STAFF SECURITY AND WORK PRESSURE - CONTRASTING PATTERNS OF STABILITY AND CHANGE ACROSS 5 DIALYSIS UNITS

Differences among clinical care units in social dynamics and social or ganization are associated with differences in the clinical course of p atients with a range of chronic illness. These differences are also as sociated with well-being of staff members. Recent attention has focuse d on understanding these differences among units with an eye towards c orrecting deficiencies and enhancing strengths of clinical care units. The current study sought to delineate the effect of social and organi zational dynamics unique to each unit on staff perceptions of the secu rity of their relationships with other staff and their perceived work pressure. The unit as a major source of differences among staff subjec ts was compared with the impact of ethnic identity, of work in the mor ning shift vs other shifts, and of professional role. Results confirme d that unit membership was, by far, the most important correlate of st aff perceptions of the unit, particularly those concerning security of relationships with others and perceived work pressure. Moreover, the results suggested that unit differences in perceived security were due to differences among units in long standing turmoil within the unit o r long standing problematic ties between the unit and the larger insti tution which controls it. However, perceived work pressure seems more transient and may reflect the challenge of shorter-term fluctuations i n the demands of patient care. Copyright (C) 1996 Elsevier Science Ltd