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

IF 2.4 Q1 NURSING
Julia van Kraaij, Frits van Merode, Emma Lenssen, Hester Vermeulen, Catharina van Oostveen, Rn Blend Consortium
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Abstract

Background/objectives: The nursing work environment is a critical element in healthcare delivery and a strong predictor of both patient and nurse outcomes. Understanding the complexity and multifaceted nature of this environment is essential for improving nursing practices and optimizing healthcare systems. This study aimed to gain insights into the perceived characteristics of the nursing work environment, considering it as a complex and multifaceted system.

Methods: A qualitative research approach was employed, involving 42 semi-structured interviews with 43 nurses and managers from academic, teaching, and general hospitals in The Netherlands. Data were collected between July 2020 and August 2021 through convenience sampling. Thematic coding was conducted to identify key patterns and themes.

Results: The findings revealed that nurses demonstrated flexibility and a strong commitment to high-quality care, despite grappling with rigorous organizational tasks and processes. Four key themes emerged: (1) direct patient care as a standard feature of nursing work; (2) nurses' flexibility for hospital productivity; (3) interdependencies, which decrease autonomous nursing practices; and (4) organizational structures that determine how nurses can shape their work. Nurses found it difficult to balance direct care with broader tasks due to organizational rigidity, revealing a gap between ideal nursing practices and daily reality.

Conclusions: This study highlighted the challenges within the nursing work environment, particularly in balancing direct care with organizational demands. Addressing this gap between ideal nursing practice and reality requires a systems approach. This includes autonomous practices, supportive management, and flexible structures, allowing nurses to shape their work and enhance job satisfaction and care quality.

组织的僵化与要求:复杂组织中护理工作的定性研究》。
背景/目标:护理工作环境是医疗保健服务的关键因素,也是预测病人和护士治疗效果的重要指标。了解这一环境的复杂性和多面性对于改进护理实践和优化医疗保健系统至关重要。本研究旨在深入了解护理工作环境的感知特征,将其视为一个复杂而多面的系统:采用定性研究方法,对来自荷兰学术、教学和综合医院的 43 名护士和管理人员进行了 42 次半结构化访谈。数据收集时间为 2020 年 7 月至 2021 年 8 月,采用便利抽样法。对数据进行了主题编码,以确定关键模式和主题:研究结果表明,护士们尽管要应对严格的组织任务和流程,但仍表现出灵活性和对高质量护理的坚定承诺。出现了四个关键主题:(1)直接护理病人是护理工作的标准特征;(2)护士为提高医院生产率而表现出的灵活性;(3)相互依存关系降低了护理工作的自主性;(4)组织结构决定了护士如何塑造自己的工作。由于组织结构僵化,护士很难在直接护理与更广泛的任务之间取得平衡,这显示了理想的护理实践与日常现实之间的差距:本研究强调了护理工作环境中存在的挑战,尤其是在平衡直接护理与组织要求方面。要解决理想护理实践与现实之间的差距,需要采用系统方法。这包括自主实践、支持性管理和灵活的结构,使护士能够塑造自己的工作,提高工作满意度和护理质量。
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来源期刊
Nursing Reports
Nursing Reports NURSING-
CiteScore
2.50
自引率
4.20%
发文量
78
期刊介绍: Nursing Reports is an open access, peer-reviewed, online-only journal that aims to influence the art and science of nursing by making rigorously conducted research accessible and understood to the full spectrum of practicing nurses, academics, educators and interested members of the public. The journal represents an exhilarating opportunity to make a unique and significant contribution to nursing and the wider community by addressing topics, theories and issues that concern the whole field of Nursing Science, including research, practice, policy and education. The primary intent of the journal is to present scientifically sound and influential empirical and theoretical studies, critical reviews and open debates to the global community of nurses. Short reports, opinions and insight into the plight of nurses the world-over will provide a voice for those of all cultures, governments and perspectives. The emphasis of Nursing Reports will be on ensuring that the highest quality of evidence and contribution is made available to the greatest number of nurses. Nursing Reports aims to make original, evidence-based, peer-reviewed research available to the global community of nurses and to interested members of the public. In addition, reviews of the literature, open debates on professional issues and short reports from around the world are invited to contribute to our vibrant and dynamic journal. All published work will adhere to the most stringent ethical standards and journalistic principles of fairness, worth and credibility. Our journal publishes Editorials, Original Articles, Review articles, Critical Debates, Short Reports from Around the Globe and Letters to the Editor.
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