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Magnet hospital nurses describe control over nursing practice
Western Journal of Nursing Research
|June 7, 2003
Summary
Staff nurses define control over nursing practice (C/NP) as a key professional function. However, most nurses in magnet hospitals report little C/NP due to organizational changes negatively impacting supportive structures.
Area of Science:
- Nursing Practice
- Organizational Behavior
- Healthcare Management
Background:
- Control over nursing practice (C/NP) is a professional nursing function.
- Nurses perceive C/NP as leading to greater organizational acclaim, status, and prestige.
- Effective C/NP requires an empowered, formal organizational structure.
Purpose of the Study:
- To explore staff nurses' descriptions of control over nursing practice (C/NP).
- To identify the characteristics and categories of C/NP.
- To understand factors affecting C/NP in magnet hospitals.
Main Methods:
- Qualitative study using interviews with 279 staff nurses across 14 magnet hospitals.
- Constant comparative analysis of nurses' descriptions of C/NP activities.
- Ranking of C/NP categories based on problem ownership and degree of control.
Main Results:
- Five ranked categories of C/NP emerged, based on problem ownership and control effectiveness.
- C/NP extends beyond clinical decision-making and is similar to professional autonomy.
- Hospital mergers and reorganization negatively impacted structures for C/NP.
- Nearly 60% of nurses reported little or no C/NP.
Conclusions:
- Effective C/NP requires a formal, empowered organizational structure.
- Organizational changes can significantly hinder nurses' control over their practice.
- Despite being in magnet hospitals, many staff nurses experience limited C/NP.