April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: A Qualitative Application of Structurational Divergence Theory to Evaluate Socio-Cultural Structures in the Nursing Sector
Although the nursing sector is expected to grow by nine percent in the United States of America (Bureau of Labor Statistics, 2020), it has faced a consistent shortage of registered nurses (RN) that has been projected between 2016-2030, specifically in the Southern and Western parts of the United States (Zhang et al., 2018). Authors 4 and 5 (2017) found intergenerational hostility and the administration’s view of “nurses as dispensable resources” as few reasons attributing to the shortage in nursing. This study extends the work of the fourth and fifth authors by examining how intergenerational hostility is communicatively manifested and tied to organizational structures. Interviews with nurses (N=50) from two data sets were analyzed. The first set of data was collected in 2013 (n=32; female=29, male=3) and the second set of data was collected in 2017-18 (n=18; female=15, male =3). From the first set of data, three questions that focused on managing stress at work, guiding new nurses, and concluding thoughts by the participants were coded. The second set of interviews were fully coded as they explored the phrase “nurses eat their young” to understand how it was communicatively manifested in healthcare institutions. The recent global pandemic highlighted the importance of effective communication for nurses to provide care (Simonovich et al., 2021). We propose that while the nursing field will be changed by COVID-19, any changes in communication effectiveness will build on pre-existing structures, thus, necessitating analysis of pre-existing data. Structurational divergence theory (SDT) was applied to understand participants’ experiences. Nicotera and colleagues (2013, 2014, 2016) posited that a “structurational divergence” occurs when an institutional position (i.e., nexus) is formed due to contradictory and equally urgent obligations. This creates a structurational cycle resulting in unresolved issues of a group of people. SDT facilitated in identifying various competing sets of structures that created communication issues for nurses including: 1) the healthcare sector requires nurses to physically and mentally multitask, and manage emotions on a daily basis to prioritize patient care 2) the gendered nature of nursing which creates subservience for female nurses from their male counterparts, male physicians, and sometimes patients. 3) hierarchical organizing within health care teams (doctors, nurses, CNAs) 4) intergenerational issues created by a lack of experience of younger nurses, and the fast-changing pace of healthcare for elder nurses 5) the service element attached to the job fosters the need to care with confidence, while managing self-doubt and self-care These structural sets highlight systemic issues and institutional challenges that are acutely experienced by the healthcare sector. We found that while communicating within these structural sets, nurses are caught in a system which ‘gaslights’, and contributes to a divergence cycle leading to workforce shortages in the sector. We recommend that public and private healthcare administrators need to invest in addressing a few core issues which affect the communication with and amongst nurses to create a healthier work environment for a pertinent part of our healthcare industry.