Nurses' Experiences of Restructuring in Three Ontario Hospitals
Bibliographic record
Abstract
PURPOSE: To describe the effects of restructuring, particularly redeployment, on nurses' personal and work lives, and to compare the utility of "survivor syndrome" and empowerment as alternative concepts for understanding these effects and planning change. METHODS: Twenty-six focus groups or interviews were held with 59 nurses working 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 compromised their ability to deliver effective care. CONCLUSIONS: Restructuring intensifies structural weaknesses in professions, such as nursing, whose members are primarily employed by bureaucracies. Nurses may not find survivor syndrome a useful model to explain their low morale following restructuring because it identifies nurses as "patients" in need of therapy. An empowerment model that takes into account nurses' concerns about uncertainty and integration may be more fruitful for devising strategies to enhance their ability to practice effectively in hospital settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.011 | 0.006 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".