It has been documented that up to 40% of the workday of nurses is taken up by meeting the ever-increasing demands of the systems of healthcare delivery in which nurses are employed. These demands include the need for increasing documentation, for learning new and seemingly ever-changing procedures, and for adapting to turnover in management and administration. Attention to these issues also means that 40% of that workday is not available to patients. Believing that these increasing demands are affecting nurses' decisions to remain in nursing or to leave, a group of Minnesota nurses and nurse educators examined the work environments of nurses and the issues related to those environments. The result of this examination was discovery of a phenomenon affecting all nurses that may be central to the projected shortage of nurses. The phenomenon is complexity compression-what nurses experience when expected to assume additional, unplanned responsibilities while simultaneously conducting their multiple responsibilities in a condensed time frame. The phenomenon was validated by a group of 58 nurses who participated in focus groups that led to the identification of factors influencing the experience of complexity compression. These factors were clustered into six major themes: personal, environmental, practice, systems and technology, administration/management, and autonomy/control. Further validation studies are planned with the population of practicing professional nurses in the state of Minnesota.

Researchers in Minnesota have described and validated the phenomenon of Complexity Compression in qualitative studies of registered nurses. Analysis of themes from this research led to the design of a survey to assess nurses' agreement with variables that contribute to their experience of Complexity Compression. The survey was administered to a random sample of 199 registered nurses in Minnesota. Exploratory factor analysis was used to evaluate the attributes of Complexity Compression and its underlying structure. Three factors emerged that explained 51.4% of the variance in responses: work of nursing, systems, and personal factors. Internal consistency of the factors ranged from .79 to .89. Validity of the survey for assessment of Complexity Compression in hospital-based nurses was supported. The construct of Complexity Compression and its contributing factors will be tested in future studies with nurses in a variety of health care settings.

No abstract

No abstract