The psychological effects of organizational restructuring on nurses

This paper reports a comparison of nurses affected by the restructuring associated with healthcare organization mergers (1998-2000) in the United Kingdom and those of non-affected nurses in the UK.

Restructuring, a feature of healthcare organizations for decades, has been associated internationally with negative outcomes for nurses. Despite this, no model to evaluate management of change factors and psychological stress processes has been operationalized and tested.

A sample of 351 Registered Nurses was recruited from southern England. Participants either worked in organizations that were within 6 months of merging or were not affected by mergers. On two occasions, 6 months apart, all were sent a questionnaire that had been formulated for the study. Questions related to the parts of the model being tested: restructuring initiatives (i.e. stressors) information and participation, coping action, and coping effectiveness (i.e. outcomes). The data were collected between 1998 and 2000.

Nurses affected by mergers reported statistically significantly higher restructuring initiatives before and after an event than non-affected nurses. Moreover, up to 12 months after an event some affected nurses reported lower information and participation, and lower coping effectiveness (i.e. higher job insecurity, job stress, job pressure, lower job satisfaction, physical, psychological, and environmental quality of life) than non-affected nurses, which was consistent with the model's proposals. However, there was no difference between affected and non-affected nurses' coping action.

The psychological effects of restructuring are linked with perceptions of low information and participation, and with negative outcomes for nurses. Managers, therefore, need to communicate information and encourage staff to participate in decisions about restructuring events.