Doctoral Dissertation Research: Impact of Restructuring on Nurses

Harvard University, Cambridge MA

Investigators

Abstract

Abstract DelVecchio Good In the hope of gaining a competitive edge, various hospitals have responded with mergers, organized delivery systems, and other reorganization strategies to challenges posed by managed care. While some of these strategies prove financially prudent, we know very little about the consequences of reorganization strategies for hospital workers and for patient care. This dissertation research addresses this knowledge gap through an examination of the impact of hospital reorganization on staff registered nurses. This research explores the impact of these changes on hospital nurses and nursing care. It uses a combination of official hospital documentation, interviews, focus groups, surveys, and observation to explore nurses' perceptions and daily experience of these changes. The questions it seeks to answer are: What changes have been introduced that affect nurses' everyday work? How have these new arrangements affected the official role that nurses play in the hospital as a whole as well as within their individual departments? How have nurses and other hospital employees reacted to these changes, and how have these responses affected the working relationships between different professional groups in the hospital? Most importantly, how have the altered organizational arrangements influenced nurses' ability to care for patients in a professional and responsible manner?