A grass roots approach to developing inpatient nursing unit work groups

The change has taken three years. Many obstacles (attitudes, scheduling, philosophical differences, etc.) had to be overcome. The unit needed to develop its own autonomy and culture. The head nurse found it necessary to relinquish some control and the clinical nurses, in turn, had to determine manageable versus unmanageable problems. Risks were involved on every level from clinical nurses to the Director of Neuroscience Nursing, but all responded with trust and commitment to nursing and to the organizational goals. The unit was fortunate in a number of ways during the implementation of the work groups. It was advantageous to have a consultant who continually made the head nurse and group leaders look at the unit as a part of a total organization. The many "buts" that were interjected when comparing/contrasting nursing with other professions were refuted. It became apparent that the majority of nurses were fully aware that the profession involves working 24 hours a day, seven days a week including holidays. For the most part, the new graduate understands that hands on care includes such tasks as changing incontinent patients, making beds, and lifting and turning patients. Nursing also means intangible rewards in serving patients who need care. For nurses on our unit, what needed to be changed was the idea that a nurse has little or no control over the work life on a unit. If indeed nurses are committed to nursing, it is up to them, with appropriate support, to identify and alter the aspects of the job which are unsatisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)