Relation between Arrogant Nursing Supervision and Work Effectiveness from Nurses' Prospective

Background : Arrogant nursing supervisor affect negatively on work effectiveness, they can lead to lower access to information, support, opportunity and resources. The Study Aim: was to assess the relation between arrogant nursing supervision and nurses’ work effectiveness. Method: Design: A descriptive correlation research study design was used in this study. Setting: It was conducted in all departments at Tanta University Main Hospital. Subject: A convenience sample of nurses n=911 who were working in the previous setting Tools: Two tools were used to collect data Arrogant Nursing Supervision and Conditions for Work Effectiveness Structured Questionnaire. Results: 72.8% of nurses perceived a low level of total work effectiveness, 23.6% of nurses perceived a moderate level of personal traits dimension of arrogant supervision and 28.9% of nurses perceived a high level of relation with other dimension of arrogant supervision. 71.8%, 68.5%, 65.1% and 55.7% of nurses had a low level of access to information, support, opportunity and resources respectively. Conclusion : There was a statistically significant negative correlation between nurses’ perception of arrogant nursing supervision and nurses’ work effectiveness. Recommendation : it was recommended that hospital administrators need to e nsure open channels of communication between nursing supervisors and nurses to provide transparent flow of information, also nursing supervisors need to appreciate and recognize nurses' positive contributions .


Introduction
The relationship between nursing supervision and the effectiveness of nurses' work is a critical aspect of healthcare management.A positive work environment is essential to ensure the delivery of high-quality patient care.However, an arrogant nursing supervisor can create a hostile work environment, leading to negative consequences for the nursing staff and the quality of patient care. (1)ursing supervision involves overseeing the work of nursing staff and ensuring that they meet the standards of patient care.However, when the supervisor displays arrogant behavior, it can negatively impact the morale of the nursing staff, leading to a decrease in work effectiveness. (2)he relationship between nurses and supervisor may contribute to eliminate intention to leave workplace by nurses.Supervisor-nurse relationship and cooperative communication are positively related to team effectiveness.The supervisor is responsible for Vol. 31.No. 4 (Suppl 1) ,November 2023 maintaining close relationships with only a few subordinates due to timepressure and lack of resources. (3)rrogance is defined as that species of pride which consists in exorbitant claims of rank, dignity, estimation of power or which exalts the worth or importance of the nurse to an undue degree.Arrogant behavior can be an especially challenging problem to deal with due to the fact that arrogant individuals consider own behavior acceptable and thus do not monitor own actions when interacting with others. (4,5) good supervisor avoids overconfidence and is prepared to admit personal fallibility while having confidence in team as a unit and ability to lead well.A bad and arrogant supervisor fears for job, is desperate to impress, and is not a team player.Most nurses can tolerate subtle arrogance, especially if directed at everyone.People often learn to adapt, accept as one of the unfavorable aspects of job and keep going.Recognizing subtle arrogance in others and depersonalizing makes it tolerable. (8)rrogance supervision as the personality trait whereby a person has an obnoxiously elevated sense of selfworth.An arrogant supervisor is the one who acts more worthy, and more important than others.Therefore, tend to disrespect and put subordinates down.At the same time, want admiration and respect from others.Want to be appreciated for the great things have done and for special qualities and abilities. (9)rrogant nursing supervisors characterized by tendency to engage in aversive interpersonal behaviors.Workplace arrogance is therefore likely to have a stronger impact on nurses outcomes compared to narcissism.Arrogant leadership may manifest itself in a variety of behaviors completely independent of abusive supervision. (10)As a relation with others, Caring too much about what others think, while natural to care about what others think, for an arrogant person it's a matter of life and death, may do irrational things to impress others, often seeming desperate.Arrogant supervisor may go to any extent to be in the good books of people consider above selves.Work effectiveness is usually interpreted as the success achieved by an organization in efforts to achieve predetermined goals.The effectiveness is the achievement of goals set by cooperative effort.Clearly, if the target or goal has been achieved as is planned before, is called effective.Thus, if the target or goal is not completed within the allotted time, the work is not effective. (13-14) The success and failure of the hospital to achieve intended goals depends on the ability of nurses to carry out duties and responsibilities for the assigned tasks.If the work results are in accordance with what has been determined, the situation can be said to be effective.Effectiveness is a successful work to achieve predetermined goals, because the word Vol. 31.No. 4 (Suppl 1) ,November 2023 "effective" is a state of success in achieving targets or goals that are really useful. (15)ffectiveness is not based on how much costs to achieve goals, but on the success of an overall goal, because the hospital can be said to be effective if the organization can achieve goals properly.Effectiveness becomes one of the measurement standards in the hospital covering all areas of activity with individual capabilities within the hospital.Work effectiveness is the extent to which the hospital achieves the various goals and objectives that have been set, where the setting of goals and objectives reflects the strategic constituencies, subjective interest of assessors, and the stage of hospital growth. (16)taff nurses are empowered to achieve hospital goals and work effectiveness if their work environments are structural in ways that provide access to information, support and resources as well as opportunities to learn and grow.They are considered as job related empowerment factors.Empowerment is an active participatory process through which individuals and organizations gain greater control, efficacy and social justice Critical structural components of an empowered workplace can contribute to a healthy productive, and innovative nursing workforce that increase perceived work effectiveness.Structural empowerment is the presence of social structures in the workplace that enable employees to accomplish their work in meaningful ways. (17)ower is derived not from an individual's characteristics and motives, but entirely from the structural conditions in the work environment.Job empowerment model by four structural factors such as: access to information, support, resources, and opportunity in the work setting that are posited to have a major influence on employee's ability to get work done. (18)Access to Information, refers to the data, technical knowledge, and expertise required to function effectively in staff nurse' position.Information is defined as knowledge about goals, plans, decisions, and policies of the hospital. (19)ccess to Support may be in forms as the feedback and guidance received from superiors, peers, and subordinates.Support is acknowledgment of achievements, authorization, legitimacy, approval, advice, and problem solving of the work.Also, material and psychosocial are the main categories of support.Material support as money, equipment, supplies and the physical environment where psychosocial support as advice from the manager or supervisor. (20)Access to resources refers to the ability to make influence in the hospital to bring in needed materials.Resources may be in the form of equipment, financial resources , supplies necessary for the job, Time available to accomplish job requirements, temporary help when needed Influence decisions about obtaining unit human resources, Influencing decisions about obtaining unit supplies. ( Access to opportunities It refer to the chances to increase competencies of individuals, give them recognition and rewards, provide possibilities of their growth and Vol. 31.No. 4 (Suppl 1) ,November 2023 advancement in their positions and to participate on committees, task forces and interdepartmental work groups Managers at all levels in an organization's hierarchy due to societal change, scientific advancement and specialization are responsible for developing, upgrading nurse's knowledge, skills and attitudes to improve effectiveness and productivity of the organization. (22)rrogant nursing supervisor can be lead to a lot of nurse and hospital problems.They make interactions between nurses so difficult, make an uncomfortable and potentially stressful work environment for others, and have poor performance ratings.It is important for healthcare organizations to be aware of such behaviors and take steps to reduce these behaviors to reach common gales and enhance work and work effectiveness.( 23) Significance of the study Arrogant supervision can be a destructive force within any hospital.With power over their nurses' work assignments, promotion opportunities and performance reviews, arrogant supervisors put subordinates in a helpless position.They do not mentor junior colleagues nor do they motivate a team to benefit the hospital as a whole, contributing to a negative social workplace effectiveness. (

Study setting
The study was conducted in all departments at Tanta University Main Hospital.

Subjects
The subject of this study will include a convenient sample of all nurses (N=911) working in the previously mentioned setting and distributed in the following units obstetric (165), cardiac (229), neurological and mental (163), plastic surgery (32), pediatric surgery (43), tropical (48), physiotherapy (10), dermatology (13), oncology (208) units.Tool Tool I: Arrogant nursing supervision structured questionnaire.This tool was developed by the investigator guided by Shyamsunder et al., (2007) (14) and other by recent related literature (25,24) .It consisted of two parts as follow; Part I: nurses' data age, gender, marital status, unit name, education level, years of experience.Part II: Arrogant Nursing Supervision Structured Questionnaire.It was used to assess nurses' perception of their supervisors' level of arrogance. (26)This tool consisted of 26 items divided into two subscales as follow:  Personal traits included 5 items. Relation with others included 21 items.

Scoring system
It was used to assess level of nurse work effectiveness and classified into four subscales as follow; -Opportunity as challenging work environment in hospital -Information as specific information about thing do well -Support as the current state of hospital -Resources as having supplies necessary for the job Scoring system Nurses' responses were measured on a three points Likert scale ranging from 1= never, 2=sometimes and 3= always.The total score will be calculated by cutoff point and summing scores of all categories.The total scores represented varying levels as follows:  High work effectiveness>75%  Moderate work effectiveness60-75%  Low work effectiveness<60% Method -Official permission to conduct the study was obtained from administrator of Tanta Main University Hospitals and was submitted to the responsible authorities of the selected units.
-Ethical and legal consideration Approval of The Scientific Research Ethical Committee Faculty of Nursing-Tanta University was obtained.Nature of the study was not cause any harm or pain to the nurses.Nurses consent to participate in the study was obtained after informed them about the privacy of information obtained from them, nature of the study, their right to withdraw.Confidentiality and privacy was taken into consideration regarding data collection.A code number was used instead of names.Tools I and II was translated to Arabic and modified by the investigator and presented to a jury of five experts in the area of specialty to check their content validity.The experts were three professors, one assist professor, and one lecturer of Nursing Administration from the Faculty of Nursing Tanta University.
Face validity for tool (I) and (II) was 100%.A pilot study was carried out on 10% of the subject (91) to test the clarity, reliability of tools, identify obstacles and problems that may be encountered during data collection and modification was done.Time estimation for tool (I) and (II) were twenty minutes.Reliability of tools was tested using Cronbach's Alpha coefficient factor, its value for tool I was (0.898) and for tool II was (0.923).
Data was collected by the investigator who distributed the questionnaires on nurses individually at their work setting in a small group of five nurses during their work shifts morning and afternoon.The questionnaires were completed at the presence of the investigator.
-Data was collected within six months from January to June 2022.Statistical analysis of the data Data were fed to the computer and analyzed using IBM SPSS software package version 20.0.(Armonk, NY: IBM Corp) Qualitative data were described using number and percent.eported that the study subjects perceived a moderate level about personal trait dimensions of arrogant supervision.This result was contradicted with Alan and Baykal (2012) (39) who found that the study subjects perceived a low levels about personal trait dimensions of arrogant supervision.The present study result was showed that more than quarter of nurses perceived a high level regarding total relation with other dimension of arrogant supervision.This can be due to the nurse supervisor didn't find it necessary to explain their decisions and they discredit nurse's ideas during meetings to make the staff nurses look bad.Our study result was supported by Kumar et al. (2023) (40) ; Johnson et al., (2010) (41) reported that their study subjects perceived a high level regarding relation with other dimension of arrogant supervision.The current study results reflected a high percentage of the studied nurses had a low level of total work effectiveness.This can be justified as more than half of nurses had low access to information, support, opportunity and resources .This may be due to some nurse supervisors didn't share their knowledge, skills and ideas with nurses, there is lack of opportunity for nurses to learn and grow.This  (46) they found that the study subjects had a high level of total work effectiveness.Our study result showed that more than half of nurses had low levels of access to information, support, opportunity and resources.This may be due to lack of communication skills of some supervisors, and lack in their abilities to recognize and provide the required support and resources for their staff nurses to accomplish their work tasks.This result was congruent with Ullah et al. (2022) (47) ; Roji and Jooste (2020) (48) ; Lashinger et al. (2020) (49) ; Ali (2018) (50) they found that the staff nurses had a low access to information, support, opportunity and resources.This result disagreed with Mota (2015) (51) ; Kassem and Gaber (2015) (52) ; Cummings et al. (2014) (53) they found that the staff nurses had access to information, support, opportunity and resources.Regarding correlation between arrogant nursing supervision and work effectiveness, the results of the current study revealed that there was a statically significant negative correlation between the nurses' total perception of their supervisions' arrogance and their work effectiveness.This can be interpreted as perception of total work effectiveness can be influenced by their supervisors' behaviors and leadership styles.Arrogant supervisors are more likely to be involved in counterproductive work behaviors.Also, they can limit nurses access to information and opportunity to develop.

Table ( 1
): Nurses' Personal data.The table shows that around half (47.1%) of nurses fall in the age group between 20 to less than 30 years old while less than one fifth (16.6%) of nurses fall in the age group more than or equal 40 years old with mean age 31.56 ±6.81.