Healthcare, hospital environments, and the nursing workforce have been a focus of late in both the professional literature and public media especially in the wake of the Institute of Medicine's reports Keeping Patients Safe-Transforming the Work Environment of Nurses (IOM, 2004) and The Future of Nursing-Leading Change Advancing Health (IOM, 2011). These reports address patient safety and workforce issues such as staffing, organizational culture, and workforce characteristics. Very little research has been undertaken on the culture of night nursing or the roles, experiences and characteristics of night nurses. Therefore, a study of night nursing, using a qualitative ethnographic methodology, was chosen to address this gap. Because subcultures can influence the larger culture, knowledge regarding their unique characteristics and attributes becomes critically important especially in the culture of a large hospital.
The purpose of this study was to develop a description of night nursing as a subculture within the larger culture of nursing care and nursing practice that exists in a hospital setting. Data were collected during the researcher's 100 hours of participant observations on five differing nursing units in two hospitals, using semi-structured transcribed interviews with eight nurse informants on these same units, and through an analysis of relevant hospital documents. A synthesis of the collected data identified a subculture of night nursing with shared domains or attributes such as unique roles, rituals, hierarchies, and insider/outsider perspectives.
The final description included four themes that were extrapolated from the synthesized data: (1) night nursing is characterized by camaraderie and teamwork; (2) the environment of a night nurse is conducive to the development of critical thinking; (3) night nurses engage in a constant reflection about sleep; and (4) night nurses share a feeling of being undervalued.
The findings from this study have implications for administrators who must be aware of and understand the needs of night nurses especially related to being valued and included. For nurse educators, important implications center on preparing students for the uniqueness of the role of the night nurse, and planning formal educational offerings during the night shift for nurses. Further research is warranted using quantitative methods to validate and explore the themes and domain descriptions identified in this study.
|School Location:||United States -- New York|
|Source:||DAI-B 76/10(E), Dissertation Abstracts International|
|Subjects:||Nursing, Organizational behavior, Higher education|
|Keywords:||Critical thinking, Night nursing, Social structure, Subculture, Team work, Work environment|
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