Impact Of Restructuration On Nurses Working Conditions
Uploaded by bdogg on Apr 25, 2007
Impact Of Restructuration On Nurses Working Conditions
The world health care sector, as the industrialized organizations, has undergone dramatic restructuring and downsizing during the past decades, which incurred serious changes of conditions in which nurses deliver healthcare. As human resources management strategies seemed to have had a positive effect on the similar problems beard by other industries, it appears that the public healthcare sector as failed to endeavor in the same way and is still struggling to design and implement effective schemes.
This issue is becoming more and more urgent. Indeed, as governments focus on improving quality and cost effectiveness of patient care, the public healthcare sector has fallen into a vicious circle caused by: "overall workforce shortage, increasingly high and complex workloads, difficult working conditions, a feeling of continuous change and a feeling that the profession is less valued."(Review Body 1999; NHS, 1999, DoH, 1998b; 1999).
This paper will resume the major impacts restructuring brought out on nurses working conditions, and thus on quality of care. We will then look at the solutions to take up in order to maintain and improve quality of service.
There are two degrees of consequences resulting from the restructuring of hospitals, one leading to the other. As Reeves (1997) says, nursing personnel consist of the largest workforce and the most costly of the NHS, which explains why this group has been most affected by downsizing and reduction of costs leading to a first degree of staff-shortage and mistrust towards the system. This engendered many other problems thrusting the NHS in a vicious circle.
Indeed, the staffing shortage increased the workload of nurses and the hiring of unlicensed assistive personnel. This demanded that nurses have a wider range of skills such as supervising the workers and multiplied the amount of paper work. As a result, nurses were faced with heavier responsibilities. In addition, as hospitals tried to increase workforce flexibility, nurses are not as specialized as they were and, thus, are more and more rotated to other unfamiliar areas. Moreover, nurses have less and less time to take care of their patient, which, according to the study led by McNeely (1996), leaves nurses with a feeling of guilt and anxiety having the impression that "they have let their patients down". The changes mentioned above have been proved by the Corey-Lisle et al. (1999) study to be factors of lower job satisfaction...