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A Phenomenological Study of the Nurse Leader: Before, During, and After Merger

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A Phenomenological Study of the Nurse Leader: Before, During, and After Merger A PHENOMENOLOGICAL STUDY OF THE NURSE LEADER: BEFORE, DURING, AND AFTER MERGER Debra A. Ball A Dissertation Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of DOCTOR OF EDUCATION August 2014 Committee: Mark A. Earley, Advisor Penny K. Soboleski, Graduate Faculty Representative Joyce P. Litten Patrick D. Pauken Deborah J. Vargo © 2014 Debra A. Ball All Rights Reserved iii ABSTRACT Mark A. Earley, Advisor The purpose of this qualitative phenomenological research study was: (a) to understand nurse leaders’ lived experience before, during and after a merger; (b) to explore and gain insight and understanding into the experiences of nurse leaders who have led, managed, and guided others through a merger in healthcare; and (c) to appreciate the attributes of the merger experience that led to meaning-making for the nurse leaders. Sixteen nurse leaders were interviewed two times as they all had experienced the merger phenomena. Study findings emerged using the Stevick-Colaizzi-Keen (1978) phenomenological data analysis process in examining the participants’ narrative transcripts. The descriptions of how I arrived at the significant statements, the formulated interpretive meaning statements, and the explanation of the analysis of textual theme clusters were provided. Data from this study generated an exhaustive description. The four structural descriptions or essential themes of masking, mirroring, mitigating and moving on, and; the universal essence of the phenomena was discovered and validated as accurate by the participants. The nurse leaders’ lived experience of merger exposed not only the strong beating heart of nurse leadership, but its brain, muscle, and nerve endings: alert, throbbing, raw and exhausted. The study findings contributed to an understanding of how the narrative of the merger experience is laid down in the layers below our everyday awareness in which the self is always changing, always growing, and always discovering itself. This research raised further questions to be explored in understanding other factors nurse leaders experienced with organizational change through merger: loss of control; loss of identity, iv and resilience and may provide ample background in which to approach additional qualitative research in the study of leadership. All of the nurse leaders in this study were female serving in the subordinate community hospital organization. Further research with a more diverse gender base may reveal interesting findings. The accumulated expertise and experience of this group of nurse leaders is untapped in terms of mobilizing organizational change in hospitals and healthcare delivery systems. Three policy issues were offered to assist with the achievement of healthcare organizational change through merger and acquisition: (a) improved communications, (b) appropriate learning and development, and (c) individual experiential change journeys. Changing an organization is fundamentally and undeniably an emotional human process. Keywords: qualitative, phenomenological, nurse leader merger experience, Stevick-Colaizzi-Keen method of analysis. v This dissertation is dedicated to all registered nurses and in particular, a very special one my daughter: Kristin, RN “The symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different.” ― Florence Nightingale, Notes on Nursing (1859) vi ACKNOWLEDGMENTS The quest for the doctorate degree in education equates to completing a warrior dash, as it requires extensive preparation, steady endurance, and an absolute commitment to the journey with other people. It seems fitting then, “to remember that there are a number of people who come in our lives…they awaken us to new understanding with the passing whisper of their wisdom and make the sky more beautiful to gaze upon. Some people stay in our lives awhile and leave footprints on our hearts, and we are never, ever the same” (author unknown). My educational endeavor would not have been possible without the support and encouragement of many, including my committee members, leadership studies and policy professors, research participants, cohort and colleagues, friends and family. So it is with humble and heartfelt appreciation that I acknowledge the constellation of people who guided and walked with me along my educational path. Committee Members: If you go to the dictionary and look up “catalyst” you find this definition: “a person or a thing that precipitates an event or change,” as my committee you have been my catalyst on so many levels, and it has been an honor and a privilege to be your student. To Dr. Joyce Litten: the dance is between emotion and logic; passionate intensity and reasoned logic. Great dancing requires both. You have helped me become clearer in my consciousness about how shifting the lens through which we view things, a whole new world appears. Thanks to you, here is my six-word story: Seeking the fullest expression of self. Dr. Patrick Pauken: the seasonal metaphor deepens our understanding of others. Through you, I have slowed down to examine my life as eighteen seasons have passed since meeting you, and I have learned that life is neither a battlefield nor a game of chance but something infinitely richer, thank you for encouraging me to embrace it all. Dr. Penny Soboleski: I could not have dreamed for a more amazing Graduate College Representative. Your quality of enthusiasm for me and my topic has vii been inspiring! Dr. Deborah Vargo: your gifts as a nurse leader and scholar provided my dissertation with the insight of nurses I hold most dear. You demonstrate care, compassion, courage and commitment to all nurse leaders. Thank you for your generous time you shared with me on the rich topic of nurse leaders. Finally, to my dissertation advisor, it is hard to find the words to appropriately share an expression of gratitude to Dr. Mark Earley: so I naturally turn to the word “love.” However, this word seems vague and imprecise. The Eastern tradition for a definition of love reads: "Love is a bird with two wings. One wing is compassion; the other wing is wisdom. If either wing is broken, the bird cannot fly." I was stuck in a deep hole, and you jumped in with me, and led me out. This organic union has provided me with gifts beyond measure. You taught me to think in a way that I could have never imagined. In some ways suffering ceases to be suffering at the moment it finds meaning. Thank you for your selfless patience and stillness in guiding me to ‘meaning’ and I pray that our journey will last a lifetime. Leadership Studies and Policy Professors: Dr. Judith Jackson May, Dr. Judith Zimmerman, Dr. Patrick Pauken, Dr. Paul Johnson, Dr. Kyle Ingle, Dr. Rachel Vannatta Reinhart, Dr. Joyce Litten, Dr. Terry Herman, and Dr. Mark Earley; thank you from the bottom of my heart. Beyond the learning experiences, team projects, presentations, and formal class instruction our cohort became a family as each of you revealed your intellect and leadership. Research Participants: Nursing as a caring profession is steeped in stories. Stories are how we make sense of things and help us understand how and why things change and what we might do to make a difference. When we are no longer able to change a situation, we are challenged to change ourselves; as this becomes the currency of our character. It is a great honor and privilege to know all of you. Our sacred soul to soul experience has helped redefine me as a woman, leadership student, and human resource development practitioner. Each one of you is an extraordinary nurse leader that has made the lives of countless patients better, and the narratives viii of your experience made this dissertation possible. Through your many gifts, I have been changed for good: thank you. Cohort and Colleagues: The impact of my doctoral education started one Tuesday night, sitting beside 14 strangers who were about to take the journey of a lifetime together. The photograph of our cohort family smiles down on me from my shelf. I am drawn to a quote by William Golding, “My yesterday’s walk with me, they keep step, as they are the faces that peer over my shoulder.” Much appreciation to these hearty travelers: J.R. Ratcliff, Tinola Mayfield- Guerrero, Shay Bankston, Gereon Methner, Dennis Muratori, Jaclyn Schalk, Andrea Joldrichsen, Battalion Chief Bryce Blair, Battalion Chief Robert Krause, Matthew Lambdin, Stephanie Sickler, Colleen Boff, and with special thanks to: Bill Davis and Jennifer Fong. Thank you to all my colleagues and caretakers in my professional life that encouraged me countless days, especially my HRD team: before, during, and after. A very special thank you to Richard P. Anderson, the late Dr. Joseph C. Christen, Dr. Clinton O. Longenecker, Patti Hathaway, Dr. Bryan Adkins, Dr. Gretchen Carroll, and Dr. Matthew Kutz for all our amazing explorations and your rousing words along the way. Friends and family: Nothing I accomplish is possible without the sacrifice of my family who prayed for the successful completion of my studies and carried on without me on so many occasions so that I could complete my research. My sisters: Julie, Kathleen and Theresa you are amazing in every way. To my kids Jeri, Mindy, Kristin, Nathan and Dylan: mind your compass and the clock; and, do good things for others. To my husband: thank you for keeping everything nearly afloat while I pursued this dream. I love
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