Page 392 - Encyclopedia of Nursing Research

ORGANIzATIONAL CULTURe n 359

However, the substantive theoretical and of attitudes, values, behavioral norms, and
practical knowledge of self-care is the foun- expectations shared by the organization’s
dation for both dependent care and nursing members.” Organizational culture is often O
care. From this theoretical view, it is essen- distinguished from organizational climate,
tial that nurses have substantive knowledge a construct that also refers to the experience
about self-care and understand that human of working in institutions but which tends to
beings are both the focus of their actions vary over shorter time horizons and is often
and the agents of their actions (Orem, 1991). conceptualized and operationalized as hav-
In conclusion, nurses use the self-care deficit ing more of a personal and psychological
theory of nursing to aid them in their practice. component.
Many clinical studies have shown that imple- Schein (1985) writes of three levels of
menting Orem’s theory has a positive effect manifestations of organizational culture,
on patients, nurses, and health care organiza- each more challenging for the outsider to
tions. Orem’s seminal work, Nursing: Concepts identify, yet each progressively is more
of Practice, originally published in 1971, has unique and potentially useful in under-
been revised to its current sixth edition in standing how an organization functions: the
2001. Orem’s book remains a standard, hav- artifacts or outward trappings of an orga-
ing been published in seven languages and nization, including the physical environ-
implemented by nurses in over 19 countries. ment, that communicate the culture (e.g., the
meanings embedded in architecture, design,
Eileen Virginia Romeo uniforms) and the ways of accomplishing
Mary Jo Devereaux specific types of the work done by the orga-
nization (e.g., slogans). The second layer con-
sists of shared values or what is prioritized
and valued in the organization through the
OrganizatiOnal culture eyes of the group. On occasion, stated values
may be quite different from the “real” values
that guide decisions, rewards, and penalties.
Organizational culture is one of several con- The third layer consists of the basic assump-
cepts often brought to bear in studying the tions that are held by members of an organi-
settings where nurses tend to work (such zation and may take a great deal of patient
as hospitals and other health care institu- observation and analysis to uncover. Many
tions); it attempts to explain individual and writers assume culture to be built over the
group behavior in workplaces in terms of course of years and thus believe that it is not
longstanding, shared, and generally implicit particularly easy to change.
(as opposed to explicit) operating “rules.” Two fundamental approaches to study-
Organizational culture is a term used in ing organizational culture include quanti-
social science approaches to the study of tatively oriented self-reports (questionnaires
complex groups and workplaces that bor- or surveys) and qualitative approaches
rows and adapts from a core concept in (fieldwork approaches such as ethnography
anthropology referring to enduring systems and content analysis of organizational “arti-
of beliefs and customs (ways of being and facts”). Organizational culture researchers
doing) that guide interactions of a group’s must rapidly choose a stance in relation to
members with each other and with outsiders the nature of the underlying phenomenon
and that are transmitted from one genera- and the assumptions implicit in data collec-
tion of the group to the next. Schein’s (1985) tion strategies (i.e., whether culture can be
widely cited definition of organizational cul- captured by surveying members of an orga-
ture is “a cognitive framework consisting nization and aggregating their self-reports