Survival of the fittest: An ethnographic study of Nurse Administrators
Culture is a powerful force that gives meaning to people's lives, reduces uncertainty, and creates stability. Many groups and organizations develop a culture which affects how people think, feel, and act. Nurse administrators, like those in any field, strongly influence the culture where their profession is practiced. Thus, the problem of this study was to describe and analyze a culture of nurse administrators at a large not-for-profit hospital. An ethnographic approach with participant observation and indepth interviews (semi-structured and unstructured) was used. Twenty respondents from the department of nursing were interviewed.
Data were analyzed and the cultural theme (concept) of survival emerged with three primary subconcepts: acceptance, types of group members, and success or failure. The culture of nurse administrators was based on the need for survival, thus directors devised methods to work in a cooperative manner and limit competition with each other for all to survive. These methods resulted in the development of survival strategies: learning the rules, mastering skills, gaining access, and getting along with the boss. Survival in the culture encompassed acceptance, functioning as a group member, and becoming successful.
Findings indicated that (a) nurse administrators expend time and energy on survival strategies to maintain their jobs, (b) there are no uniform or written sequential steps or designated patterns to follow in the process involving survival strategies, (c) formation of alliances contributes to survival, and (d) knowledge of informal rules is important. Implications indicated that survival strategies beneficial to the hospital should be supported and encouraged, but previous management experience does not guarantee that new nurse administrators will identify and master necessary survival strategies. Most nurse administrators learn successful survival strategies as well as informal rules by trial and error, and hospitals can provide help and support for new nurse administrators by developing mentorship programs based ideally on one-to-one relationships between experienced (mentor) and new (mentee) nurse administrators. Educational programs based on practical experiences in survival strategies can be provided by work-study programs, resident experience, and/or project opportunities.