One definition of organizational culture is that the culture is the attitudes, values, behaviors, assumptions, and beliefs of those working in the organization (Gochhayat, Giri, & Suar, 2017). The hospital that I work for creates its culture from its core values and mission statement. These values include respect, honesty, service, performance, and stewardship (Baptist Health, 2019). The value that is the most substantial part of the culture is respect. Not only does it mean respect to our patients, but also to those we work with. The next most robust value is performance. This aspect of the culture can cause problems between units, as each unit can have different standards of performance. For example, when a patient in the emergency department is assigned a hospital bed, the ER nurse is expected to have the patient upstairs within 30 minutes. The floor, however, cannot always take a patient when the ER is ready to send the patient. With both units judged on their performance on transferring/admitting patients, respect can put to the side as each unit only things about their own performance goals.

This focus on performance is seen in other aspects of care within the hospital. In the emergency department, we are getting weekly stats on our half-hour rounding, a board in the break room showing everyone’s scanning rates, and emails regarding improper documentation or lack of documentation. While these are important for our patients, management can, at times, make it seem like specific stats matter more than genuinely taking care of the patient. For example, due to our half-hour rounding many nurses find it harder to do their jobs, as they have to ensure they have charted a rounding note on each of their 3 to 5 patients every 30 minutes. It has caused problems as there are questions on if charting certain procedures count, does it have to be exactly 30 minutes or just sometime between the top and bottom of the hour. It has also led to discontent as when asked why 30 minute rounding for the ER and not hourly, or what research was used to determine it, we are given no response.

As a nurse leader, I would want to analyze these metrics and then talk to staff to find out why are they not working? Since half-hour rounding is one of our lowest scoring areas, I would see with them what seems to work with it and what does not work. I would also talk with the administration to see if it could be changed to hourly rounding. I would look into this as research has shown hourly rounding is useful in helping keep patients updated, prevent falls, and address pain concerns (Hourly rounding, 2015). Another thing would be to arrange unit shadowing between units. This way, each unit can see the struggles that each unit goes through and can learn to have more respect for what they are going through and are expected to do. When nurses feel respected in their workplace, they are more likely to stay and be happy (Boafa, 2018).

References

Baptist Health. (2019). About Baptist Health. In Baptist Health. Retrieved from https://www.baptist-health.com/about-baptist-health-arkansas/

Boafo, I. M. (2018). The effects of workplace respect and violence on nurses’ job satisfaction in Ghana: a cross-sectional survey. HUMAN RESOURCES FOR HEALTH, 16. https://doi-org.ezp.waldenulibrary.org/10.1186/s12…

Gochhayat, J., Giri, V. N., & Suar, D. (2017). Influence of organizational culture on organizational effectiveness: The mediating role of organizational communication. Global Business Review, 18(3), 691. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edo&AN=123600377&site=eds-live&scope=site

Hourly rounding is a key contributor to patient-centered care at high-performing hospitals. (2015). ED Management: The Monthly Update On Emergency Department Management, 27(10), 109–113. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.or…Si