[Modernizing nursing with holistic nursing systems? Results of a formative assessment]

A project aiming at the implementation of a holistic nursing system was conducted on selected wards of a general hospital. The results of a formative evaluation are presented from a work psychological perspective. The reorganisation of nursing led to a higher degree of patient and employee orientation. Most aspects of nurses' work load were reduced but the improvement did not effect nurses' strain to the expected degree. Decision latitudes at the workplace were enlarged, whereas only few changes in decision latitudes were stated with regard to areas outside the ward. The project is discussed as a reflexive strategy of modernization; its success is a result of a process-oriented management which is able to react on unavoidable consequences in the reorganization process.