Comparison between the working environment of nurse managers and nursing assistants in the hospital context

Santos, José Luís Guedes dos; Erdmann, Alacoque Lorenzini; Peiter, Caroline Cechinel; Alves, Murilo Pedroso; Lima, Suzinara Beatriz Soares de; Backes, Vânia Marli Schubert

doi:10.1590/S1980-220X2017017103300

Acessibilidade / Reportar erro

Brasil

Revista da Escola de Enfermagem da USP

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 51 • 2017 • https://doi.org/10.1590/S1980-220X2017017103300 copy

Comparison between the working environment of nurse managers and nursing assistants in the hospital context

Comparación entre ambiente laboral de enfermeros gerentes y asistenciales en el marco hospitalario

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

Comparing the working environment of nurse managers and nursing assistants in the hospital context.

Method

A mixed methods research with concomitant triangulation of data developed in a university hospital in the South of Brazil. Participants in the quantitative study were 94 nursing assistants and 12 nurse managers. The data were collected using the Brazilian Nursing Work Index − Revised (B-NWI-R) and analyzed through descriptive and inferential statistics. Eight (8) nurse managers and 18 nursing assistants were interviewed for the qualitative study. The data were analyzed through thematic analysis.

Results

The total B-NWI-R mean score for nurse managers was 2.15±0.39, and for nursing assistants it was 2.22±0.39. No statistical significance was identified in the comparison between the groups (p=0.508). The qualitative results show the existence of collaborative relationships between nurse managers and nursing assistants.

Conclusion

The working environment was similarly evaluated by nurse managers and nursing assistants in the hospital context.

Nursing; Working Environment; Nursing, Supervisory; Nursing Administration Research; Hospitals, Public

Nurses	Managers (n=12)		Nursing assistants (n = 94)

Variables	n(%)	AM±SD*	n(%)	AM±SD*
Age (years)		35.92±7.98		38.3±9.66
Gender
Female	12(100)		86 (91.5)
Male	-		8 (8.5)
Marital status
With a partner	5(41.7)		48(51.1)
Without a partner	6(50)		40(42.5)
Others	1(8.3)		6(6.4)
Profissional experience (years)		11.55±8.26		13.96±8.72
Experience at the hospital (years)		9.77±7.8		12.53±9.89
Experience in the sector (years)		6.27±6.26		7.99±7.68
Training
Specialization	6(50)		43(45.7)
Master’s degree	5(41.7)		36(38.3)
Undergraduation	1(8.3)		9(9.6)
Doctorate degree	-		6(6.4)
Weekly workload (hours)		40.91±13		36.98±11.6
Other part-time work
No	9(75)		80(85.1)
Yes	3(25)		14(14.9)

Nurses	Managers (n=12)		Nursing assistants (n=94)		p-value

Subscales	AM*	SD**	AM*	SD**
Control over the environment	2.59	0.54	2.46	0.54	0.381
Organizational support	2.21	0.42	2.20	0.41	0.971
Physician-nurse relationship	2.02	0.54	2.16	0.54	0.466
Autonomy	1.93	0.95	2.09	0.51	0.365

Total B-NWI-R	2.15	0.39	2.22	0.39	0.508

MANAGER	ASSISTANT
Autonomy
We (nurse managers) have autonomy in part. They (nursing assistant) can have a greater autonomy, especially in care management (P21). They are the ones (nursing assistants) who define the patients that go to another part of the sector, the medication schedule (...), who indicates what to use for dressings (P22). All managers participate at meetings with the Director, and each of them raises the problems of their unit for discussion (P24).	I know everything that happens in the sector. (...) Everything goes by me (P17). It has happened that I had to (...) admit the patient myself (...) and do a delivery (P15). Unfortunately the institution is still centered on the hegemonic medical model. So we lose some autonomy (P4). Things do not always happen as you wish they would because there are hierarchies to be followed and to obey (P14).
Control over the environment
You cannot be choosing things to do. If you need to do a certain activity, you end up helping them (nursing assistants) (...) (P20). The quality of care is not reaching what is desired. (...) We are understaffed, we don’t have the complete team every day and a lot of things don’t get done (P22).	Workload is one of the things that hurts me. (...) Stress due to lack of material, lack of sufficient staff, (...) you can’t do anything (P10). (...) the number of doctor’s notes for staff medical leave is increasingly higher and this ends up hurting the team because it overloads some individuals, and these things make me feel helpless in this situation (P13).
Relationship with the physicians
In the care (as an assistant) I had a much better relationship with the physicians than I do now in a leading role. (...) Before the nurse was recognized as a leader (...), everything the physician wanted to do they would question the nurse if they could it and about what was best, and now the doctors simply come and do whatever they want (P23). Ninety-nine percent of the medical staff relates very well to the nursing staff, (...) one complements the activity of the other (P19).	Here, being a school hospital, we have a better opening than in other hospital settings. We are closer. (P8). It’s a good relationship. (...) We still can’t work in a multiprofessional way, not as we should. But it has improved a lot (P12). It’s easy to get along with the doctors. Of course there’s always someone that you pray it isn’t their shift. (P13).
Organizational support
We also participate in all the decisions that come from the Nursing Director (...) (P24). The nursing board is very close to the managers. We have a forum every 15 days where several issues of the sectors are discussed (...), the nursing director is a nurse who is above us, but they work with us (P19).	I can only thank both the immediate supervisor and the nursing director for how much our relationship is peaceful and open (P6). She (the director) is in the same “boat” as we are (...) (P10). The manager sends all the decisions that are made to us by email (...) (P13).

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: José Luís Guedes dos Santos. Universidade Federal de Santa Catarina, Centro de Ciências da Saúde. Departamento de Enfermagem Bloco I, Sala 404, Trindade. CEP 88040-970 – Florianópolis, Santa Catarina, Brazil. jose.santos@ufsc.br