Shaping positive work environments for nurses: the contributions of nurses at various organizational levels

This paper focuses on nurses' perceptions of their individual contributions to the work environment. Fourteen community hospitals participated in the study. A positive nursing work environment was selected in each agency by its Director of Nursing. Selection was based on subjective and objective criteria. All staff nurses, nurse managers and the director of nursing associated with these units were asked to respond to an open-ended question describing their perceived contributions to the work settings. Ninety-two nurses responded for a response rate of 42%. Overall the three themes of People, Practice and Place surfaced from 15 categories of responses. The same three themes surfaced for all three nurse groups but variation was noted with regards to the categories of contributions the groups most frequently reported within the theme. In this time of continuous change throughout the health care system, nurses need to be able to articulate and affirm their important contributions to the effective shaping of positive health care settings. A focus on contributions could assist with team building, leadership development and have an important impact on quality patient care outcomes.