Developing culturally appropriate leadership for nursing in Saudi Arabia
[Thesis]
Aldawood, AbdulrahmanAldawood, Abdulrahman
Cardiff University
2017
Thesis (Ph.D.)
2017
The healthcare services in Saudi Arabia currently face many challenges, the most pressing being the shortage of local nurses. In common with many other countries in the Gulf region this has necessitated the hire of expatriate nurses and has led to health care provision in Saudi Arabia being highly multicultural in its composition. The ensuing cultural diversity of the health care professional population has resulted in there being a significant challenge regarding the lack of culturally competent nurses to meet the growing needs and expectations of health care provision in Saudi Arabia. In essence, there is a cultural mismatch between the nurses and those they care for that extends far beyond not sharing the same native language. Moreover, the staff group itself is culturally diverse and as well as not sharing the same mother tongue they do not share the same mores, values, religion and training. In turn, culturally competent and effective nursing leadership, the literature suggests, is sadly lacking and not addressing the deficit in culturally appropriate nursing care for the Saudi population. Moreover, this lack of culturally competent leadership will negatively impact not only on work performance and quality of nursing care delivered but also on the job satisfaction of this multicultural and diverse staff group. The overall aim of this thesis is to understand the relationship between nurse leadership and the cultural sensitivity of nursing care delivered in the hospital setting in Saudi Arabia. Furthermore, this study will attempt to identify the future training and development needs of nurse leaders in Saudi Arabia to enable a service to be delivered that can best address the needs of its people. This thesis is based on a qualitative study carried out from the perspective of nurse leaders working in the medical city in Riyadh, the capital of Saudi Arabia. The sample in the study consisted of 46 participant nurse leaders from different cultural backgrounds who work in the largest Medical City in Riyadh (King Saud Medical City). Data for this qualitative study were collected by semi-structured interviews and 6 focus groups and were analyzed thematically. The results indicated that culturally competent nurse leaders require a set of characteristics and personal qualities. Moreover, it is demonstrated that cultural factors are of critical importance; not only in influencing the quality of nursing care delivered, but also on the effectiveness of the leadership style of nurse leaders and how they learn and develop professionally. This research study suggests that there are three considerations which need to be taken into account for the development of nurse leaders in this context. First, gender is a key issue and its implications are important for the future of nursing in Saudi Arabia. Second, key characteristics and essential personal qualities are required for culturally competent nurse leaders. Third, exploration of what works and (what does not) for nurse leaders is required to overcome situations where there may be a risk of cultural conflict. There has been a lack of previous research and knowledge into nurse leadership development in Saudi Arabia and the significance of this study is that it provides new empirical evidence to address this deficit. This new evidence will inform the development of training programmes for nurse leaders in Saudi Arabia that stress the need for cultural awareness and competency. The provision of such training could have far reaching benefits not only for nurse leaders and the staff they manage, but also for the quality of nursing care delivered and how it is perceived by the recipients of that care. In turn, this could impact the recruitment and training of other health care professionals in Saudi Arabia and delivery of its health care policy in a wider context. Keywords: cultural competence, nursing leadership, Saudi Arabia, expatriate, multicultural, thematic analysis, qualitative method. Note: Throughout this thesis the full name of Saudi Arabia, and its shortened form SA, are used interchangeably.