Nurses Manage

This text is an investigation into "who does what, and why" on acute nursing wards. It examines the nature of the concept of decision-making at ward level, in the context of the relevant decision at different levels of the hospital hierarchy. It looks at all constraints operating at ward level such as workload, staffing levels, and upredictable disruptions to the routine and to planned care. It also examines the influence on behaviour of ward attitudes and philisophies. The book describes the development and implementation of a multidimensional data collection instrument, resulting in the acquisition, by means of over 500 hours of observations on 14 acute wards, of a detailed and unique database. The message of the book depends also upon a number of interview studies with both hands-on nurses and nurse managers, and a contextualizing study looking at the influence of broad trends and policies such as Project 2000, resource management, and computerised workload measurement.