| Summary: | <p> Directors of nurses in long-term care are faced with significant changes in the healthcare industry. The responsibilities of the position have evolved and now require director of nurses to have additional skill sets that were not previously associated with the expectations of the position. The purpose of this qualitative descriptive case study was to explore the perception of 8 directors of nursing in long-term care facilities in the Downstate Area of New York State. This research was guided by the following questions: What are the perceptions of directors of nurses or nurse executives in long term care facilities? Who may or may not be educated in graduate level business, particularly in the area of business decision making and fiscal responsibilities? How can registered nurses in leadership and executive positions enhance their educational preparedness as they pursue the responsibilities associated with their roles? A case study is an in-depth examination of individuals, organizations, or processes that seek further theoretical understanding. Several pertinent and relevant themes were identified such as; a) the review of the nursing curriculum, b) the need for standardized requirement to practice as a director of nurses, c) self-direction in ongoing education, mentorship and, d) training in business and fiscal responsibilities. Additionally, sub themes emerged during this qualitative study which included; a) organizational responsibility, b) director of nursing demanding change, and c) accelerated nursing programs. </p>
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