Towson University.
University of Pittsburgh.
Nurs Ethics. 2024 Dec;31(8):1524-1536. doi: 10.1177/09697330241230520. Epub 2024 Feb 28.
Healthcare worker retention and burnout are confounding issues. Trust among workers and their employer, that is, organization, is an important yet underexplored concept in research.
The aim of this qualitative study is to explore organizational actions and systems that promote or denigrate trust among registered nurses and patient care aides (aides).
The study uses the Model of Psychological Contract as a theoretical framework. Focus groups were conducted to explore the concept of organizational trust and the consequences of broken trust.
Registered nurses (RNs) (n=6) and aides (n=6) participated in the study. Six focus groups (three RN and three aide) were conducted, with two participants per group. Focus groups were conducted online.
The study's methods were reviewed by the University of Pittsburgh Institutional Review Board.
Among RNs and aides, a sense of trust and feeling valued were important to their sense of relationship with their employers. Trust was breached when resources were scarce, employees did not feel validated and listened to, and problems were not addressed. RNs and aides described feeling devalued when compensation practices were unjust or inequitable, they had limited autonomy, and the employer created an organizational climate where business needs superceded human caring. Consequences of trust breach included burnout, dejection, and feelings of non-belonging.
Tangible organizational resources (compensation and staffing) and intangible resources (value, respect, autonomy) are important to RNs and aides alike. Inability to provide these resources diminishes trust and even causes a sense of betrayal.
Future research can explore the concepts of organizational justice and interventions to restore lost trust and improve healthcare worker well-being. This is one of only a few identified studies to explore organizational factors and well-being among aides and more research among this healthcare worker population is warranted.
医疗保健工作者的留用和倦怠是令人困惑的问题。员工与其雇主之间的信任，即组织，是研究中一个重要但尚未充分探索的概念。
本定性研究的目的是探讨促进或破坏注册护士和患者护理助理（助理）之间信任的组织行动和系统。
该研究使用心理契约模型作为理论框架。进行焦点小组讨论，以探讨组织信任的概念和信任破裂的后果。
注册护士（RN）（n=6）和助理（n=6）参加了这项研究。进行了六组焦点小组（三组 RN 和三组助手），每组有两名参与者。焦点小组在线进行。
匹兹堡大学机构审查委员会审查了该研究的方法。
在 RN 和助手之间，信任和被重视的感觉对他们与雇主的关系感很重要。当资源稀缺、员工感到没有得到验证和倾听以及问题没有得到解决时，信任就会被打破。RN 和助手在薪酬做法不公平或不平等、他们自主权有限以及雇主创造一种组织氛围，使商业需求优先于人类关怀时，感到被贬低。信任破裂的后果包括倦怠、沮丧和归属感缺失。
有形的组织资源（薪酬和人员配备）和无形的资源（价值、尊重、自主权）对 RN 和助手同样重要。无法提供这些资源会削弱信任，甚至导致背叛感。
未来的研究可以探索组织公正的概念和恢复失去的信任以及改善医疗保健工作者福祉的干预措施。这是为数不多的研究之一，探讨了助手的组织因素和幸福感，更需要对这一医疗保健工作者群体进行更多研究。
