Factors leading to a strike vote and strategies for reestablishing relationships

Nursing strike, America, 2019: Concept analysis to guide practice

BACKGROUND

In 2018 a nursing 'sympathy strike' occurred. Although unionized nurses were directed to participate, many expressed questions about what a strike or sympathy strike was. Literature revealed no seminal article to define the term. A concept analysis for the nursing workforce was created.

METHOD

The Hybrid Method of Concept Analysis, (theoretical literature analysis, qualitative stakeholder interviews; applicability) was used. 33 articles and 7 books were reviewed. Nine interviews took place.

RESULTS

The literature and interviews agreed on the definition, antecedents, and consequences of a nursing strike. Strikes in the United States were defined as "a last resort effort, after significant bargaining on the issue between nurses and management has not allowed for agreement, where a work stoppage occurs and nurses leave the bedside." Interviews alone introduced the concept of duty to patients. A model case, contrary case and borderline case are offered.

CONCLUSION

This study contains recommendations for practice.

The nursing shortage: breach of ideology as an unexplored cause

The worldwide nursing shortage is unprecedented. Studies show increasing demand for nursing services coupled with a finite nursing supply. Many theories have been developed to explain the nursing shortage, to no avail. One unexplored theory is the psychological contract, which explores the impact of unwritten yet real expectations on work relationships. Understanding breach of the psychological contract is essential to resolution of the ongoing nursing shortage.

Healthy work environments: a validation of the literature

Nursing leaders are under intense pressure to ensure that safety and quality exist at every point of service. Landmark reports set forth many calls to action to transform systems and processes of care to improve healthcare delivery. Evidence indicates that healthy work environments (HWEs) are at the heart of the solutions to significantly affect patient outcomes and professional nursing practice. Findings from an HWEs literature review and focus groups indicate that nursing leaders must prioritize efforts to improve the culture in the work environment. Three elements emerged to help nursing leaders set the tone and standard of practice for HWEs: (1) effective communication, (2) collaborative relationships, and (3) promoting decision making among nurses.

Reshaping the Practice Environment

Today's nurse leader is challenged to create a practice environment that fosters multidisciplinary collaboration, professional development, and a culture of safety. Fostering a sense of coherence among staff nurses about their place within the nursing department and the department's place within the broader organization id essential to the development of such environments. When nurses have a sense of coherence about their work setting, they are more likely to feel confident that their care of patients and families is fully supported by the organization in which they work. The authors describe the concept of coherence, discuss findings from a preliminary study regarding attributes that may contribute to coherence in individual nurses, and describe systems ans programs that have been implemented in a large academic medical center to foster a sense of coherence in individual nurses, the nursing department, and the institution as a whole.