The leadership experience of first line nurse managers working in the Cook Islands: a qualitative descriptive study
A qualitative descriptive approach was undertaken to explore the leadership experience of seven first line nurse managers working in the Cook Islands. For the purposes of this study first line nurse managers are those nurses working as a charge nurse in a hospital, nursing supervisors, chief public health nurse, and nurses working autonomously in the outer islands of the Cook Islands. Nurses in these roles are in key positions to influence the practice of others and set the standard of practice and culture of a unit. The participants were recruited if they were currently employed in any of these positions. The seven participants were all Cook Islands women who received their undergraduate nursing education in the Cook Islands. The purpose of the study was to describe their leadership experience, to raise an awareness of their role, and to make recommendations to support and improve the preparation of nurses for leadership roles in the Cook Islands. Through face-to-face interviews, the participants' stories were audio taped and transcribed verbatim. Six of the seven transcripts required translation from Cook Islands Maori to English and this was conducted by the researcher who is fluent in both languages. Content and thematic analysis of the data revealed a spiritual, emotive and intuitive theme in the participants' leadership experience. The findings of the study revealed the self confidence of these nurses to manage in this role despite being challenged by management issues and the lack of preparedness for the role. The supportive network established within their staff, their family and the people around them has provided the impetus to continue to 'serve' their people. The findings also revealed that these nurses recognised the need to continue to learn and develop themselves and their staff. The findings of this study have significance for nurses aspiring to be nurse leaders in the Cook Islands or other Pacific Islands and rural communities. A key stakeholder in this study is the Cook Islands Ministry of Health, as insights and awareness gained can contribute to an appropriate preparation and support programme for nurses working in its organisation.