Striving for safety: experiences of nurses in a hospital under siege

The hospital in which this study took place served as a centre for emergencies, critically ill patients and maternity cases during a nurses' strike in 98 hospitals in Alberta, Canada. Nurses at this hospital were not members of the striking union; they belonged to their own independent union and they worked throughout the 19-day siege. Thirty-two nurses at the hospital responded to posters seeking volunteers for telephone interviews. The objective of the research was to discover the perceptions and experiences of nurses coping with extraordinarily heavy workloads arising out of a labour dispute. Interview data were gathered and analysed according to the conventions of grounded theory. Nurses voiced many concerns about the care patients received and they coped as best they could in a process described as 'striving for safety'. Fearing they would make mistakes that would harm their patients, they engaged in two subordinate processes of 'assessing competence' and 'preserving integrity'. Several organizational factors were identified that, if present, contributed to nurses' ability to continue or 'hang in' but if absent, contributed to despair or 'feeling demoralized'. The study was exploratory in nature and thus limited, but several implications for supporting nurses and managing such crises were discussed.