Survival of the Fittest: A Hermeneutic Phenomenological Inquiry into the Lived Experiences of Hospital Bedside Nurses during Periods of Organizational Change

Abstract

The nursing profession has a rich history of nurse-nurse aggression. Despite three decades of examination, little is known about why the phenomenon exists. Understanding nurse-nurse aggression is imperative considering the impending nursing shortage and reports that fewer young people are pursuing nursing careers. Organizational change is a variable that has yet to be explored despite the constancy of change in the health care industry. This phenomenological study examined the experiences of registered nurses who had experienced a reorganization and downsizing while working at the bedside in a hospital setting. The purpose of the study was to determine if lateral aggression was a theme that emerged from the interview texts of registered nurses who had experienced at least one reorganization and downsizing while working at the bedside. To meet this objective, eight registered nurses with varying degrees of nursing and downsizing experience were interviewed. Van Manen’s (2000) six activities of hermeneutic research were then used to analyze the data. The results of this study indicate novice nurses and seasoned nurses have different understandings of the reorganization and downsizing experience. Furthermore, this study found multiple forms of aggression are present during periods of reorganization and downsizing, including lateral aggression. The findings of this study add to what is known about the experiences of registered nurses during periods of reorganization and downsizing, in addition to adding to extent knowledge about aggression in the nursing profession. This study offers several recommendations to nurse leaders and hospital administrators, predominately with regard to effectively communicating and effectively managing through periods of reorganization and downsizing.