Bessie Wat


Assuming that the performance of duties not specifically on the head nurse level detract from her effectiveness as a head nurse, the problem of this study was to determine what proportion of time the head nurse spent in different activities, on what level of skill these activities were, where she performed them, with whom, and the duration of each activity.

This study was conducted on a selected medical unit of the Loma Linda Sanitarium and Hospital. The normative survey method as recommended by the Division of Nursing Resources was used. The morning and afternoon head nurses or their reliefs were shadowed for five consecutive days and their activities were recorded on a pre—coded form. The data gathered were then tabulated, analyzed and interpreted.

The figures indicate that the head nurse was spending two-thirds of her time in the area of patient care management. The largest proportion of this time was spent in indirect activities which included processing charts for the patient's benefit and discussing his condition with physicians, staff, friends and relatives. She spent almost three times as much time directing patient care activities than at the patient's bedside.

Although it appeared that the head nurse spent almost two thirds of her time on head nurse level activities, it was revealed that almost a third of her time was spent in clerical level activities. Time was also spent in activities which could have been performed by the unit nursing staff.

A very small proportion of the head nurse's time was spent in staff supervision. An even smaller amount of time was spent in professional growth. The head nurse was not able to spend any length of time on any one activity. Over 60% of her activities were one minute or less in duration.

The findings of this study bear out the hypothesis that the head nurse is now performing certain non-head nurse activities which could be delegated to others.

Based on the findings of this study recommendations were suggested to improve the head nurse job by: (1) studying the activities of all other nursing personnel on the unit, including the ward clerk, and all reassignable activities be delegated to them, (2) studying the physical environment of the head nurse's desk and such action be taken so that she will have some degree of privacy, and (3) re-evaluating the nursing team plan so that the head nurse, team leaders and members can together clarify their respective responsibilities and functions.

Since the ultimate aim of all nursing function studies is the improvement of nursing care, it is hoped that this study has stimulated interest in that objective.

LLU Discipline





Graduate Studies

First Advisor

Anne P. Martin

Second Advisor

Bernice F. Hawkins

Third Advisor

Erwin J. Remboldt

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Nursing, Supervisory



Page Count

ix; 90; iv

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives