Workplace culture among operating room nurses

S Eskola, M Roos, B McCormack, Paul Slater, N Hahtela, T Suominen

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Aims To investigate the workplace culture in the Operating Room (OR)environment and the factors associated with it.Background In health care, the workplace culture affects the delivery andexperience of care. The OR can be a stressful practice environment, where nursesmight have occasionally either job stress or job satisfaction based on theircompetence.Method A quantitative cross-sectional approach was used. The study consisted of96 Finnish OR nurses. A Nursing Context Index instrument was used to obtaindata by way of an electronic questionnaire.Results The primary role and working unit of respondents were the maincomponents relating to workplace culture, and especially to job stress. Nurseanaesthetists were found to be slightly more stressed than scrub nurses. In localhospitals, job stress related to workload was perceived less than in universityhospitals (P = 0.001). In addition, OR nurses in local hospitals were moresatisfied with their profession (P = 0.007), particularly around issues concerningadequate staffing and resources (P = 0.001).Conclusions and implications for nursing management It is essential that nursemanagers learn to recognise the different expressions of workplace culture. Inparticular, this study raises a need to recognise the factors that cause job stress tonurse anaesthetists.
LanguageEnglish
Pages725-734
JournalJournal of Nursing Management
Volume24
Issue number6
Early online date26 Apr 2016
DOIs
Publication statusPublished - Sep 2016

Fingerprint

Operating Rooms
Workplace
Nurses
Nursing
Job Satisfaction
Workload
Delivery of Health Care
Surveys and Questionnaires

Keywords

  • job satisfaction
  • job stress
  • operating room nurse
  • practice environment
  • workplace culture

Cite this

Eskola, S., Roos, M., McCormack, B., Slater, P., Hahtela, N., & Suominen, T. (2016). Workplace culture among operating room nurses. Journal of Nursing Management, 24(6), 725-734. https://doi.org/10.1111/jonm.12376
Eskola, S ; Roos, M ; McCormack, B ; Slater, Paul ; Hahtela, N ; Suominen, T. / Workplace culture among operating room nurses. In: Journal of Nursing Management. 2016 ; Vol. 24, No. 6. pp. 725-734.
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title = "Workplace culture among operating room nurses",
abstract = "Aims To investigate the workplace culture in the Operating Room (OR)environment and the factors associated with it.Background In health care, the workplace culture affects the delivery andexperience of care. The OR can be a stressful practice environment, where nursesmight have occasionally either job stress or job satisfaction based on theircompetence.Method A quantitative cross-sectional approach was used. The study consisted of96 Finnish OR nurses. A Nursing Context Index instrument was used to obtaindata by way of an electronic questionnaire.Results The primary role and working unit of respondents were the maincomponents relating to workplace culture, and especially to job stress. Nurseanaesthetists were found to be slightly more stressed than scrub nurses. In localhospitals, job stress related to workload was perceived less than in universityhospitals (P = 0.001). In addition, OR nurses in local hospitals were moresatisfied with their profession (P = 0.007), particularly around issues concerningadequate staffing and resources (P = 0.001).Conclusions and implications for nursing management It is essential that nursemanagers learn to recognise the different expressions of workplace culture. Inparticular, this study raises a need to recognise the factors that cause job stress tonurse anaesthetists.",
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note = "Reference text: Arakiel E., Gunningberg L. & Larsson J. (2008) Job satisfaction or production? How staff and leadership understand operating room efficiency: a qualitative study. Acta Anaesthesiologica Scandinavica 52, 1423–1428. Arora S., Hull L., Sevdalis N. et al. (2010) Factors compromising safety in surgery: stressful events in the operating room. American Journal of Surgery 199, 60–65. Berland A., Natvig G.K. & Gundersen D. (2008) Patient safety and job-related stress: a focus group study. Intensive and Critical Care Nursing 24, 90–97. Browne J.A. (2009) Healthy workplaces and ethical environments. A staff nurse’s perspective. Critical Care Nursing Quarterly 32 (3), 253–261. Bull R. & FitzGerald M. (2006) Nursing in a technological environment: nursing care in the operating room. International Journal of Nursing Practice 12, 3–7. Chen C.-K., Lin C., Wang S.-H. & Hou T.-H. (2009) A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle-level hospital operating rooms. Journal of Nursing Research 17 (3), 199–210. Chiron B., Michinov E., Chiron E.O., Laffon M. & Rusch E. (2010) Journal of Health Psychology 15 (6), 948–958. Cristian C.K., Gustafson M.L., Roth E.M. et al. (2006) A prospective study of patient safety in the operating room. Surgery 139, 159–173. Estryn-B�ehar M., Van der Heijden B., Og�ınska H., Camerino D., Le N�ezet., Conway P., Hasselhor H-M & the NEXT Study Group (2007) The impact of social work environment, teamwork characteristics, burnout, and personal factors upon intent to leave among European nurses. Medical Care 45 (10), 939–950. Gillespie B.M., Chaboyer W., Wallis M. & Grimbeek P. (2007) Resilience in the operating room: developing and testing of a resilience model. Journal of Advanced Nursing 59 (4), 427– 438. Gillespie B.M., Wallis M. & Chaboyer W. (2008) Operating theater culture. Implication for nurse retention. Western Journal of Nursing Research 30 (2), 259–277. Gillespie B.M., Chaboyer W., Longbotton P. & Wallis M. (2010) The impact of organizational and individual factors on team communication in surgery: a qualitative study. International Journal of Nursing Studies 47, 732–741. Hahtela N., Paavilainen E., McCormack B., Slater P., Helminen M. & Suominen T. (2014) Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care. Journal of Nursing Management 23 (7), 931–939. Hemmelgarn A., Glisson C. & Lawrence R.J. (2006) Organizational culture and climate: implications for service and interventions research. Clinical Psychology: Science and Practice 13, 73–89. Henry L., Hunt S.L., Kroetch M. & Yang Y.T. (2012) Evaluation of patient safety culture. A Survey of Clinicians in a Cardiovascular Operating Room. Innovations 7 (5), 328–337. Higgins B.L. & Macintosh J. (2010) Operating room nurses’ perceptions of the effects of physician-perpetrated abuse. International Nursing Review 57, 321–327. Kalisch B.J., Lee H. & Rochman M. (2010) Nursing staff teamwork and job satisfaction. Journal of Nursing Management 18, 938–947. Kuokkanen L., Suominen T., H€ark€onen E., Kukkurainen M.-L. & Doran D. (2009) Effects of organizational change on work-related empowerment, employee satisfaction, and motivation. Nursing Administration Quarterly 33 (2), 116–124. Lazarus R.S. & Folkman S. (1984) Stress, Appraisal and Coping. Springer Publishing Company, New York, NY. Leach L.S., Myrtle R.C., Weaver F.A. & Dasu S. (2009) Assessing the performance of surgical teams. Health Care Management Review 34 (1), 29–41. Lindwall L. & von Post I. (2008) Habits in perioperative nursing culture. Nursing Ethics 15, 670–681. Locke E.A. (1976) The nature and causes of job satisfaction. In Handbook of Industrial and Organizational Psychology (M. D Dunnette ed.), p 1304. Rand McNally, Chicago, IL. Mackintosh C. (2007) Making patient better: a qualitative study of registered nurses’ reasons for working in surgical areas. Journal of Clinical Nursing 16, 1134–1140. Manley K. (2008) ‘The way things are done around here”– developing a culture of effectiveness: a pre-requisite to individual and team effectiveness in critical care. Australian Critical Care 21, 83–85. Manley K., Sanders K., Cardiff S. & Webster J. (2011) Effective workplace culture: the attributes, enabling factors and consequences of a new concept. International Practice Development Journal 1 (2). Available at http://www.fons.org/library/journal/ aspx/, accessed 10 November 2014. McCormack B., Kitson A., Harvey G., Rycroft-Malone J., Tichen A. & Seers K. (2002) Getting evidence into practice: the meaning of ‘context’. Journal of Advanced Nursing 38 (1), 94–104. McCormack B., Dewing J., Breslin L. et al. (2010) Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal of Older People Nursing 5, 93–107. Meeusen V., Van Dam K., Brown-Mahoney C., Van Zundert A. & Knape H. (2011a) Understanding nurse anaesthetist’ intention to leave their job: How burnout and job satisfaction mediate the impact of personality and workplace characteristics. Health Care Management Review 36 (2), 155–163. Meeusen V., Van Dam K., Brown-Mahoney C., Van Zundert A. & Knape H. (2011b) Work climate related to job satisfaction among Dutch nurse anaesthetists. Journal of the American Association of Nurse Anaesthetists 79 (1), 63–70. Minnick A.F., Donaghey B., Slagle J. & Weinger M.B. (2011) Operating room team members’ views of workload, case difficulty, and nonroutine events. Journal of Healthcare Quality 34 (3), 16–24. Riley R. & Manias E. (2006) Governing time in operating rooms. Journal of Clinical Nursing 15, 546–553. Riley R. & Manias E. (2009) Gatekeeping practices in nurses in operating rooms. Social Science & Medicine 69 (2), 215–222. Rydef€alt C., Johansson G., Larsson P.A., �Akerman K. & Odenrick P. (2011) Social structures in the operating theatre: how contradicting rationalities and trust affect work. Journal of Advanced Nursing 68 (4), 783–795. Schein E.H. (2004) Organizational Culture and Leadership, 3rd edn. Jossey-Bass, San Francisco, CA. Slater P. & McCormack B. (2006) The Person-Centred Nursing Index. Instrument. University of Ulster, Ulster, UK Tengvall E. (2010) Professional Competence of Perioperative and Anaesthetist Nurse: a Questionnaire Research to Perioperative and Anaesthetist Nurses, Anaesthesiologists and Surgeons. Publication of the University of Eastern Finland. Dissertations in Health Sciences, no. 32. Available at: http://epublications. uef.fi/pub/urn_isbn_978-952-61-0226-9/, accessed 2 February 2015. Wakim N. (2014) Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. A generational perspective. Journal of Nursing Administration, 12 (44), 632–639. Weller J., Janssen A., Merry A. & Robinson B. (2008) Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crises. Medical Education 42, 382–388. Wilson G. (2012) Redesigning OR orientation. AORN Journal 95 (4), 453–462. Wilson V.J., McCormack B.G. & Ives G. (2005) Understanding the workplace culture of a special care nursery. Journal of Advanced Nursing 50 (1), 27–38. Wilson B., Squires M., Widger K., Cranley L. & Tourangeau A. (2008) Job satisfaction among a multigenerational workforce. Journal of Nursing Management 16, 716–723. World Health Organisation (2009) Guidelines for Safe Surgery. Available at: http://whqlibdoc.who.int/publications/2009/ 9789241598552_eng.pdf/, accessed 3 April 2014. World Medical Association. (2013).Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. Available at: http://www.wma.net/en/30publications/ 10policies/b3/index.html accessed 18 February 2015. Wovels A., Topp R.V. & Berger J. (2012) Understanding stress in the operating room: a step toward improving the work environment. Kentucky Nurse 60 (2), 5–7. Zhou H. & Gong Y.-H. (2015) Relationship between occupational stress and coping strategies among operating theatre nurses in China: a questionnaire survey. Journal of Nursing Management 23, 96–106.",
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Eskola, S, Roos, M, McCormack, B, Slater, P, Hahtela, N & Suominen, T 2016, 'Workplace culture among operating room nurses', Journal of Nursing Management, vol. 24, no. 6, pp. 725-734. https://doi.org/10.1111/jonm.12376

Workplace culture among operating room nurses. / Eskola, S; Roos, M; McCormack, B; Slater, Paul; Hahtela, N; Suominen, T.

In: Journal of Nursing Management, Vol. 24, No. 6, 09.2016, p. 725-734.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Workplace culture among operating room nurses

AU - Eskola, S

AU - Roos, M

AU - McCormack, B

AU - Slater, Paul

AU - Hahtela, N

AU - Suominen, T

N1 - Reference text: Arakiel E., Gunningberg L. & Larsson J. (2008) Job satisfaction or production? How staff and leadership understand operating room efficiency: a qualitative study. Acta Anaesthesiologica Scandinavica 52, 1423–1428. Arora S., Hull L., Sevdalis N. et al. (2010) Factors compromising safety in surgery: stressful events in the operating room. American Journal of Surgery 199, 60–65. Berland A., Natvig G.K. & Gundersen D. (2008) Patient safety and job-related stress: a focus group study. Intensive and Critical Care Nursing 24, 90–97. Browne J.A. (2009) Healthy workplaces and ethical environments. A staff nurse’s perspective. Critical Care Nursing Quarterly 32 (3), 253–261. Bull R. & FitzGerald M. (2006) Nursing in a technological environment: nursing care in the operating room. International Journal of Nursing Practice 12, 3–7. Chen C.-K., Lin C., Wang S.-H. & Hou T.-H. (2009) A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle-level hospital operating rooms. Journal of Nursing Research 17 (3), 199–210. Chiron B., Michinov E., Chiron E.O., Laffon M. & Rusch E. (2010) Journal of Health Psychology 15 (6), 948–958. Cristian C.K., Gustafson M.L., Roth E.M. et al. (2006) A prospective study of patient safety in the operating room. Surgery 139, 159–173. Estryn-B�ehar M., Van der Heijden B., Og�ınska H., Camerino D., Le N�ezet., Conway P., Hasselhor H-M & the NEXT Study Group (2007) The impact of social work environment, teamwork characteristics, burnout, and personal factors upon intent to leave among European nurses. Medical Care 45 (10), 939–950. Gillespie B.M., Chaboyer W., Wallis M. & Grimbeek P. (2007) Resilience in the operating room: developing and testing of a resilience model. Journal of Advanced Nursing 59 (4), 427– 438. Gillespie B.M., Wallis M. & Chaboyer W. (2008) Operating theater culture. Implication for nurse retention. Western Journal of Nursing Research 30 (2), 259–277. Gillespie B.M., Chaboyer W., Longbotton P. & Wallis M. (2010) The impact of organizational and individual factors on team communication in surgery: a qualitative study. International Journal of Nursing Studies 47, 732–741. Hahtela N., Paavilainen E., McCormack B., Slater P., Helminen M. & Suominen T. (2014) Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care. Journal of Nursing Management 23 (7), 931–939. Hemmelgarn A., Glisson C. & Lawrence R.J. (2006) Organizational culture and climate: implications for service and interventions research. Clinical Psychology: Science and Practice 13, 73–89. Henry L., Hunt S.L., Kroetch M. & Yang Y.T. (2012) Evaluation of patient safety culture. A Survey of Clinicians in a Cardiovascular Operating Room. Innovations 7 (5), 328–337. Higgins B.L. & Macintosh J. (2010) Operating room nurses’ perceptions of the effects of physician-perpetrated abuse. International Nursing Review 57, 321–327. Kalisch B.J., Lee H. & Rochman M. (2010) Nursing staff teamwork and job satisfaction. Journal of Nursing Management 18, 938–947. Kuokkanen L., Suominen T., H€ark€onen E., Kukkurainen M.-L. & Doran D. (2009) Effects of organizational change on work-related empowerment, employee satisfaction, and motivation. Nursing Administration Quarterly 33 (2), 116–124. Lazarus R.S. & Folkman S. (1984) Stress, Appraisal and Coping. Springer Publishing Company, New York, NY. Leach L.S., Myrtle R.C., Weaver F.A. & Dasu S. (2009) Assessing the performance of surgical teams. Health Care Management Review 34 (1), 29–41. Lindwall L. & von Post I. (2008) Habits in perioperative nursing culture. Nursing Ethics 15, 670–681. Locke E.A. (1976) The nature and causes of job satisfaction. In Handbook of Industrial and Organizational Psychology (M. D Dunnette ed.), p 1304. Rand McNally, Chicago, IL. Mackintosh C. (2007) Making patient better: a qualitative study of registered nurses’ reasons for working in surgical areas. Journal of Clinical Nursing 16, 1134–1140. Manley K. (2008) ‘The way things are done around here”– developing a culture of effectiveness: a pre-requisite to individual and team effectiveness in critical care. Australian Critical Care 21, 83–85. Manley K., Sanders K., Cardiff S. & Webster J. (2011) Effective workplace culture: the attributes, enabling factors and consequences of a new concept. International Practice Development Journal 1 (2). Available at http://www.fons.org/library/journal/ aspx/, accessed 10 November 2014. McCormack B., Kitson A., Harvey G., Rycroft-Malone J., Tichen A. & Seers K. (2002) Getting evidence into practice: the meaning of ‘context’. Journal of Advanced Nursing 38 (1), 94–104. McCormack B., Dewing J., Breslin L. et al. (2010) Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal of Older People Nursing 5, 93–107. Meeusen V., Van Dam K., Brown-Mahoney C., Van Zundert A. & Knape H. (2011a) Understanding nurse anaesthetist’ intention to leave their job: How burnout and job satisfaction mediate the impact of personality and workplace characteristics. Health Care Management Review 36 (2), 155–163. Meeusen V., Van Dam K., Brown-Mahoney C., Van Zundert A. & Knape H. (2011b) Work climate related to job satisfaction among Dutch nurse anaesthetists. Journal of the American Association of Nurse Anaesthetists 79 (1), 63–70. Minnick A.F., Donaghey B., Slagle J. & Weinger M.B. (2011) Operating room team members’ views of workload, case difficulty, and nonroutine events. Journal of Healthcare Quality 34 (3), 16–24. Riley R. & Manias E. (2006) Governing time in operating rooms. Journal of Clinical Nursing 15, 546–553. Riley R. & Manias E. (2009) Gatekeeping practices in nurses in operating rooms. Social Science & Medicine 69 (2), 215–222. Rydef€alt C., Johansson G., Larsson P.A., �Akerman K. & Odenrick P. (2011) Social structures in the operating theatre: how contradicting rationalities and trust affect work. Journal of Advanced Nursing 68 (4), 783–795. Schein E.H. (2004) Organizational Culture and Leadership, 3rd edn. Jossey-Bass, San Francisco, CA. Slater P. & McCormack B. (2006) The Person-Centred Nursing Index. Instrument. University of Ulster, Ulster, UK Tengvall E. (2010) Professional Competence of Perioperative and Anaesthetist Nurse: a Questionnaire Research to Perioperative and Anaesthetist Nurses, Anaesthesiologists and Surgeons. Publication of the University of Eastern Finland. Dissertations in Health Sciences, no. 32. Available at: http://epublications. uef.fi/pub/urn_isbn_978-952-61-0226-9/, accessed 2 February 2015. Wakim N. (2014) Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. A generational perspective. Journal of Nursing Administration, 12 (44), 632–639. Weller J., Janssen A., Merry A. & Robinson B. (2008) Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crises. Medical Education 42, 382–388. Wilson G. (2012) Redesigning OR orientation. AORN Journal 95 (4), 453–462. Wilson V.J., McCormack B.G. & Ives G. (2005) Understanding the workplace culture of a special care nursery. Journal of Advanced Nursing 50 (1), 27–38. Wilson B., Squires M., Widger K., Cranley L. & Tourangeau A. (2008) Job satisfaction among a multigenerational workforce. Journal of Nursing Management 16, 716–723. World Health Organisation (2009) Guidelines for Safe Surgery. Available at: http://whqlibdoc.who.int/publications/2009/ 9789241598552_eng.pdf/, accessed 3 April 2014. World Medical Association. (2013).Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. Available at: http://www.wma.net/en/30publications/ 10policies/b3/index.html accessed 18 February 2015. Wovels A., Topp R.V. & Berger J. (2012) Understanding stress in the operating room: a step toward improving the work environment. Kentucky Nurse 60 (2), 5–7. Zhou H. & Gong Y.-H. (2015) Relationship between occupational stress and coping strategies among operating theatre nurses in China: a questionnaire survey. Journal of Nursing Management 23, 96–106.

PY - 2016/9

Y1 - 2016/9

N2 - Aims To investigate the workplace culture in the Operating Room (OR)environment and the factors associated with it.Background In health care, the workplace culture affects the delivery andexperience of care. The OR can be a stressful practice environment, where nursesmight have occasionally either job stress or job satisfaction based on theircompetence.Method A quantitative cross-sectional approach was used. The study consisted of96 Finnish OR nurses. A Nursing Context Index instrument was used to obtaindata by way of an electronic questionnaire.Results The primary role and working unit of respondents were the maincomponents relating to workplace culture, and especially to job stress. Nurseanaesthetists were found to be slightly more stressed than scrub nurses. In localhospitals, job stress related to workload was perceived less than in universityhospitals (P = 0.001). In addition, OR nurses in local hospitals were moresatisfied with their profession (P = 0.007), particularly around issues concerningadequate staffing and resources (P = 0.001).Conclusions and implications for nursing management It is essential that nursemanagers learn to recognise the different expressions of workplace culture. Inparticular, this study raises a need to recognise the factors that cause job stress tonurse anaesthetists.

AB - Aims To investigate the workplace culture in the Operating Room (OR)environment and the factors associated with it.Background In health care, the workplace culture affects the delivery andexperience of care. The OR can be a stressful practice environment, where nursesmight have occasionally either job stress or job satisfaction based on theircompetence.Method A quantitative cross-sectional approach was used. The study consisted of96 Finnish OR nurses. A Nursing Context Index instrument was used to obtaindata by way of an electronic questionnaire.Results The primary role and working unit of respondents were the maincomponents relating to workplace culture, and especially to job stress. Nurseanaesthetists were found to be slightly more stressed than scrub nurses. In localhospitals, job stress related to workload was perceived less than in universityhospitals (P = 0.001). In addition, OR nurses in local hospitals were moresatisfied with their profession (P = 0.007), particularly around issues concerningadequate staffing and resources (P = 0.001).Conclusions and implications for nursing management It is essential that nursemanagers learn to recognise the different expressions of workplace culture. Inparticular, this study raises a need to recognise the factors that cause job stress tonurse anaesthetists.

KW - job satisfaction

KW - job stress

KW - operating room nurse

KW - practice environment

KW - workplace culture

U2 - 10.1111/jonm.12376

DO - 10.1111/jonm.12376

M3 - Article

VL - 24

SP - 725

EP - 734

JO - Journal of Nursing Management

T2 - Journal of Nursing Management

JF - Journal of Nursing Management

SN - 0966-0429

IS - 6

ER -

Eskola S, Roos M, McCormack B, Slater P, Hahtela N, Suominen T. Workplace culture among operating room nurses. Journal of Nursing Management. 2016 Sep;24(6):725-734. https://doi.org/10.1111/jonm.12376