병원조직구조의 특성에 따른 간호사의 전문직 정체성 = The Influence of Organizational Characteristics of Hospitals on the Professional Identity of Nurses

다국어 초록 (Multilingual Abstract)

In the hospital system, the nursing staff comprises the largest number of personnel as well as providing most of the interaction with patients. Despite many attempts to prescribe nursing as a profession, they aren't given many opportunities to develop themselves as professionals in Korea's hospital system, as shown in the low level of the career satisfaction of nurses and the high turnover rate among nurses. The previous studies on the professionalism of nurses have claimed that the professional identity of nurses are determined by an objective professional standard. Other studies emphasized only the influence of social-psychological variables.
This study tries out a systematical and structural analysis on the professional identity of nurses and thus to focus on the influence of the structural characteristics of the nursing delivery system. We compare and analyze the data obtained from two case studies, S hospital and H hospital, which are enforcing the modified primary nursing delivery system and the functional nursing delivery system, respectively. It is expected that the characteristics of each nursing delivery system would affect the level of professional identity of nurses. The results of the analysis are as follows.
First, comparing the two hospitals, S hospital has the best medical service as their managing ideology. In addition, its size and manpower are superior to H hospital. These enable S hospital to adopt the modified primary nursing delivery system.
Second, in a nursing unit of the modified primary nursing delivery system, the structural characteristics tend to be less complex, centralized and formalized than the functional nursing delivery system. These differences make it clear that the modified primary nursing delivery system is a more affirmative system in terms of the professional identity of nurses.
Third, in the modified primary nursing delivery system, the structural characteristics of nursing department tend to be less complex, centralized than the functional nursing delivery system. In the case of S hospital, nursing department is on the equal position with the medical and the administrative department in terms of hierarchy, which results in a positive influence on the professional identity of nurses.
This study enables a close sociological approach to the professional identity of nurses by introducing a systematic and structural view in a hospital system. This study suggests that the improvement of the professional identity of nurses no longer depends on the level of individual nurses but on the structural level of the hospital system, and more importantly on the level of policy-making. Despite of these findings, the theoretical notion of the nursing delivery system is still not in accord with the hospital practice.