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O r d e r N u m b e r 9426S57
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Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Development of a Conceptual Model for Nursing Service
Administration: A Phenomenological Study
By
H. Michael Wenger
BSN Goshen College May 1977
MSN Indiana University May 1981
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School of Nursing
Virginia Commonwealth University
1U./H '
mmi itee Member',s Marne and School Name
-2
Committee Member's Name and
d Schotfl Name
, ---
Af&jiL M o. Pa )_________________
Department Chair and Comnuttee Member's Name
Date
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H. Michael Wenger_________________ 1994
All Rights Reserved
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Acknowledgments
express.
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iii
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iv
Dedication
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V
Table of Contents
Page
List of T a b l e s ............................................vii
List of Figures...........................................viii
A b s t r a c t ................................................ ix
CHAPTER
1. Introduction......................................... 1
Purpose ........................................... 6
Underlying Philosophies .......................... 7
Research Question . . 9
S u m m a r y ........................................... 10
Model D e v e l o p m e n t ................................. 11
Existing Models forNursing Administration. . . . 14
S u m m a r y ........................................... 21
3. Methodology ....................................... 23
Scientific Rigor................................... 24
Sampling P l a n ..................................... 27
Data Collection Methods .......................... 29
Data A n a l y s i s ..................................... 33
4. Findings.............................................. 35
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vi
Reference L i s t ......................................... 95
APPENDICES
V i t a ....................................................... 108
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vii
List of Tables
Table Page
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List of Figures
Figure Page
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Abstract
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X
service administrators.
knowledge development.
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C H A PT E R 1
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2
be described.
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3
in this research.
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4
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5
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6
Purpose
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7
administration.
Underlying Philosophies
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are positivism and phenomenology (Taylor & Bogdan, 1984) . The
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9
administration.
Research Question
administrators?
Summary
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10
administrators.
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C H APTER 2
Literature Review
Model Development
11
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12
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13
1992).
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14
described further.
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15
E
N
V
I
R
0
N
M
. S E
N
SYSTEMS OUTCOMES T
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task, and general sectors. Health and client were the unifying
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17
mfi&Zki:
GENERAu,ENVIRONM ENT
V ( achnolog
T A S K ENVIRONMENT
INTERNAL
C onsum ers ENVIRONMENT Producers \h w
Client/Health
Nursing Technology
Nursing Administrative Practice
Organization
P rofessions
'^SocfS,Cultural Political-Legal
Reprinted by permission.
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18
Nursing
_ \
theory
Nursing
Nursing
administrative
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19
concerns with one system goal (Scalzi & Anderson, 1989). The
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20
N URSI NG
ORGANIZATIONAL DOMAIN
E F F E C T I VE N E S S INTERFACE
concern c o n c e rn
QUALI TY
ORGANI
NURSING
ZATIONAL
v DOMAIN PRODUCT
S YS TE M V I T A L I T Y
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21
service administration.
useable m o d e l .
Summary
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22
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CHAPTER 3
Methodology
of something as it appears.
23
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24
Scientific Rigor
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25
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26
that people say is a part of their lives and makes sense, (c)
experience.
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27
issues.
Sampling Plan
desired.
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28
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29
the sample.
the sample was gained through the chief nursing officers and
90 minutes.
research tool and must learn what questions to ask and how to
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30
Table 1
Demographic Data of Sample (n=10)
1. Gender
Frequency
Female 10
Male 0
Associate Degree 3
Diploma 1
Baccalaureate 6
Baccalaureate (nursing) 1
MSN or MA (nursing) 8
MS or MA (other than Nsg) 1
Range = 13-34
Mean = 22.1
Range = 7-19
Mean = 14
6. Clinical Specialty
(some participants indicated more than one area)
Frequency
Critical Care 2
Emergency Nursing 1
Labor and Delivery 1
Oncology 1
Pediatrics 1
Medical/Surgical 2
Neuroscience 1
Neurosurgery 1
Recovery Room 1
None 1
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31
Table 1
Demographic Data of Sample (n=10)
(continued)
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32
professional experiences.
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Data Analysis
tapes for accuracy, and then listened for themes and essences.
familiarity with the data and ability to analyze the data. The
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34
participants.
administrators.
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CHAPTER 4
Findings
35
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36
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Figure 5 .
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need to be made. I just came from a meeting, talking with
while we are going through what this means, and also deal
experience.
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39
did his residency here with us. But, really from, you
know he's been with me a little over a year now and doing
rather than just what the finances and space look like.
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40
behaviors?
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41
word, but it's the best one I can think of right now.
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42
needs of persons.
said, "I am aware of what impact the decision has on the front
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43
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look at all the pieces and try and put it together right
playing field is the health care system. This broad view was
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Figure 6
^ eo \* Core Systenj
IN ST IT U T IO N S
M eeting N e e d s of Persons
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46
system."
issues that we work with are really much more health care
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there is a direct phone number and that is given to that
person and a packet for the physician and for the primary
updated information.
system.
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48
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those regulations?
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said, "One of the problems with our system is that we make the
think that in this day and age of health care reform and
in this example.
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51
administrators.
far you could go. And there was a lot of, a world that
certainly no more than two years from now. And I'm not
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industry or business.
those places that have tried that have had some major
Administrators
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meanings and the words used for the concepts were those used
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Figure 7
L
\th Care SySf{
IN ST ITU T IO N S
M eeting N ee d s of Persons
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55
the practice."
much about that, but trying to carve out the time for
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School stopped doing CE, we were in a good position and
illustrative example.
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that with other people and I think you tend to, probably.
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but a mentoring program. It also builds professional
man for himself, and we've just got to get past that
provide role modeling for your staff, staff that work for
it.
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60
nursing home where the mother was with the daughter and
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was left in a room and tied and we know that that happens
And she told me that the mother had now forgotten this
come out and told her that we were going to take care of
The nurse went on with a second example and then said, "Those
but they are things that I think are important and so in the
think I prioritize."
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62
Another related:
communicating.
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63
Another said:
We get lots of information that's not prepared in a
format that we can make any sense out of and what unit
way.
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losing in lost charges, etcetera, etcetera, all those
Another said:
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65
survival as an industry.
major part of any nursing exec's life and how can we do what
hospital administration."
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66
cents, but what? How will it change patient care and what
to develop? What are we, you know, how much support are
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67
take that back to the unit base level and talk to the
the state.
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68
the community.
think we are all, the days of being fat and happy are
look in what does this mean five years from now? Yes, it
are viewed when you go out into a company and you want
organization] or whatever?
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concepts.
follows.
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70
the end of the day you've called all the right people and
sharing. That has been in place for three months and has
is now coming and saying okay, where else can we, you
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would be wonderful.
examples.
the first year we are gonna more than, have more than
a little money.
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72
administrators.
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said:
o thers.
facilitating.
interactive pieces.
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74
So that they feel like that they have a real live person
that they can talk to and that can explain things to and
that work within their region are, really feel like I'm
advocate.
Another said:
and say, "All right. Well, tell me why you think that's
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going to work." People have to have a sense that you
trust them and that you know they can do the work so
give suggestions. And you say, "Well, I'm not sure that
Administration
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76
Other Data
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77
compatible.
ways the needs of staff were met. One participant said, "So we
major piece of what you have to pay attention to." The concern
service administrators.
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CHAPTER 5
78
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and their meanings are the themes that capture the essence of
said patients, the term clients was chosen for this model to
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81
Figure 8
^co\* CareSystem
INSTITUTIO NS
M eeting N ee d s of Persons
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82
making. The bottom line question is, "Will this meet the needs
institution?"
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83
field.
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84
environment.
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85
organization.
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86
the unique health care system as the playing field for nursing
institution.
service administrators.
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87
institutions.
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88
care system does not preclude vision, but directs the nursing
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90
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91
administrators.
Two other areas that need further study are the effects
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92
based disciplines.
Summary
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93
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95
References
Publication.
Century-Crofts.
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Gardner, D. L. , Kelly, K. , Johnson, M. , McCloskey, J. C.,
Viking.
La n g e .
7,28.
78-82 .
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Morse, J. M. (1989). Strategies for sampling. In J. Morse
Publication.
2(1), 20-28.
Century-Crofts.
43-49.
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Omery, A. (1983) . Phenomenology: A method for nursing
Lippincott.
2342B.
2(1), 9-13.
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Scalzi, C. C. (1989) . A conceptual model for nursing
Virginia.
Scientific.
California.
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100
& L a nge.
Co.
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Appendix A
Interview Critique
responses?
8 . Other comments:
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102
Appendix B
Demographic Sheet
1. Gender.
6. Clinical specialty.
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Appendix C
Interview Guide
administration.
service administrator.
administrator.
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104
Appendix D
Introduction
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Appendix E
being in the study. Please read the entire form, initial the
bottom of each page in the space provided, and sign your full
Investigator's Nam e :
Introduction:
Benefits:
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106
participants.
Cost of Participation:
Confidentiality of Records:
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107
Withdrawal:
that I h a v e .
Participant's Rights;
Chairperson -
Richmond, VA 23298-0001
Consent:
read this form fully, I have received a copy of the form, and
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108
Vita
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