An exploratory study of recognition behaviors practiced by mid-level nurse managers and perceived by mid-level staff nurses

Objectives: This study explored mid-level nurse managers’ recognition behaviors and the perception of those behaviors by mid-level staff nurses. This information is needed for nurse manager training, and may improve nurses’ work engagement and retention in the workforce. Methods: The exploratory qualitative study gathered data through semi-structured interviews with mid-level nurse managers and nurses selected through purposive sampling at a large acute care hospital in Aichi, Japan. Data were analyzed using Bryman’s content analysis, and categories were generated both deductively and inductively. The Recognition Behavior Scale of Nurse Managers was used for deductive analysis. Inductive analysis enabled emergence of new themes. Results: Five recognition behavior frameworks were identified from 91 (nurse managers) and 50 (staff nurses) codes: Close Communication, Supportive Consultation/Advice, Comfortable Attention, Positive Performance Evaluation, and a newly identified framework, Recognition Environment Fostering. Mid-level nurse managers practiced behaviors such as ensuring recognition from appropriate individuals and considering nurses’ family situations. Staff nurses emphasized the importance of involvement in ward operations, receiving recognition from managers, and being entrusted with mentoring roles. Certain recognition behaviors were common across both groups. However, some managers expressed uncertainty regarding the effectiveness of their recognition practices. Conclusion: This study identified key recognition behaviors commonly understood by mid-level nurse managers and staff nurses. These shared behaviors could serve as foundational elements for developing educational programs that support mid-level nurse managers in practicing recognition behaviors more consciously and effectively. Such programs may contribute to fostering work engagement and improving retention of mid-level staff nurses.