Edinburgh Napier University

  Building on the findings of a critical ethnography that investigated the impact of workplace culture on the delivery of person centred care in an acute surgical ward in regional Queensland, this presentation outlines a solution to the problem of dehumanisation, moral distress and distancing. It concerns the development of psychosocial safe spaces; that is, workplace environments that ensure nurses are valued, heard, engaged and able to practice safely and autonomously. This represents a shift from the current work climate in which participants believed their work was confined by doctors’ orders, the requirements of patient safety and fiscal restraints.

It is argued that while participants retained a philosophical commitment to providing compassionate person centred care they were constrained in a system that rendered them unable to consistently do so. The necessity for measurable outcomes and achievement of tasks disempowered and silenced nurses and diminished opportunities for compassionate care. Findings indicated that while nurses struggled to maintain their professional commitment to compassionate caring practice, high levels of moral distress ensued causing nurses to further emotionally distance themselves from patients.

Findings suggest that cultivating psychosocial safe spaces might encourage nurses to keep hold of their aspirations and values based practice, use warmth and creativity in their patient care, and support and validate each other’s efforts to make the workplace a friendly and humanistic environment. This strategy could help redress the prevailing culture of efficiency that tends to produce defensiveness and dehumanizing practices. Practice development is one solution as it adopts a facilitative approach to achieving excellence and leads to sustainable change, promotes workplace ownership and engagement, ultimately leading to person centred cultures. This has proved effective in other contexts and ought to be trialed in workplaces where nurses’ exhibit stress and patients complain of a lack of compassion.

Academic paper (PDF): Reorienting cultures of nursing care through the development of a psychosocial safe space.. Available from: https://www.researchgate.net/publication/308118166_Reorienting_cultures_of_nursing_care_through_the_development_of_a_psychosocial_safe_space [accessed Apr 4, 2017].