that people perceive that their lives are
going well.

3.10 DATA COLLECTION AND QUALITY ASSURANCE

3.10.1 BEFORE DATA COLLECTION;
We will collect and prepare data, material discussion about data collection with group members, how to
writing and we get information from instructor .and projectl writing methods about, get consent from
bonga Geberetsadik shawogeneral hospital.

DURING DATA COLLECTION

We will collect data from the hospital communicate with instructor about data collection, Clean And
Clear The Data, Insure the Quality of the Data.

After Data Collection;

Analyze and Process The Data, Check The Material That Full Fill The Necessary information Minimize
Logical Error And Design Skipping ,Present Or Show All Result For Responsible Stake Holder.

In General Data Collection: To Ensure Quality, All The Data From Each ward Where Checked For The
Completeness, Accuracy, Clarity And Consistency By The Group Members .The Data Was Collected.
Constructive Community And Measures Have Being Under Taken Throughout The Data Collection
Period. Then The Data Cleaning And Clearing Was Performed.

We Have Received Orientation On Data Collection, Objective Of The Study, The Way To Keep Privacy,
Confidentiality And Other Ethical Issue.
3.11 Data Process and Analysis
The Collected Data Was Processed And Analyzed Through Manually By Using Tally And Summarized
Using Frequency, And Percentage. Finally, Relevant Discussion, Conclusion Was Made Based On The
Result Obtained From The Study.

3.12 Ethical Considerationration

The participants were contacted via electronic mail and received ver-bal and written information
emphasizing their free participation, confi-dentiality, data anonymity and the use of their data for
scientificpurposes. The first author encoded the identities of the participantsas ‘NM’, with the number
assigned to the interviewed nurse manager,and no other members of the team had access to identifying
nurse

Ethical Clearance Was Obtained From BONGA University, College Of Health Sciences, Department Of
Nursing. Formal Letter of Cooperation was written for bonga Geberetsadik shawogeneral
hospital.Hospital Will Ask Willingness and hospital Will Thanks Well.

3.13. Dissemination of Plan

The Report Will Be Disseminated To BONGA University College Of Health Sciences, Department Of
Nursing And Concerned Stakeholders. Feedback Will Be Given To hospital And The Findings Of The Study
Will Be Presented.

4. Working Plan

4. Results
4.1. Socio Demographic Characteristics of professional status.

In The Study 0f 20 Individuals From 156 NURSES In Bonga Geberetsadik shawogeneral Were Included.
Among These 49.08% Percent of Them Were Males And 50.91% of them were Females. The Minimum
Age the hospital is the interval between 20-30 .While the Maximum Age Is above 40.
Table 1: Socio Demographic Characteristics of bonga Geberetsadik shawogeneral hospital in 2023

Age Female Male Frequency Percent

20-30 19 6 25 89.28

30-40 0 3 3 10.72

Above 40 0 0 0 0

Total 19 9 28

Table 2: unit status of nurse’s managers in hospital

Unit Frequency Percent

Critical 1 5

Impatient 7 35

Opd 6 30

Emergency 3 15

OR 3

15

total 20 100

Table: 3 marital statuses of nurse’s managers in hospital

Marital status Frequency Percent

Single 8 34.78

Married 15 65.22

Divorce 0 0

total 23 100

Table: 4 educational qualification status of nurse’s managers in hospital

Educational qualification Frequency Percent

Diplo 5 25

ma

BSc 15 75

MSc 0 0

total 20 100

Table: experience status in year nurse in the hospital

Experience in year Frequency Percent

1-5 17 77.27

6-10 5 22.72

Above 10 0 0

Total 22 100

Table: 5 challenge of nurse managers in the hospital

Challenge of nurse managers frequency percent

Lack Infrastructure challenge 22 16.66

Challenge of lack knowledge 14 10.61

Lack nurse 18 13.63

Punctuality 0 0

Carelessness 3 2.27
Work of environment 17 12.88

Stressful 10 7.58

Conflict 5 3.79

Nurse burn out 18 13.63

Insufficient salary 12 9.09

Lack of experience 7 5.3

Lack of learning opportunity 6 4.56

Total 132 100

Table: 6 challenge of stuff retention in hospital

Opportunity of staff retention Frequency Percent

Enough payment 6 30

Comfortable of environment 4 20

Good relationship 5 25

All them 5 25

total 20 100
Table: 7 patient care experiences in the hospital

Patient experience Frequency Percent

Fostering healthy 4 16.66

Respect the environment 10 41.7

Compassion 7 29.17

Others 3 12.5

total 24 100
Table: 8 improve safety of job in the hospital

Improve safety job Frequency Percent

Training 10 62.5

Punishment 1 6.25

Reinforcement 5 31.25

total 16 100
 sharp injury 42.86%

infecious disease 35.71%

toxic
chemical
s
21.43%

Figure ;1common occupational hazard

 managing bussy work load

increase number of staff

40.91%

manage of time
59.09%

FIGURE: 2 how to manage abussy work load of nurse managers in hospital

Discussion
5.1 Socio demographic characteristics
A total of 20 nurses were included in the study, the majority of the respondents 394(50.9%) were
females and the remaining 381(49.1%) were males. The majority (67.1%) were orthodox
Christian. Among the total study population 25.67%were unable to write and read while
15.1%were reached collage and above.

According to our study most of respondents or the participants 33.7%were bsc nurse
Conclusion
This study provides evidence on the experiences of nurse managers during the challenges and
opportunity. This knowledge can inform the design of educational and management strategies aimed
at improving the management of challenges and opportunities crisis and future pandemic out-breaks
of a similar nature. A first step could be the development of training strategies for nurse managers to
promote continuous and dili-gent adaptation to change and to help them manage uncertaintythrough
training in emotional self-management and the promotion of a proactive and visionary attitude.
Similarly, the importance of their This study provides evidence for the experiences of nurse managers
during challenges and opportunity . In addition, analysing these experiences has helped identify some
of the key competencies that these nurses must have to respond to acrisis and in their dual role as
patient and nurse mediators.
9. Reference
1.

1. Abu Mansour, S. I. , & Abu Shosha, G. M. (2021). Experiences of first‐line nurse

managers during Covid‐19: A Jordanian qualitative study. Journal of Nursing
Management, Early View, 30, 384–392. 10.1111/jonm.13530 - DOI - PubMed

2.

1. Al Knawy, B. A. , Al‐Kadri, H. M. , Elbarbary, M. , Arabi, Y. , Balkhy, H. H. , & Clark, A.

(2019). Perceptions of post outbreak management by management and healthcare
workers of a middle east respiratory syndrome outbreak in a tertiary care hospital: A
qualitative study. BMJ Open, 9(5), e017476. 10.1136/bmjopen-2017-017476
- DOI - PMC - PubMed

3.

1. Bambi, S. , Lozzo, P. , & Lucchini, A. (2020). New issues in nursing management during
the Cove‐19 pandemic in Italy. American Journal of Critical Care, 29(4), E92–E93.
10.4037/Ajcc2020937 - DOI - PubMed

4.

1. Baykal, Ü. , Türkmen, E. , Alan, H. , Başulaş, Ç. Y. , Göktepe, N. , Gümüş, E. , Güngör, S. ,

Serbest, Ş. , Harmanci Seren, A. K. , Şen, H. T. , Şen, S. , & Tekin, D. E. (2020). The COVID‐
19 outbreak in Turkey: Experiences of nurse managers and activities of the nurse
managers association in crisis management. Koç University Journal of Education and
Research in Nursing, 7(3), 290–293. 10.5222/HEAD.2020.36024 - DOI

5.
 1. Cathro, H. , & Blackmon, E. (2021). Nurse leaders' experiences and learnings navigating
through the chaos of a pandemic. The Journal of Nursing Administration, 51(2), 63–66.
10.1097/NNA.0000000000000971 - DOI - PubMed

6.

1. Daly, J. , Jackson, D. , Anders, R. , & Davidson, P. M. (2020). Who speaks for nursing?
Covid‐19 highlighting gaps in leadership. Journal of Clinical Nursing, 29(15–16), 2751–
2752. 10.1111/jocn.15305 - DOI - PMC - PubMed

7.

1. Deldar, K. , Froutan, R. , & Ebadi, A. (2021). Nurse managers' perceptions and

experiences during the Covıd‐19 crisis: A qualitative study. Iranian Journal of Nursing
and Midwifery Research, 26(3), 238–244. 10.4103/ijnmr.IJNMR_285_20
- DOI - PMC - PubMed

8.

1. Erlingsson, C. , & Brysiewicz, P. (2017). A hands‐on guide to doing content analysis.

African Journal of Emergency Medicine, 7, 93–99. 10.1016/j.afjem.2017.08.001
- DOI - PMC - PubMed

9.

1. Gab Allah, A. R. (2021). Challenges facing nurse managers during and beyond Covid‐19
pandemic in relation to perceived organizational support. Nursing Forum, 56, 539–549.
10.1111/nuf.12578 - DOI - PMC - PubMed

10.

1. Goh, Y. S. , Ow Yong, Q. Y. J. , Chen, T. H. , Ho, S. H. C. , Chee, Y. I. C. , & Chee, T. T.

(2021). The impact of COVID‐19 on nurses working in a University Health System in
Singapore: A qualitative descriptive study. International Journal of Mental Health
Nursing, 30, 637–
646. https://doi-org.libproxy1.nus.edu.sg/10.1111/inm.12826 - DOI - PubMed

11.

1. Hoffmann, R. L. , Battaglia, A. , Perpetua, Z. , Wojtaszek, K. , & Campbell, G. (2020). The

clinical nurse leader and Covid‐19: Leadership and quality at the point of care. Journal of
Professional Nursing, 36(4), 178–180. 10.1016/j.profnurs.2020.06.008
- DOI - PMC - PubMed

12.
 1. Hofmeyer, A. , & Taylor, R. (2020). Strategies and resources for nurse leaders to use to
lead with empathy and prudence so they understand and address sources of anxiety
among nurses practising in the era of Covid‐19. Journal of Clinical Nursing, 30(1–2), 298–
305. 10.1111/jocn.15520 - DOI - PMC - PubMed

13.

1. Holge‐Hazelton, B. , Kjerhot, M. , Rosted, E. , Hansen, S. T. , Borre, L. Z. , & McCormack,

B. (2021). Improving person‐centred leadership: A qualitative study of ward managers'
experiences during the Covid‐19 crisis. Risk Management and Healthcare Policy, 14,
1401–1411. 10.2147/RMHP.S300648 - DOI - PMC - PubMed

14.

1. Hsieh, H. F. , & Shannon, S. E. (2005). Three approaches to qualitative content analysis.

Qualitative Health Research, 15(9), 1277–1288. 10.1177/1049732305276687
- DOI - PubMed

15.

1. International Council of Nurses (ICN) . (2021). The COVID‐19 Effect: World's nurses
facing mass trauma, an immediate danger to the profession and future of our health
systems. Available at: https://www.icn.ch/news/covid-19-effect-worlds-nurses-facing-
mass-trauma.... [Online Resource] (accessed 13 January 2021).

16.

1. Kagan, I. , Shor, R. , Ben Aharon, I. , Yerushalmi, S. , Kigli‐Shemesh, R. , Gelman, S. , &

Itzhaki, M. (2021). A mixed‐methods study of nurse managers' managerial and clinical
challenges in mental health centers during the Covid‐19 pandemic. Journal of Nursing
Scholarship, 53(6), 663–670. 10.1111/jnu.12685 - DOI - PMC - PubMed

17.

1. Legido‐Quigley, H. , Mateos‐García, J. T. , Cam‐ Pos, V. R. , Gea‐Sánchez, M. , Muntaner,

C. , & Mckee, M. (2020). The resilience of the Spanish health system against the Covıd‐
19 pandemic. The Lancet Public Health, 5(5), E251–E252. 10.1016/S2468-
2667(20)30060-8 - DOI - PMC -
10 Annex

Tools that are used in data collection includes: questionnaire paper, and pen .