Tacit Knowledge of Nurse Manager Working to Improve Nursing Services

Abstract

The objective of this study is to examine the types of tacit knowledge that nurse managers accumulate through their experiences and then actually practice to improve nursing services on the wards. Participant observation and semi-structured interviews were conducted with three nurse managers working at Hospital A, and the data were analyzed qualitatively to explore their insights and intentions about nursing services. Eight categories and twenty-two subcategories were distilled from the data. This paper describes nurse managers' tacit knowledge, which is the "key to change", used to implement effective nursing services. Integrating the staff's capabilities and the insights of patients and their families to acknowledge needs, nurse managers made the best use of the "key to change" to generate and enhance nursing services. This demonstrated knowledge leaders' wisdom when promoting innovations, and enabled them to improve nursing services while coping with changing nursing environments.

Results from analyzing distributions of the data showed that subjects tended to supervise the staff, and not to delegate authority in the supervision of chief clerks. This finding suggests that it is necessary for nurse managers to attend to matters beyond the wards, and to engage the whole organization in nursing service improvement.