Between a rock and a hard place: Registered nurses’ accounts of their work situation in cancer care in Swedish acute care hospitals
Between a rock and a hard place: Registered nurses’ accounts of their work situation in cancer care in Swedish acute care hospitals
Purpose
Hospital organizational features related to registered nurses' (RNs') practice environment are often studied using quantitative measures. These are however unable to capture nuances of experiences of the practice environment from the perspective of individual RNs. The aim of this study is therefore to investigate individual RNs’ experiences of their work situation in cancer care in Swedish acute care hospitals.
Methods
This study is based on a qualitative framework analysis of data derived from an open-ended question by 200 RNs working in specialized or general cancer care hospital units, who responded to the Swedish RN4CAST survey on nurse work environment. Antonovsky's salutogenic concepts “meaningfulness”, “comprehensibility”, and “manageability” were applied post-analysis to support interpretation of results.
Results
RNs describe a tension between expectations to uphold safe, high quality care, and working in an environment where they are unable to influence conditions for care delivery. A lacking sense of agency, on individual and collective levels, points to organizational factors impeding RNs’ use of their competence in clinical decision-making and in governing practice within their professional scope.
Conclusions
RNs in this study appear to experience work situations which, while often described as meaningful, generally appear neither comprehensible nor manageable. The lack of an individual and collective sense of agency found here could potentially erode RNs’ sense of meaningfulness and readiness to invest in their work.
Hospitals, Patient safety, Qualitative research, Registered nurses, Workplace
101778
Smeds Alenius, Lisa
bfe92430-fd72-43b1-801b-a968ce6413a0
Lindqvist, Rikard
23451573-1677-473e-8f1a-326c3b72c9ef
Ball, Jane E.
85ac7d7a-b21e-42fd-858b-78d263c559c1
Sharp, Lena
1bd4dcbc-522c-4a48-a1ce-d91901227412
Lindqvist, Olav
c7c3fc92-ed27-4faf-abdb-ca0408b06431
Tishelman, Carol
11d9dd11-f992-48d7-b8ef-a9f428a809d6
1 August 2020
Smeds Alenius, Lisa
bfe92430-fd72-43b1-801b-a968ce6413a0
Lindqvist, Rikard
23451573-1677-473e-8f1a-326c3b72c9ef
Ball, Jane E.
85ac7d7a-b21e-42fd-858b-78d263c559c1
Sharp, Lena
1bd4dcbc-522c-4a48-a1ce-d91901227412
Lindqvist, Olav
c7c3fc92-ed27-4faf-abdb-ca0408b06431
Tishelman, Carol
11d9dd11-f992-48d7-b8ef-a9f428a809d6
Smeds Alenius, Lisa, Lindqvist, Rikard, Ball, Jane E., Sharp, Lena, Lindqvist, Olav and Tishelman, Carol
(2020)
Between a rock and a hard place: Registered nurses’ accounts of their work situation in cancer care in Swedish acute care hospitals.
European Journal of Oncology Nursing, 47, , [101778].
(doi:10.1016/j.ejon.2020.101778).
Abstract
Purpose
Hospital organizational features related to registered nurses' (RNs') practice environment are often studied using quantitative measures. These are however unable to capture nuances of experiences of the practice environment from the perspective of individual RNs. The aim of this study is therefore to investigate individual RNs’ experiences of their work situation in cancer care in Swedish acute care hospitals.
Methods
This study is based on a qualitative framework analysis of data derived from an open-ended question by 200 RNs working in specialized or general cancer care hospital units, who responded to the Swedish RN4CAST survey on nurse work environment. Antonovsky's salutogenic concepts “meaningfulness”, “comprehensibility”, and “manageability” were applied post-analysis to support interpretation of results.
Results
RNs describe a tension between expectations to uphold safe, high quality care, and working in an environment where they are unable to influence conditions for care delivery. A lacking sense of agency, on individual and collective levels, points to organizational factors impeding RNs’ use of their competence in clinical decision-making and in governing practice within their professional scope.
Conclusions
RNs in this study appear to experience work situations which, while often described as meaningful, generally appear neither comprehensible nor manageable. The lack of an individual and collective sense of agency found here could potentially erode RNs’ sense of meaningfulness and readiness to invest in their work.
Text
Between a rock and a hard place Registered nurses’ accounts of their work situation in cancer care in Swedish acute care hospitals
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More information
Accepted/In Press date: 3 June 2020
e-pub ahead of print date: 12 June 2020
Published date: 1 August 2020
Additional Information:
Funding Information:
Funding for this study came from the European Union's Seventh Framework Programme ( FP7 /2007–2013, grant agreement no. 223468 ), the Swedish Association of Health Professionals , Karolinska Institutet's National Research School of Health Care Sciences , the Swedish Council for Working Life and Social Research (FAS/FORTE) , the Karolinska Institutet Strategic Research Programme in Care Sciences (SFO–V).
Publisher Copyright:
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
Keywords:
Hospitals, Patient safety, Qualitative research, Registered nurses, Workplace
Identifiers
Local EPrints ID: 443112
URI: http://eprints.soton.ac.uk/id/eprint/443112
ISSN: 1462-3889
PURE UUID: 1239dc0f-9799-44fa-82ab-b1c1219dadfd
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Date deposited: 11 Aug 2020 16:31
Last modified: 17 Mar 2024 03:37
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Contributors
Author:
Lisa Smeds Alenius
Author:
Rikard Lindqvist
Author:
Jane E. Ball
Author:
Lena Sharp
Author:
Olav Lindqvist
Author:
Carol Tishelman
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