A Focused Ethnography Exploring the Influence of Organizational Culture on Perioperative Nursing Professional Development at a Hospital in Rwanda, Africa
Abstract
Guided by a constructivist lens, a focused ethnography study was conducted to explore how a hospital’s organizational culture influences perioperative nurses (PNs) professional development (PD) at a hospital in Rwanda. With advances in surgical techniques and anaesthesia, highlighting the vital role of qualified PNs, factors like limited specialized education and inadequate continuous PD have resulted in a global shortage of PNs. Both formal and informal PD opportunities are essential for PNs to gain advanced skills and expertise. Supportive organizational cultures can enhance job satisfaction, reduce turnover, and motivate more nurses to enter the perioperative specialty and engage in continuous PD. However, there was a paucity of literature about the impact of organizational culture on PNs’ PD in low and middle-income countries, which motivated this study to explore how organizational culture influences PNs’ PD at a hospital in Rwanda, Africa. A qualitative approach was used in this study to address three research questions: 1) What values, assumptions, behaviours, and practices are enacted within a hospital organization in Rwanda that influence PNs’ PD? 2) How do organizational factors support or constrain PNs’ PD? and 3)What do informants/participants recommend advancing organizational culture in Rwandan hospitals to further support PNs’PD? Data were collected through in-depth individual interviews and document reviews. Using thematic analysis, eight key themes emerged:(1) PD to uphold professional integrity, (2) PD focused on delivering high-quality healthcare services, (3) Engaging in PNs’ PD, (4) PD, a multifaceted and systemic journey for PNs, (5) Continuous learning is essential for the nursing profession, (6) Recognizing and investing in PNs’PD-Benefiting nurses, patients, and the nation,(7) Teams-Enacting a spirit of teaching, and (8) Additional recommendations. The study identified that PNs’ PD is a multifaceted phenomenon involving many stakeholders within and outside the hospital. PNs’ PD is essential for delivering quality care and upholding nursing professional integrity. The gap in PNs’ competencies motivated the nurses to pursue continuous learning. Hospital administration and stakeholders shall prioritize collaboration, advocacy, and investment in PNs’ PD. Further research is encouraged in the area of perioperative nursing practice in low- and middle-income countries to inform quality improvement projects and the PNs’ education.