Nurses' experiences of restructuring in three Ontario hospitals

Purpose: To describe the effects of restructuring, particularly redeploymen t, on nurses ' personal and work lives, and to compare the utility of "surv ivor syndrome" and empowerment as alternative concepts for understanding th ese effects and planning change. Methods: Twenty-six focus groups or interviews were held with 59 nurses wor king in three hospitals in Ontario, Canada. Findings: Participants described how restructuring strategies had affected them as individuals, as members of nursing teams, and as employees. In each of these aspects of their work lives, relationships became less integrated , their work activities became less controllable, and the changes compromis ed their ability to deliver effective care. Conclusions: Restructuring intensifies structural weaknesses in professions , such as nursing, whose members are primarily employed by bureaucracies. N urses may not find survivor syndrome a useful model to explain their low mo rale following restructuring because it identifies nurses as "patients" in need of therapy. An empowerment model that takes into account nurses' conce rns about uncertainty and integration may be more fruitful for devising str ategies to enhance their ability to Practice effectively in hospital settin gs.