Unclear goals and performance obstacles in a surgical department in Sweden, A case study
(English)Manuscript (preprint) (Other academic)
Background: To improve working conditions and counteract nursing shortages, more knowledge is needed about the goals that guide nurses’ work, and the opportunities nurses have to carry out their work well. The aim of this study is to describe how nurse managers, registered specialist nurses and non-registered assistant nurses interpret stated organisational goals and their own daily goals, and to identify performance obstacles for nurses in a surgical department.
Methods: A descriptive case study design was performed in a surgical department, comprising structured individual and group interviews according to work content analyses with nurse managers, registered specialist nurses and assistant nurses. Interviews were analysed in terms of predetermined aspects regarding working conditions and criteria for performance obstacles. Extracts from documents stating goals and registered data supplemented the interviews.
Results: The findings show that the daily surgery schedule, not the goal documents, guided daily work. An over-optimistic surgery schedule with unplanned changes and cancellations, over which the nurses had very little influence, as well as the time required to locate necessary equipment that was spread throughout the ward, resulted in nurses rushing through medical records and other preparations rather than preparing calmly for surgery. Although the registered specialist nurses and assistant nurses considered quality of care to be highly important, no standardised evaluations on quality of care were performed.
Conclusion: Due to goal incongruence and performance obstacles, the nurses were often unable to reach their daily goals. Involving registered specialist nurses in the schedule-planning process could facilitate their work to better match the requirements of the physical work environment and the staff availability. In order for the Surgical Department Goal Document to guide work, goals must be transformed into understandable, realistic, applicable and evaluable aims, and incorporated into daily work.
The study also reveals the importance of a functioning physical work environment including storage, technical equipment supplies, and the positioning of technical equipment in operating rooms, in order for registered specialist and assistant nurses to perform their tasks well.
case study, interview, nurses, operating rooms, organisational objectives, professional practice
Medical and Health Sciences
Research subject Caring Sciences
IdentifiersURN: urn:nbn:se:uu:diva-267047OAI: oai:DiVA.org:uu-267047DiVA: diva2:872711