Professional identity |
• Professional values pride, esteem and autonomy. |
• Best practice nursing care standards. |
• Holistic patient care, with positive caring and emotional focus linked to job satisfaction. |
Training, development and progression |
• Professional nursing care standards, ‘evidence-based’ best-practice approaches to nursing. |
• Lack of available resources for training and development – as required by professional bodies. |
• Training and development becoming more academic, with less focus on ‘beside care’. |
• Fewer prospects for promotion, with promotion more towards management roles and responsibilities at the expense of professional nursing. |
Management decision-making |
• Managerial decision-making and involvement paradox – moving further away from professional nursing role. |
• Fewer resources available for patient care, professional training and development, and terms and conditions of nursing professionals. |
• Deskilling through greater use of unqualified and agency nurses. |
• Emphasis on cost issues as the basis for ‘organisational performance’, rather than quality care. |
Resource and performance management |
• Emphasis on cost issues as the basis for ‘organisational performance’. |
• Greater use of unqualified and agency nurses. |
• Fewer resources for professional training and development. |
• Fewer resources available for quality patient care. |
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Trust within immediate ward environment and with line manager |
• The salience of trust in immediate ward environment, amongst nurse line-manager and nurse colleagues. |
• Managers outside ward ‘distant’ and removed’ – with limited insight into the impact of decision-making at ward level. |
• Immediate ward environment: nurse line-manage and colleagues act as the basis for establishing and building trust. |
• Role of line manager in positively or negatively influencing trust. |
• Managers outside ward are environment ‘distant’ and removed’, with limited insight into the impact their decision-making has at ward level. |
Reciprocity |
• Trust facilitated and established through active communication, engagement and reciprocal gestures demonstrating trust and good faith. |
Propensity towards trusting others |
• Propensity to trust and reciprocity linked to previous work history, work experience, training, political views, psychological contract issues, profession, staff association and union membership. |