Health care reform and the scope of independence in decision making by environmental/family nurses. IV. Contracts realized by the payer and occupational independence of nurses.
New legal and organizational conditions enabled nurses to sign contracts directly with the disposers of allocations. It was anticipated, among others, that contracting specific health services would result in the staff obtaining greater independence in the matters of nursing. Showing one's own initiative at work may lead to an increase in satisfaction among patients and nurses, as well as the strengthening of the occupational position of nurses in the future. For this reason, the study was undertaken to confirm whether PHC nurses perceive the relationship between actual independence and performing work activities within individual or group contracts. The study was conducted in a form of a diagnostic survey, and covered 120 environmental/family nurses from non-public and public health care units. The results were analyzed from the aspect of statistical differences between the experimental and control groups. A significantly greater number of staff employed on the new basis performed independent tasks in the environment, compared to nurses employed in traditional structures. Differences were also observed concerning respondents' opinions in relation to freedom in making decisions experienced in various organizational forms. According to the respondents of the experimental group, group contracts guarantee a greater autonomy, while those of the control group evaluate individual practices in more positive terms.
Chair and Department of Management in Nursing, Faculty of Nursing and Health Sciences, Medical University of Lublin.
Anna
A
Ksykiewicz-Dorota
Beata
B
Kamińska
D003152:Community Health Nursing / Q000331:legislation & jurisprudence*; D003657:Decision Making; D018166:Health Care Reform; D006801:Humans; D007588:Job Satisfaction; D009723:Nurse-Patient Relations; D011044:Poland; D011795:Surveys and Questionnaires