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Nursing in the nineties: managing the uncertainty.
1Department of Adult Health Nursing, Virginia Commonwealth University, School of Nursing, Richmond, USA.
The Journal of Nursing Administration
|May 20, 1999
Summary
Nurses in 53 hospitals experience turbulent work environments due to heavy workloads, loss of identity, and constant re-engineering. Addressing unique personnel needs is crucial for successful healthcare management strategies.
Area of Science:
- Nursing Administration
- Healthcare Management
- Organizational Behavior
Background:
- The Outcomes Research in Nursing Administration (ORNA) project investigates how nursing unit organizational structures affect patient outcomes.
- This study complements ORNA's quantitative data by providing qualitative insights into nurses' daily work experiences.
Purpose of the Study:
- To qualitatively examine the work lives of nurses across 53 hospitals participating in the NIH-funded ORNA project.
- To understand the factors contributing to the perceived turbulence and uncertainty in acute care settings from the nurses' perspective.
Main Methods:
- Qualitative data collection through monthly journal entries from site coordinators over six months.
- Content analysis of documented critical incidents and implications from 53 hospitals (81.5% response rate).
Main Results:
- Nurses perceive the acute care environment as turbulent and uncertain.
- Key contributing factors identified: high workload (census, staffing, turnover), loss of workplace identity (consolidation, mergers), and continuous re-engineering (skill mix, technology, systems).
Conclusions:
- The findings highlight the narrative perspective of environmental uncertainty in nursing.
- Effective organizational and management strategies must prioritize unique personnel needs within each care setting to ensure successful implementation and quality enhancement.