Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Dr. Yolanda Babenko-Mould

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.

Summary for Lay Audience

Advances in surgical techniques and anaesthesia highlight the vital role of qualified nurses in perioperative settings. Factors like limited specialized education and inadequate continuous professional development (PD) have resulted in a global shortage of perioperative nurses (PNs). Supportive organizational cultures motivate more nurses to enter the specialty and engage in continuous PD. Both formal and informal PD opportunities are essential for PNs to gain advanced skills and expertise. However, a shortage of literature about PNs’ PD in low- and middle-income countries motivated this study to explore how a hospital’s organizational culture influences PNs’ PD at a hospital in Rwanda.

A qualitative approach, using focused ethnography as the study design, was conducted 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 study participants recommend to further advance organizational culture in Rwandan hospitals?. Data was collected through in-depth individual interviews and document reviews, transcribed verbatim, and key themes emerged in the data.

This study identified eight themes:(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

Perioperative nurses’ PD is a multifaceted phenomenon involving many stakeholders within and outside the hospital, and the support of this is essential for quality care delivery and professional integrity. The study identified a gap in PNs’ education and the need for continuous learning. Recommendations include hospitals and other key stakeholders prioritizing collaboration, advocacy, and investment in supporting PNs’ PD. Further research is encouraged to inform PNs’ education, practice, and PD projects in low and middle-income countries.

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Available for download on Friday, April 30, 2027

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