Nurses perception of their work environment at a Referral Hospital in Western Kenya

Abstract

The nursing practice environment has been defined as the organizational characteristics of a work setting that facilitate or constrain professional nursing practice5 . Examples of these characteristics include the nature of nurses' relationships with managers and physicians, and the status of nurses within the hospital hierarchy. The purpose of this study was to assess the nurses’ perception of the work environment and the subsequent work morale using the Practice Environment Scale of the Nursing Work Index (NWI-R).Specific Objectives: 1).To determine the nurses’ work morale at the Moi teaching and referral hospital. 2). To determine the nurse physician relationship levels at the Moi teaching and referral hospital. We used a cross-sectional study design with consecutive sampling. Data was collected from 167 nurses working in various units in the month of August 2013. Analysis was done using the SPSS version 18.0, item total of all the five scales of the NWI-R factor analysis was done whereby the subscale mean scores were obtained. Qualitative responses were grouped according to similarities of phrases used to the NWI-R scales. These phrases were then used in the discussion. Of those interviewed, males were 29 and females138. Majority of the nurses (53%) had a feeling that they are not in control of their own practice. One third (32%) felt they rarely participate in policy decisions for the hospital. With regard to staffing, 55.7% agreed with the presence of adequate support services that allow them time to spend with their patients. Most of the nurses do not agree (means below 2.5) that they participate in hospital affairs, that there is nursing foundations for quality care that there is adequate staffing and resources and lastly that there is collegial relationship between them and physicians. It is only on the nurse manager ability, leadership and support that they seem to agree (mean of 2.8). Based on this study it is evident there is low morale among the nursing staff at the Referral Hospital (NWI-R score of below 2.5). The working relationship between nurses and physicians is poor (NWI-R score of below 2.5) There is need to engage nurses in morale boosting activities like refresher courses, recognition of a job well done, and engaging them more often in decision making activities in the hospital