The Social Logic of Nursing Communication and Team Processes in Centralized and Decentralized Work Spaces

Real, Kevin; Santiago, Joshua E; Fay, Lindsey; Isaacs, Kathy; Carll-White, Allison

doi:10.1080/10410236.2018.1536940

Cited by 11 publications

(16 citation statements)

References 26 publications

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“…Decisions about the use of space may appear to be purely functional, having little to do with collaboration, but this is not the case. These findings build on existing research about space and its recursive relationship to communication (Barbour et al, 2016;Real et al, 2019) by focusing on the key variable of power relationships. This is an important area for future research, which should investigate how decisions are made, either explicitly or by default, about how groups occupy space during face-to-face interactions like meetings and in general (i.e., where different staff offices are located, who can enter and occupy different spaces, etc.…”

Section: Discussionmentioning

confidence: 74%

“…In contrast to the research that has focused on how communication impacts outcomes, other research has focused more on how factors like the physical environment impact communication, which in turn affects group collaboration. Unsurprisingly, health care groups that work in closer physical proximity were found to communicate better and more often (Hager et al, 2018;Real et al, 2019). Spatial boundaries also shape the type of communication that takes place in different spaces within health organizations and can reinforce disciplinary status "by locating those with less status in more visible and immoveable spaces but supporting flexibility of movement for those with higher status" (Barbour et al, 2016, p. 110).…”

Section: Collaborative Care In Health Organizationsmentioning

confidence: 99%

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Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups

Noyes

2021

Management Communication Quarterly

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Interdisciplinary health care groups increasingly face issues related to power and authority in the patient care process. Many of these issues stem from a tension between the historically entrenched hierarchy in health care organizations and the growing pressure of collaborative models of care that require a flattening of this hierarchy, greater mutual respect among disciplines, and more willingness to share power. This project used the framework of text and conversation to explore how groups negotiate this tension through communication. Findings suggest how some groups navigate texts that reinforce the hierarchy alongside texts that challenge it, creating a delicate balance of power that supports collaboration without threatening the position of those at the top of the hierarchy. Other groups primarily use texts that reinforce the hierarchy without consistently using texts that challenge it, which seems to make collaboration more difficult. These findings challenge the idea that equal balance should always be the goal of power sharing in collaborative interdisciplinary groups and offer a more nuanced understanding of how everyday group communication creates and recreates power relationships that impact collaborative care.

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Section: Discussionmentioning

confidence: 74%

Section: Collaborative Care In Health Organizationsmentioning

confidence: 99%

Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups

Noyes

2021

Management Communication Quarterly

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Section: Health Nursing Work and Social Supportmentioning

confidence: 99%

“…New research in social support in health care organizations has also begun to look at implications of space and design, where supportive design systems can improve relational communication among patients and staff [55]. For instance, centralized units and physical proximity enhanced communication between individuals and teams and fostered a supportive, communicative climate [55]. These new studies have just started to explore the implications of physical spaces and designs, which we believe are especially important during COVID-19 due to social distancing challenges.…”

Section: Health Nursing Work and Social Supportmentioning

confidence: 99%

“Everything Is Changing, but I Am Not Alone”: Nurses’ Perceptions of Social Support during COVID-19

Sahay

Wei

2022

Sustainability

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COVID-19 has created numerous stressors for nurses, which have impacted their work, self-efficacy, and wellness. Social support helps manage stress and burnout. Through 24 semi-structured interviews, the current article explores the perspectives of nurses who worked with COVID-19 patients in the initial days of the pandemic in the United States. This study unpacks the types and sources of social support nurses sought during this time, especially as they faced significant burnout. Through thematic analysis, the current study found that these nurses interacted with the crisis situation to evaluate their social support needs and the plausibility of fulfilling these needs. They focused on the support that was available or at least perceived to be available and let go of certain needs that could not plausibly be addressed in that moment. Peer-to-peer support was critical during this process, and nurses avoided sharing concerns with their families as they enacted protective buffering. The findings also highlight the complex and dynamic nature of social support as nurses interact with their peers and evaluate the support they receive. Peers helped with haptic support like providing hugs to coworkers, and at times even became surrogates for coworkers’ family members as they participated in communal coping. Organizational support was critical for sharing information centrally with nurses and for organizational sustainability.

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“…Finally, theory is an important consideration. The DNS is a system structure that influences the processes and outcomes in healthcare settings (Real et al 2017; Real, Fay et al, 2018; Real, Santiago et al, 2018). Systems theory is useful for understanding how nursing stations operate within complex systems comprised of many components, including built environment, department/unit, staffing, information technology, organizational culture, nursing care model, and more.…”

Section: Limitations and Future Workmentioning

confidence: 99%

A Systematic Literature Review of Empirical Studies on Decentralized Nursing Stations

Fay

Cai

Real

2018

HERD

Self Cite

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Objectives: The objective of this systematic review of literature was to critically evaluate peer-reviewed evidence regarding the effectiveness of decentralized nurse stations (DNSs). Background: The DNS has become an important topic in healthcare design research and practice over the past decade with aims of improving staff efficiency and patient experience. Research has shown to be inconclusive, with studies reporting an assortment of mixed findings. Method: A systematic review of literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses search process of electronic databases, citation tracking, and manual searches of references. All authors evaluated the studies independently. Studies included were empirical, peer-reviewed investigations of DNS in hospitals over the past 15 years. Each study was evaluated using an accepted healthcare design evaluation framework. Results: Over 200 studies were identified. After exclusions, 21 studies published since 2003 were available for full evaluation. Key findings from this review include (a) there is a positive trend toward patient experience in units with DNS, (b) nursing teamwork was perceived to decline in units with DNS, (c) methodological issues may be responsible for the mixed and inconsistent findings, and (d) there is no consistent categorization of nurse station typology or standard definition for DNS. Conclusions: Based on the evaluation framework, DNS are supportive of the patient experience yet have a negative impact on nursing teamwork. Higher quality studies are needed to classify specific typologies of DNS and account for elements such as patient care models, communication, visibility, and other patient care-related factors.

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The Social Logic of Nursing Communication and Team Processes in Centralized and Decentralized Work Spaces

Cited by 11 publications

References 26 publications

Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups

Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups

“Everything Is Changing, but I Am Not Alone”: Nurses’ Perceptions of Social Support during COVID-19

A Systematic Literature Review of Empirical Studies on Decentralized Nursing Stations

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