Factors affecting assertiveness among nurses.

Abstract

In Malta, the demand for state health care services is on the increase and expectations are becoming higher than ever. Moreover, nowadays all nurses are qualified with a university degree or diploma, and this in itself explains that the profession of nursing has changed over the past decade. Therefore, as nurses are assuming an increasingly professional role, it is widely recognised that they need to behave in an assertive manner to be more effective. Nursing is the largest workforce at the state-funded hospital in Malta, therefore it is of benefit that this study sought to identify the factors affecting assertiveness among nurses in the local context. This study sought to assess the factors that affect the level of assertiveness among nurses. A mixed method approach was used. This included a self-administered questionnaire which was distributed to staff and enrolled nurses (n=300) with a response rate of 73%; two focus group sessions which included nursing officers and deputy nursing officers (n=10); and four interview sessions with top level managers (n=4). Through quantitative research, nursing staff at ward level answered questions about factors affecting their assertiveness with their nursing colleagues, nursing management, medical personnel and ancillary staff. Several statistically significant associations between assertiveness in nurses and demographic factors, as well as with previous qualifications and experiences were found. Moreover, through qualitative inquiry, Ward Managers and Top Level Managers gave their opinion about the assertive behaviour of nurses. Different opinions about the assertive behaviour of nurses emerged. Additionally, nurses highlighted the main obstacles to which they prohibit themselves from using assertive behaviour.

Executive Summary The main recommendations were to enhance communication skills and the implementation of training and education programmes on assertiveness with ongoing monitoring so as to further enhance assertiveness among nurses.