Are theoretical perspectives useful to explain nurses' tolerance of suboptimal care?
OBJECTIVE
This paper explores two theoretical perspectives that may help nurse managers understand why staff tolerate suboptimal standards of care.


BACKGROUND
Standards of care have been questioned in relation to adverse events and errors for some years in health care across the western world. More recently, the focus has shifted to inadequate nursing standards with regard to care and compassion, and a culture of tolerance by staff to these inadequate standards.


RESULTS
The theories of conformity and cognitive dissonance are analysed to investigate their potential for helping nurse managers to understand why staff tolerate suboptimal standards of care.


RESULTS
The literature suggests that nurses appear to adopt behaviours consistent with the theory of conformity and that they may accept suboptimal care to reduce their cognitive dissonance.


CONCLUSIONS
Nurses may conform to be accepted by the team. This may be confounded by nurses rationalising their care to reduce the cognitive dissonance they feel.


CONCLUSIONS
The investigation into the Mid Staffordshire National Health Service called for a change in culture towards transparency, candidness and openness. Providing insights as to why some nursing staff tolerate suboptimal care may provide a springboard to allow nurse managers to consider the complexities surrounding this required transformation.
Glasgow Caledonian University, Glasgow, Scotland, UK.
Lesley
L
Price
NHS Education for Scotland, Glasgow, Scotland, UK.
Kathleen
K
Duffy
Glasgow Caledonian University, Glasgow, Scotland, UK.
Jacqueline
J
McCallum
Caledonian University, Glasgow, Scotland, UK.
Valerie
V
Ness
D001291:Attitude of Health Personnel; D003073:Cognitive Dissonance; D004739:England; D006801:Humans; D009718:Nurse Administrators / Q000458:organization & administration / Q000523:psychology; D009726:Nurses / Q000458:organization & administration / Q000523:psychology*; D009745:Nursing, Supervisory / Q000458:organization & administration; D015279:Organizational Culture; D011582:Psychological Theory; D012925:Social Conformity; D059039:Standard of Care; D013222:State Medicine
cognitive dissonance; conformity; management; nursing; suboptimal care