The Social Organization of the Staffing Work of Nurse Managers: A Critique of Contemporary Nursing Workload Technologies
Abstract
The multifaceted work of providing hospital services on a patient care unit requires people with the ability to coordinate, monitor, and report on the work done by nurses, unit clerks, and health care aides. Nurse managers (NMs) in hospitals are responsible for doing this work. NMs devote significant time and energy to ensure enough staff are available to care for patients; however, this “staffing work” is a source of tension. Motivated by my own experience of nursing management, in this dissertation I empirically describe and analyze NMs’ activities and the tensions they experience. I applied institutional ethnography (IE) to develop an account of how NMs’ work of staffing is socially organized. IE, a method of inquiry, offers an alternate analysis to the authorized knowledge of health care, making possible a critical empirical description of what it is like to be an NM doing staffing work in contemporary Canadian hospitals. Insights into how NMs’ thinking is influenced by economic imperatives, supporting them to act in ways that undermine nurses’ ability to provide patient care, are revealed. An evidentiary trail is built of how documents and technologies (such as the workload management system) are used to plan and administer nurse staffing. This study offers a caution against the increasing reliance on knowledge produced by workload management systems and the relations of ruling into which NMs are pulled when they use such systems. My argument is that NMs’ material knowledge of how to organize safe staffing is being subordinated by knowledge produced in and by contemporary nursing workforce technologies. The loss of this material knowledge and abstracted knowledge that replaces it jeopardize how NMs can be relied on to provide adequate nursing resources to keep patients safe.
Description
Keywords
Nursing
Citation
Fast, O. M. (2016). The Social Organization of the Staffing Work of Nurse Managers: A Critique of Contemporary Nursing Workload Technologies (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/28382