Nursing agency and governance: registered nurses' perceptions.
OBJECTIVE
To explore registered nurses' perceptions of standards of nursing practice and factors that affect nursing practice standards.


BACKGROUND
Nursing governance affects nurses' ability to manage nursing practice standards. Lack of nursing professional autonomy has been associated with occupational dissatisfaction, stress, turnover and low morale, which impact upon care quality.


METHODS
Grounded theory was used. Data, gathered by semistructured interviews with 142 nurses, theoretically sampled from three National Health Service hospitals were analysed using constant comparative analysis.


RESULTS
Nurses were dissatisfied with their governance over factors that they believed had most influence on nursing practice standards. Perceived lack of control over factors that affect practice standards generated dissatisfaction, frustration and demoralization.


CONCLUSIONS
Nurses' perceived lack of governance over their practice requires investigation and attention if occupational dissatisfaction, stress, turnover and low morale, which impact on quality care, are to be reduced. Dissatisfaction with nursing governance indicates a need to review nurses' professional involvement in clinical governance.
Attree
Moira
M
School of Nursing, Midwifery and Social Work, University of Manchester, Coupland III, Manchester, UK. moira.attree@manchester.ac.uk
D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology; D003659:Decision Making, Organizational; D004739:England; D005260:Female; D005639:Frustration; D006742:Hospital Bed Capacity; D006801:Humans; D007389:Internal-External Control; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009013:Morale; D009042:Motivation; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D015279:Organizational Culture; D010563:Personnel Turnover; D011209:Power, Psychological; D017410:Practice Guidelines as Topic; D017009:Professional Autonomy; D011787:Quality of Health Care; D011795:Surveys and Questionnaires