A Case Study of a Nursing Assignment Pattern

Abstract

At the threshold of the year 2000, the nursing environment is characterized by at least four important social forces - cost containment, nursing shortage, nurses' dissatisfaction with the profession and pressures to maintain and improve quality of care. A number of these social forces are directly linked to nursing assignment patterns practised at the unit level. The problems of absenteeism, turnover, staff dissatisfaction, quality of care and cost have been attributed to a given nursing assignment pattern (Giovannetti, 1986; Macdonald, 1988). The term "nursing assignment pattern" is used to describe roles, tasks and the policy structure that effect the allocation of nursing personnel to patients for the provision of care on a nursing unit. Previous work on nursing assignment patterns was influenced by administrative theories; the underlying philosophy was grounded in beliefs in objectivity, control, productivity and measurement of facts. Empirical research on nursing assignment patterns is commonly geared towards a perspective of cost containment, outcomes and predictability. On the other hand, there is also a holistic perspective and values are given to subjectivity, accountability and continuity of care, as well as to optimal human functioning through behavioural processes (Dunham, 1989; Jennings, 1987; Miller, 1987; Nyberg, 1989). These philosophical underpinnings led us to analyze events of a nursing assignment pattern within their real-life context. Therefore, this is a report of a case study describing the inherent elements in a currently practised assignment pattern in a nursing unit.