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Organizational Rigidity and Demands: A Qualitative Study on Nursing Work in Complex Organizations.

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  • 1IQ Health Science Department, Radboud University Medical Center, P.O. Box 9101, 6525 EP Nijmegen, The Netherlands.

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Summary

Nurses show commitment to patient care but face challenges balancing direct care with organizational demands due to rigid structures. Improving the nursing work environment requires a systems approach for better job satisfaction and care quality.

Keywords:
hospital caremanagementnurses rolesnursingnursing work environmentqualitative approachessystems thinkingwork organization

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Area of Science:

  • Healthcare Management
  • Nursing Studies
  • Organizational Psychology

Background:

  • The nursing work environment significantly impacts patient and nurse outcomes.
  • Understanding its complexity is crucial for healthcare improvement.
  • This study examines the perceived characteristics of the nursing work environment as a system.

Purpose of the Study:

  • To gain insights into the perceived characteristics of the nursing work environment.
  • To explore the multifaceted nature of nursing work.
  • To identify factors influencing nursing practices and job satisfaction.

Main Methods:

  • Qualitative research approach.
  • 42 semi-structured interviews with nurses and managers in Dutch hospitals.
  • Thematic coding of collected data.

Main Results:

  • Nurses exhibit flexibility and commitment to high-quality care despite organizational challenges.
  • Key themes include direct patient care, nurses' flexibility impacting productivity, reduced autonomy due to interdependencies, and organizational structures shaping work.
  • A gap exists between ideal nursing practices and daily reality due to organizational rigidity.

Conclusions:

  • Challenges in the nursing work environment stem from balancing direct care with organizational demands.
  • A systems approach is needed to bridge the gap between ideal and real nursing practices.
  • Enhancing autonomous practices, supportive management, and flexible structures can improve job satisfaction and care quality.