Coping with unbalanced information about decision-making influence for nurses.

The leaders of the nursing profession are trying to change nursing so that nurses will be better able to practice their profession the way it is taught in nursing schools--in a manner that will afford them the job satisfaction, power, and prestige that will attract more of the best people into nursing. Part of what is encouraging these changes is a literature that calls for increased decision making power for nurses, power that often takes the form of increased decentralized, participative, or autonomous decision making. A problem with this literature is that a sizable portion of it is unbalanced in its support of nurse influence and in its opposition to hospital bureaucracy. This article illustrates and discusses this imbalance and considers what hospital administrators might do to cope with its consequences.