A Nursing Home and Its Organizational Climate: An Ethnography

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Greenwood Publishing Group, 1996 - Medical - 160 pages
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Nursing home reform, Professor Farmer asserts, calls for increased emphasis upon issues related to life rather than care. Organizational climate, which reflects the nursing home's unique position to impact life issues, provides a conceptual framework for effective interventions, evaluations, and ultimately meaningful reform.

The general atmosphere of most nursing homes remains overwhelmingly negative in spite of those few homes that are credited with excellence. Professor Farmer believes that the concept of organizational climate holds promise for better understanding the complexities and impact of atmosphere in any one nursing home. At the same time, organizational climate as a concept is poorly understood. There is a need to rethink the concept and return to the original notion of weather as its metaphor. Farmer attempts this in her case study by describing organizational climate where it can best be captured.

Practitioners of long-term care, from the fields of administration, geronotology, nursing, nutrition, policy makers, occupational and physical therapy, social work, and therapeutic recreation will find the insights of this study of great value, as will graduate students, scholars, and others concerned with organizational studies and issues in gerontology.

 

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Contents

Introduction
3
Weather as Metaphor for Organizational Climate
5
The Meadows of Madison
11
First Encounters
12
A Descriptive View of the Meadows of Madison
15
An Average Day at the Meadows of Madison
19
Major Climate Elements of the Meadows of Madison
25
Essential Structure of a Nice Place
27
Vision
94
Regulation
96
A Study of Contrasts
101
Analysis
103
Conclusions
109
Theoretical Implications
110
Practice Implications
112
Generalizations
113

Physical Features of the Meadows
29
Organizational Arrangement and Hierarchy of the Meadows
31
Rules Rules Rules
37
Decisions
40
Core Values of a Nice Place
45
Appearances Are Important
46
Customer Services Is the Goal
51
Residents Have Rights
55
Dominant Processes of A Nice Place to Be If You Have to Be Here
63
Maintaining Building
66
Maintaining Body
69
Maintaining Others
76
Communications
78
Moving In
83
Moving Within
86
Moving Out
88
The Identified Determinants of the Organizational Climate of the Meadows of Madison
93
The Next Step
114
Perspectives of Aging
115
Review of the Literature The Nursing Home
117
Review of the Literature Organizational Climate
125
Historical Overview of Climate as an Organizational Concept
127
Efforts at Operationalization
130
Organizational Climate versus Organizational Culture
132
Present Status of Organizational Culture
135
An Ethnographic Design for the Study of Organizational Climate in a Nursing Home
139
Phases of an Ethnographic Design
141
Recording
144
Key Informants
145
Ethical Considerations
146
Bibliography
147
Index
157
Copyright

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Page 148 - J. 1990. Level-of-analysis issues in climate and culture research. In B. Schneider (Ed.), Organizational climate and culture: 193-236.
Page 148 - The National Academy of Sciences Institute of Medicine Committee on Nursing Home Regulation, Washington, DC Borgatta, EF, & Loeb, MB (1979).

About the author (1996)

BONNIE CASHIN FARMER is an Assistant Professor of Nursing at Southern Connecticut State University in New Haven, CT. Her previous appointments include university teaching positions and practice at the municipal, county, and state levels of health care.

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