Supervisory relationships in long-term care facilities: A comparative case study of two facilities using complexity science.

Journal Article (Journal Article)


This study aims to understand the factors that contribute to supervisory nurse performance in long-term care facilities.


Long-term care facilities have been faced with staffing challenges and increasing resident care needs, resulting in suboptimal quality of care. Nursing leadership has been identified as a key factor in the provision of high-quality care.


The comparative case study employed a complexity science framework to compare two facilities. The facilities were chosen based on the level of perceived supervisory support staff received from their supervisors, and 10 participants were recruited from each facility at various levels of management and staff (n = 20). Data were collected in 2015 using semi-structured interviews.


The quality and quantity of supervisory relationships was central to shaping the effectiveness of the supervision. Effective supervisory support was characterized by frequent and high-quality supervisor-staff interactions. Effective nurse supervisors acknowledged self-organisation as beneficial, and worked in environments that encouraged fluidity of roles.


The findings suggest that effective nurse supervisors and supervisory support fosters improved work environments and the staff's ability to respond to residents' needs in a timely, effective and compassionate manner.

Implications for nursing management

Nurse managers who provide effective supervisory support can improve the quality of care provided to their residents.

Full Text

Duke Authors

Cited Authors

  • Escrig-Pinol, A; Corazzini, KN; Blodgett, MB; Chu, CH; McGilton, KS

Published Date

  • March 2019

Published In

Volume / Issue

  • 27 / 2

Start / End Page

  • 311 - 319

PubMed ID

  • 30203460

Electronic International Standard Serial Number (EISSN)

  • 1365-2834

International Standard Serial Number (ISSN)

  • 0966-0429

Digital Object Identifier (DOI)

  • 10.1111/jonm.12681


  • eng