An Exploratory Descriptive Study to Evaluate Florida Nurse Leader Challenges and Opportunities in Nursing Homes Settings

Abstract

By 2020, more than 25% of the population in Florida will be more than the age of 65 years, and the population more than the age of 85 years is expected to increase by 40%. Among people more than 65 years today, 69% are expected to need some form of long-term care as they age. It is anticipated that Florida’s 680 licensed nursing homes will have challenges keeping pace with the needs. This article presents findings from an exploratory descriptive study designed to examine the leadership challenges and opportunities in nursing home settings today from the perspective of long-term care nurse leaders in the State of Florida. The target population for the study was directors of nursing in the 680 state licensed nursing homes in Florida. The final sample included 183 completed surveys from directors of nursing in 27% of the nursing homes that were surveyed. An exploratory descriptive survey design was used in this research. An online survey with 40 closed-ended questions and 2 open-ended questions was designed by the authors with input from an expert panel of long-term care nurse leaders who served in an advisory capacity. While less than 50% of the directors of nursing in this study were prepared at the baccalaureate level or higher, these leaders have complex roles and shoulder significant responsibilities. They have seen their roles expand into the management of more medically complex patients as their organizations try to adapt to a changing health-care reimbursement environment. Succession planning is a key concern for these aging leaders but only 40% of facilities had succession plans in place. The highest ranked leadership challenges involved issues with recruiting and retaining staff with the right skill sets. A poor image of long-term care nursing has contributed to recruitment and retention challenges.