Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria.
J Health Organ Manag. 2021 Jan 27;ahead-of-print(ahead-of-print):50-65. doi: 10.1108/JHOM-03-2020-0103.
This ethnographic revisit of a general hospital aims to critically explore and describe the mechanisms of corporate culture change and how institutional excellence is facilitated and constrained by everyday management practices between 1996/1997 and 2014/2015.
DESIGN/METHODOLOGY/APPROACH: A five-month field study of day-to-day life in the hospital's nursing division was conducted by means of an ethnographic revisit, using participant-observation, semi-structured interviews, free conversations and documentary material.
Using labour process analysis with ethnographic data from a general hospital, the corporate culture is represented as faceted, complex and sophisticated, lending little support to the managerial claims that if corporate objectives are realised, they are achieved through some combination of shared values, beliefs and managerial practices. The findings tend to support the critical view in labour process writing that modern managerial initiatives lead to tightened corporate control, advanced employee subjection and extensive effort intensification. The findings demonstrate the way in which the nursing employees enthusiastically embrace many aspects of the managerial message and yet, at the same time, still remain suspicious and distance themselves from it through misbehaviour and adaptation, and, in some cases, use the rhetoric against management for their own ends.
What are the implications for clinical and managerial practitioners? The recommendations are to (1) develop managerial practitioners who are capable of managing change combined with the professional autonomy of clinical practitioners, (2) take care to practise what you preach in clinical and managerial reality, as commitment, consent, compliance and difference of opinion are signs of a healthy corporate culture and (3) consider the implications between social structures and human actions with different work behaviours on different levels involved.
ORIGINALITY/VALUE: This ethnographic revisit considers data from a labour process analysis of corporate culture change in a general hospital and revisits the ways in which contradictory expectations and pressures are experienced by nursing employees and management practitioners spread 17 years apart.
本民族志研究旨在批判性地探讨和描述企业文化变革的机制，以及在 1996/1997 年至 2014/2015 年间，日常管理实践如何促进和限制机构卓越。
设计/方法/方法：通过民族志回访，对医院护理部门的日常生活进行为期五个月的实地研究，采用参与观察、半结构化访谈、自由对话和文献资料。
利用劳动过程分析和来自综合医院的民族志数据，企业文化被描述为多面、复杂和复杂的，几乎不支持管理层的说法，即如果实现了公司目标，那么这些目标是通过共同的价值观、信念和管理实践的某种组合来实现的。研究结果倾向于支持劳动过程写作中的批判观点，即现代管理举措导致公司控制更加严密，员工更加服从，工作强度大大提高。研究结果表明了护理员工热情地接受管理信息的许多方面，但同时，他们仍然通过不当行为和适应来保持怀疑和与信息保持距离，并且在某些情况下，他们会将管理言论用于自己的目的。
对临床和管理从业者有何影响？建议是（1）培养能够管理变革的管理从业者，同时保留临床从业者的专业自主权，（2）在临床和管理实践中要言行一致，因为承诺、同意、遵守和意见分歧是健康企业文化的标志，（3）考虑不同层次的不同工作行为之间的社会结构和人类行为的含义。
原创性/价值：本民族志回访考虑了来自综合医院企业文化变革劳动过程分析的数据，并重新审视了护理员工和管理从业者在相隔 17 年的时间里经历的矛盾期望和压力的方式。
