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... nd more respected. Furthermore, they can greatly contribute to improving quality and reduction of costs. As Spence Laschinger et al. (2001) mention in their study, working in an environment favoring empowerment has many positive impacts. Firstly, nurses feel more satisfied with their work and secondly they are more committed to the organization.
Meyer and Allen (1991) distinguished three types of organizational commitment, affective, continuance and normative commitment. The one we are referring to, is affective commitment, which is defined as an individual's emotional attachment, identification with, and involvement in the organization. Proof of why empowerment should be implemented in the NHS has been given, and we will look at the limits of this strategy in the NHS after having talked about organizational culture. According to Holiday (1991), organizational culture refers to the norms, values and beliefs within this organization.
When looking at the characteristics of an ideal organizational culture determined by Harris and Hartman, it is clear that this strategy punctuates with empowerment. Truly, both tend to introduce management support, shared decision making, high level of trust, commitment to the organization and availability of information and resources. However, organizational culture, emphasizes more on co-operation and communication. In the health care system, patient care often involves various teams or departments, which results in a high dependence between them. In order to provide a certain quality of care to the patient, co-operation and communication across departments and within teams is crucial. The study led by Carson et al. (2001) explains how across department collaboration can be improved inside the NHS.
If employees get information from their supervisors helping them understand how other departments work and contribute to the organization, then they will better situate themselves and their department inside the organization. This will help the process of "socialization and enculturation", prevent employees to be confused as to what their role is and make them realize that there are no real injustice that exist between services. As a result work satisfaction and commitment will increase and nurses will feel that their work is more valued. As nurses spend most of their time communicating, it is important that they communicate in a clear and concise manner in order to correctly convey information. Flynn and Ricca (2000) gave advice on how to improve communication such as meeting with other nurses to get different perspectives and share clinical information to ensure best quality care. As communication between nurses, and other medical personnel takes a lot of time and energy, it is interesting to look at the new technologies available to encourage communication and reduce the time it demands.
Indeed, Linden and English (1994) discovered on a 6 ' 709 sampling that nurses spend at least 10 % of their time "looking for someone." Today, systems such as multi parameter alarm and waveform paging, wireless telephones and nurse call systems can reduce the amount of time "wasted" in commuting from one place to another leaving more time for patient care. Moreover, the internet and many other programs for example allowing to quicker access patient information, patients to self-register, deserve a closer look as to how it can help improve quality of care. Even though empowerment and organizational culture need time to be effectively implemented in the NHS system, it seems as though most hospitals haven't even tried since the 1980 s'. As to the ones who did, something appears to be slowing down the complete achievement of human resources management strategies. Two main reasons stand out from the study of Cunningham and Hyman (1996), operational and financial pressures.
They state that "financial imperatives placed severe limitations on the amount of resources allocated to the implementation of strategies. " This is understandable, as managers have to operate within government's financial limits. But where the contradiction lies, is that the governments are knowledgeable of the crisis affecting the NHS but can not react accordingly, even though resources are at hand. Verily, they have taken initiatives such as a major recruitment advertising campaign in 1999 in the UK or raising the starting salary. Managers state that operational requirements are such, that they do not have enough time left to take care of issues required to nurture a culture of high commitment and motivation among staff. But Cunningham and Hyman (1996, p. 20) suggest that "these findings perhaps indicate a failure among line managers to appreciate the importance of such matters" and " they were not entirely committed to the aim of fostering a commitment culture among staff." These suggestions, if revealed true, could certainly be the major explanation of why strategies have not yet been put in place. This underlined by Zairi (1998) who proposes as a starting point of the application of human resources management strategies: Leadership.
Managers play a crucial role in many of the strategies and changes. If they are themselves, not motivated, not committed to the organization then you can not expect changes to be successful or simply even made. Throughout this paper, we have analyzed the various matters resulting from organizational restructuring, affecting nurses working environment. It has been proven that all factors were linked, one bringing about an other, the latter worsening the first, and thus thrusting the National Health Systems into a vicious circle. As organizations are unable to recruit, satisfy and retain nurses, the biggest crisis of the NHS appears to be staff-shortage for it is one of the problems that engenders so many others. Where it should worry governments is that parallel to their desire to improve quality of care, shortage of nurses is threatening that same quality of healthcare.
We have shown that while various other industries have recognized the need to consider people as a key factor of their success, the healthcare sector seems to underestimate this philosophy. By looking at two major human resources management strategies, we have seen that if they could be successfully implemented in public hospitals, many of the problems would be solved. Indeed, by improving the working environment of nurses, less of them would forsake their jobs and young nurses would be easier to attract, thus diminishing the threat of nurses shortage on quality of care. Additionally, these strategies would allow nurses to participate in strategic planning and cost reduction, trough commitment towards organizational goals. However, these strategies have been proven effective for some time now, and even though the healthcare sector has known the same problems since the beginning of the 1980 's, very few hospitals have made efforts to improve the situation.
We looked at two major factors, financial and operational limits, which could be the reasons of the inability to implement strategies. But it seems they may not to be the direct reason, as financial resources are available and managers do not appear very motivated for real change as to organizational culture and commitment. Further research needs to be done in order to detect if the problems truly come from the financial and operational requirements managers are faced with or from the managers themselves. Bibliography 1.
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Gaithersburg: 20 (1), 10 - 18. 6. Clark, P. & Clark, D. & Day, D. & Shea, D. (2001). Healthcare reform and the workplace experience of nurses: Implications for patient care and union organization, Industrial & Labor Relations Review. Ithaca: 55 (1), 133 - 148. 7. Carson, K. & Carson, P. & Yallapragada, R. & Roe, CW. (2001).
Teamwork or interdepartmental cooperation: Which is more important in the health care setting? , The Health Care Manager. Gaithersburg: 19 (4), 39 - 46. 8. McConnell, E. (2001). Open the lines of communication, Nursing management. Chicago: 32 (3), 45. 9. Flynn, L. & Ricca, J. (2000).
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Stress and coping strategies in nurses from palliative, psychiatric and general nursing areas, Health Manpower Management. 22 (3), 10 - 12. 12. Cunningham, I. & Hyman, J. (1996). Empowerment: the right medecine for improving employee commitment and morale in the NHS? , Health Manpower Management. 22 (6), 14 - 24. 13. Zairi, M. (1998). Managing human ressources in healthcare: learning from world class practices: part I, Health Manpower Management. 24 (2), 48 - 57. 14. Zairi, M. (1998).
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Research essay sample on Human Resources Management Organizational Culture
