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Coping with unbalanced information about decision-making influence for nurses.

R H Schwartz1

  • 1College of Business Administration, University of Toledo, OH 43606.

Hospital & Health Services Administration
|January 1, 1990
PubMed
Summary

Nursing leaders aim to enhance practice and attract talent by increasing nurse decision-making power. However, existing literature often presents an unbalanced view, favoring nurse autonomy over hospital bureaucracy, which requires administrative attention.

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Area of Science:

  • Nursing Practice and Administration
  • Healthcare Management
  • Organizational Behavior in Healthcare

Background:

  • Nursing leaders are advocating for changes to improve professional practice, job satisfaction, and prestige within the nursing field.
  • A growing body of literature supports increased decision-making power for nurses, emphasizing decentralized, participative, and autonomous models.
  • This push for enhanced nurse autonomy is partly driven by a desire to attract and retain high-caliber individuals in the nursing profession.

Purpose of the Study:

  • To critically examine the existing literature advocating for increased nurse decision-making power.
  • To identify and discuss the imbalance in the literature, specifically its strong support for nurse influence and opposition to hospital bureaucracy.
  • To explore potential strategies for hospital administrators to manage the consequences arising from this literature's imbalance.

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Main Methods:

  • Qualitative analysis of academic and professional literature concerning nurse autonomy and hospital bureaucracy.
  • Identification and illustration of biased arguments within the literature.
  • Discussion of the implications of this imbalance for healthcare administration and organizational dynamics.

Main Results:

  • A significant portion of the literature advocating for nurse empowerment presents an unbalanced perspective.
  • This imbalance is characterized by an overemphasis on nurse influence and an underrepresentation or critique of hospital bureaucratic structures.
  • The one-sided nature of the literature may create unrealistic expectations and challenges for hospital administrators.

Conclusions:

  • The current literature on nurse decision-making power requires a more balanced approach, acknowledging the complexities of hospital systems.
  • Hospital administrators need to develop strategies to address the consequences of this literature, such as managing conflicting interests and expectations.
  • Further research is needed to explore balanced models that integrate enhanced nurse autonomy with effective hospital management and bureaucratic realities.