Glasgow Caledonian University, Glasgow, Scotland, UK.
NHS Education for Scotland, Glasgow, Scotland, UK.
J Nurs Manag. 2015 Oct;23(7):940-4. doi: 10.1111/jonm.12239. Epub 2014 May 21.
This paper explores two theoretical perspectives that may help nurse managers understand why staff tolerate suboptimal standards of care.
Standards of care have been questioned in relation to adverse events and errors for some years in health care across the western world. More recently, the focus has shifted to inadequate nursing standards with regard to care and compassion, and a culture of tolerance by staff to these inadequate standards.
The theories of conformity and cognitive dissonance are analysed to investigate their potential for helping nurse managers to understand why staff tolerate suboptimal standards of care.
The literature suggests that nurses appear to adopt behaviours consistent with the theory of conformity and that they may accept suboptimal care to reduce their cognitive dissonance.
Nurses may conform to be accepted by the team. This may be confounded by nurses rationalising their care to reduce the cognitive dissonance they feel.
The investigation into the Mid Staffordshire National Health Service called for a change in culture towards transparency, candidness and openness. Providing insights as to why some nursing staff tolerate suboptimal care may provide a springboard to allow nurse managers to consider the complexities surrounding this required transformation.
本文探讨了两个理论视角，可能有助于护士长理解为什么员工会容忍护理标准的不理想。
多年来，在整个西方世界的医疗保健中，护理标准一直受到与不良事件和错误相关的质疑。最近，焦点已经转移到护理和同情心方面的护理标准不足，以及员工对这些不达标标准的容忍文化。
对遵从性和认知失调理论进行分析，以调查它们帮助护士长理解为什么员工容忍护理标准不高的潜力。
文献表明，护士似乎采用了与遵从性理论一致的行为，并且他们可能会接受不理想的护理，以减少他们的认知失调。
护士可能会为了被团队接受而遵从。这可能会因护士合理化他们的护理以减少他们感到的认知失调而变得复杂。
对米德尔塞克斯国家卫生服务中心的调查呼吁文化转变，以实现透明度、坦诚和开放性。深入了解为什么一些护理人员会容忍不理想的护理，可能为护士长提供一个跳板，让他们考虑到这一必要变革所涉及的复杂性。
