title: Reshaping the practice environment: the importance of coherence.
abstract: Today's nurse leader is challenged to create a practice environment that fosters multidisciplinary collaboration, professional development, and a culture of safety. Fostering a sense of coherence among staff nurses about their place within the nursing department and the department's place within the broader organization id essential to the development of such environments. When nurses have a sense of coherence about their work setting, they are more likely to feel confident that their care of patients and families is fully supported by the organization in which they work. The authors describe the concept of coherence, discuss findings from a preliminary study regarding attributes that may contribute to coherence in individual nurses, and describe systems ans programs that have been implemented in a large academic medical center to foster a sense of coherence in individual nurses, the nursing department, and the institution as a whole.
authors.affiliation: Nursing and Clinical Services, Hematology/Oncology, BMT, and Patient Care Services Dana Farber Cancer Institute, Boston, MA 02115, USA. pat_reid_ponte@dfci.hardvard.edu
authors.forename: Patricia
authors.initials: P
authors.lastname: Reid Ponte
authors.forename: Nancy
authors.initials: N
authors.lastname: Kruger
authors.forename: Rosanna
authors.initials: R
authors.lastname: DeMarco
authors.forename: Diane
authors.initials: D
authors.lastname: Hanley
authors.forename: Genevieve
authors.initials: G
authors.lastname: Conlin
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D006126:Group Processes; D007857:Leadership; D009726:Nurses / Q000523:psychology*; D020399:Practice Management; D011787:Quality of Health Care; D012449:Safety; D014481:United States