Abstract
The environment in which nurses deliver care is always changing. In this modern context, there has been a step away from the traditional central nurses' station to decentralised, satellite workstations. Literature on this topic shows there are both positives and unintended challenges of this design for nurses, specifically related to physical exertion, teamwork, communication, collegiality, and isolation. This research project sought to evaluate the experiences of nurses working within decentralised workstations in New Zealand to explore the intersection of the physical environment and its impact on nurses and nursing care.
The study had two main aims:
1. Determine the potential advantages and limitations of decentralised nursing stations
2. Identify the strategies that could be utilised in the decentralised nursing station (DNS) setting to improve the work environment for nurses who work in this context.
Methods: The research design was exploratory qualitative. Two focus groups were held at a tertiary level rehabilitation hospital. Each focus group consisted of seven participants and ran for approximately 30 minutes. The student researcher facilitated the focus groups, using a semi-structured format, with questions pre- planned but adapted to the flow of the conversation. The focus groups were audio-recorded, and the audio transcribed for analysis. The data was analysed using a thematic analysis.
Findings: The findings demonstrated a dichotomy of decentralised workstations in that there were benefits for patients due to a quicker response to call bells, nurses in close proximity and nurses communicating more with families. On the other hand, the nurses felt isolated which affected teamwork, collegiality and nursing culture. The nurses also faced challenges related specifically to the ward design as the layout meant increased walking, less patient visibility, and limited knowledge of other patients on the ward. There was also limited space when they needed to document their nursing care.
Conclusion: There is a need for well-researched and considered hospital design, with both the patient and the staff considered during the planning process.