Date of Award


Document Type



Edith Cowan University

Degree Name

Master of Nursing


School of Nursing


Faculty of Health and Human Sciences

First Supervisor

Kathy Ahern


Much has been written about the problems facing nurse managers in different countries including Malawi, yet the literature is sparse in relation to information about their perception of required management skills. There is enough evidence that nurse managers face many problems. These problems stem from different sources including organizational, economic, social or political changes. All changes within and outside the health care system affect nursing and its management. Nurse managers require relevant management skills to make valuable decisions and promote quality care, and enable them to motivate staff. Further, management skills will enable nurse managers to actively participate in policy making and financial management. In this way autonomy over nursing services can be maintained. This study took place in Malawi and explored tasks that Malawian middle-level nurse managers carry out, problems that they experience in carrying out their work, and their perceptions of management skills required in carrying out their work. Middle-level nurse managers in Malawi are known as matron and senior sisters. A two staged random sampling of 42 hospitals and 20 middle-level nurse managers was used. The hospitals included government and non-government hospitals known as CHAM (Christian Hospitals Association of Malawi). Data was collected using an interview schedule based on a conceptual framework adopted from King's Goal Attainment Theory. Field notes were taken alongside taped interviews, and administrative documents such as job descriptions were collected to provide complementary data. All interviews were transcribed and thematic analysis was used to analyze data. Results of the analysis demonstrated that middle level nurse managers in Malawi experience enormous problems in carrying out their work. Such problems included shortage of staff (especially registered nurses), and lack of adequate managerial knowledge of nurse managers themselves in policy making, financial management, and the setting and monitoring of nursing standards. In addition, results have indicated an increased amount of stress in the nursing profession in Malawi. Consequently, results have shown that middle-level nurse managers require management skills in resource management, setting nursing standards and financial management skills. Information obtained from this study will provide nurse managers with knowledge of the management skills they require to be more effective. The information will also be relevant for professional (management) development, as it would be used by policy makers to design management education curricula for nurses contemplating management careers or reviewing current management programs in nursing schools. In addition, the knowledge gained wi1l form a basis for future research.