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Workplace culture and critical thinking.

機譯：工作場所文化和批判性思維。

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摘要

An ethnographic case study design was used to describe from the nurse's perspective the workplace cultural influences on the quality of critical thinking in medical-surgical nurses working in a non-Magnet community acute care hospital. A conceptual framework was developed from the literature and the researcher's professional experience to identify potential cultural elements that might influence the quality of critical thinking. Organizational and unit based management, workplace systems and processes, and workplace relationships, including unit staff nurses, physician and interdepartmental relationships were explored.;Twenty RNs from two different medical-surgical units in one hospital were observed while working and interviewed to determine the quality of the RNs' critical thinking, the nature of workplace culture, and to identify how the culture influenced the RNs' quality of critical thinking. The observations were conducted using an unstructured interview technique and the interviews were conducted using a semi-structured interview guide.;The RNs quality of critical thinking was most influenced by what management emphasized and reinforced and by the absence of two way dialogue between the staff and management. Given the limited emphasis on clinical excellence, the nurses relied heavily on experienced practitioners to make clinical decisions. They created a culture in which harmonious relationships and peer support was paramount. This culture assured that the best clinical decisions were made in the absence of clinical guidelines and defined standards for practice. Negative physician relationships affected the quality of the RNs' critical thinking by causing the RNs to discontinue their thinking, because they were not heard or they were embarrassed. The RNs believed that the patient's condition and their nursing peers had the most profound influence on the quality of their critical thinking, even though through their actions, it was evident that management had the greatest influence.;Nursing leadership must be certain the needs of the patients served are adequately represented by focusing on clinical excellence and improved patient outcomes. A hospital culture must be nurtured that encourages two way dialogue, questioning of the status quo, tolerance for disagreement, on-going learning and the expressed desire for improved critical thinking.
機譯：使用人種學案例研究設計從護士的角度描述了工作場所文化對在非磁鐵社區(qū)急診醫(yī)院工作的外科護士的批判性思維質(zhì)量的影響。從文獻和研究人員的專業(yè)經(jīng)驗中建立了一個概念框架，以確定可能影響批判性思維質(zhì)量的潛在文化元素。探索了基于組織和單位的管理，工作場所的系統(tǒng)和過程以及工作場所的關系，包括單位工作人員護士，醫(yī)師和部門間的關系。；在工作中，對來自一家醫(yī)院兩個不同內(nèi)科部門的二十名注冊護士進行了調(diào)查并進行了訪談，以確定質(zhì)量RN的批判性思維，工作場所文化的性質(zhì)，以及確定文化如何影響RN的批判性思維的質(zhì)量。觀察是使用非結(jié)構(gòu)化訪談技術進行的，訪談是使用半結(jié)構(gòu)化訪談指南進行的。RN批判性思維的質(zhì)量在很大程度上受到管理層強調(diào)和強調(diào)的內(nèi)容以及員工與員工之間缺乏雙向?qū)υ挼挠绊懝芾?。鑒于對臨床卓越性的重視有限，護士們嚴重依賴經(jīng)驗豐富的從業(yè)人員來做出臨床決策。他們創(chuàng)造了一種文化，在這種文化中，和諧的關系和同伴的支持至關重要。這種文化保證了在沒有臨床指南和實踐標準的情況下做出最佳的臨床決策。消極的醫(yī)師關系通過使RN停止思考而影響了RN批判性思維的質(zhì)量，因為他們沒有聽到或感到尷尬。 RN認為患者的狀況以及他們的護理同伴對他們批判性思維的質(zhì)量影響最大，盡管通過他們的行動，很明顯管理層的影響最大。;護理領導必須確定患者的需求。通過專注于卓越的臨床表現(xiàn)和改善的患者預后來充分代表服務的患者。必須培養(yǎng)一種醫(yī)院文化，以鼓勵雙向?qū)υ?，對現(xiàn)狀的質(zhì)疑，對分歧的容忍，持續(xù)的學習以及表達對改進批判性思維的渴望。

著錄項

  • 作者

    Lockwood, Barbara J.;

  • 作者單位

    University of Illinois at Chicago.;

  • 授予單位 University of Illinois at Chicago.;
  • 學科 Health Sciences Nursing.
  • 學位 Ph.D.
  • 年度 2009
  • 頁碼 175 p.
  • 總頁數(shù) 175
  • 原文格式 PDF
  • 正文語種 eng
  • 中圖分類 遙感技術;
  • 關鍵詞

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