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Power Structures in Nursing Care

This SGW Open Competition XS funded project will study nurses’ experienced decision-making power in policy design for hospitals and patient care, using various qualitative methods.

Background
Although nurses are the largest group of health professionals which occupy a crucial role in healthcare, they rate their decision-making power as inadequate (5/10). This is reported by recent research among 2653 nurses in the Netherlands. Nurses experience a lack of input in policy-making, both on a micro scale (patient policy) and on a meso scale (hospital policy). This lack of input became clearly evident during COVID. For example, nurses were not represented in the outbreak management team (OMT), even though they formed the backbone of the COVID response.

Objectives
The project aims to improve nurses' power position, and thereby contribute to better patient care, better collaboration with doctors and higher job satisfaction. It is expected that this could also reduce the high dropout rate due to burnout among nurses. This is currently a major problem due to a shortage of nurses.

Approach
In collaboration with three Dutch hospitals, the project will examine which structures in hospitals influence nurses' power positions. The power position of nurses is examined using qualitative methods, such as ethnographic diary keeping, semi-structured interviews, partial participant observations, focus groups and multi-stakeholder workshops. The outcomes will be co-analysed together with involved nurses and presented to the board of directors of the OLVG and AUMC. In addition, the involved nurses will also participate in creating policy proposals to improve the power position of nurses. This will further the implementation of the findings in practice.

Project details

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